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Study breakdown

Does the enzyme that breaks down anandamide play a role in alcohol use disorder?

Systematic ReviewModerate evidence
The takeaway

A systematic review of 26 studies found that FAAH, the enzyme that degrades the endocannabinoid anandamide, appears to play a meaningful role in the biology and characteristics of alcohol use disorder.

Readers interested in the intersection of the endocannabinoid system and alcohol addiction, or those curious about why treating one substance use issue might involve pathways shared with cannabis.

26 studies reviewed

What the researchers found

FAAH inhibition showed promise for reducing alcohol withdrawal symptoms, including anxiety and reinstatement of alcohol intake. However, decreased FAAH activity was also linked to reduced sensitivity to alcohol and increased preference and consumption.

Why it matters

The endocannabinoid system is increasingly recognized as a potential therapeutic target for addiction. Understanding how FAAH modulation affects alcohol-related behaviors could lead to new pharmacological treatments for alcohol use disorder.

The numbers in context

224 records screened; 26 studies included; FAAH inhibition associated with reduced withdrawal symptoms but also increased alcohol preference in some preclinical models

How the study worked

Systematic review of PubMed, Embase, and Web of Science. From 224 initial records, 26 primary research studies were included for qualitative synthesis after removing duplicates (37%), off-topic articles (47%), and non-primary research (4%).

What this study cannot tell us

Qualitative synthesis only, no meta-analysis. Most included studies were preclinical. Limited human data on FAAH inhibitors for alcohol use disorder.

How to read the evidence

Systematic review with qualitative synthesis, but limited to preclinical evidence with few human studies.

When this study was published

Published in 2021; research on FAAH and alcohol use disorder continues to evolve.

The bigger picture

This review highlights a double-edged sword: blocking FAAH may ease withdrawal but could also increase the drive to drink. The findings underscore why targeting the endocannabinoid system for addiction treatment requires careful, context-specific approaches.

Questions still open

  • Could FAAH inhibitors be effective specifically during the withdrawal phase while being counterproductive during active drinking? What are the optimal dosing windows for FAAH-targeted interventions?

Common questions

What is FAAH?
Fatty acid amide hydrolase (FAAH) is an enzyme that breaks down anandamide, one of the body's own endocannabinoids. Its activity levels influence endocannabinoid signaling in the brain.
Could FAAH inhibitors treat alcohol addiction?
Preclinical studies suggest FAAH inhibition may reduce withdrawal symptoms like anxiety. However, it may also reduce sensitivity to alcohol and increase intake, making the therapeutic window complex.
How does this relate to cannabis?
Anandamide, the molecule FAAH breaks down, activates the same CB1 receptors that THC targets. This shared pathway suggests the endocannabinoid system influences multiple substance use patterns.

Read the original research

Contribution of Fatty Acid Amide Hydrolase to Alcohol Use Disorder: A Systematic Review.

Cannabis and cannabinoid research, 6(2), 105-118

Citation

Niemela, Greta; Terry, Garth E. (2021). Contribution of Fatty Acid Amide Hydrolase to Alcohol Use Disorder: A Systematic Review.. Cannabis and cannabinoid research, 6(2), 105-118. https://doi.org/10.1089/can.2020.0158

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