Q&A: "Can I Drink Alcohol While Taking CBD?"

Past articles have focused on studies regarding the use of CBD to treat alcoholism and potentially healing the physical and neurological changes associated with substance misuse.

Consumers can now find CBD in their coffee, topping their donuts, and at gyms and bicycle shops, to name just a few. So perhaps it's no surprise that it's becoming trendy for bars to offer mixed drinks infused with CBD (although it is very easy and much cheaper to make your own CBD cocktails at home, if that's your thing).

It’s not uncommon for customers to ask us, “Is it safe to drink while I’m taking CBD?” The short answer is “Yes, but you may get drunk more quickly than you’re used to. If you want to avoid this effect, you may want to wait until after drinking to take the CBD.”

The long answer delves into the pharmacology of drug metabolism, dopamine and reward, and emerging research elucidating cannabidiol’s broad range of effects. Let’s begin with a description of alcohol’s pharmacological effects.

Alcohol is described as an indirect GABA agonist, and is known to increase dopamine in all areas of the brain . An agonist is a substance that binds to a receptor and initiates some physiological response. GABA is the primary inhibitory neurotransmitter in our brains. According to Scripps Research Institute, “Alcohol is believed to mimic GABA's effect in the brain, binding to GABA receptors and inhibiting neuronal signaling.” CBD is also known to affect GABA binding sites - it acts as a positive allosteric modulator. This means that CBD binds to a site on the GABA receptor other than the site that GABA or alcohol would bind to, and that when CBD is present in the receptor, that receptor will be affected to a greater degree by GABA or alcohol. This may explain in part why people who use CBD often feel that they get drunk more quickly and for longer than they would when drinking the same amount without any CBD in their system.

Moving on from GABA, let’s look at dopamine. Dopamine is known as the “reward” neurotransmitter - when a drug causes dopamine release, it indicates that it has some potential for abuse. So-called “natural rewards” such as eating food and having sex elevate dopamine between 150-300%, whereas stimulant drugs including methamphetamine and cocaine elevate dopamine above 1000% over baseline, essentially teaching the brain that they are more essential than natural rewards. Alcohol is known to elevate dopamine to 200% over baseline, meaning that it may be more rewarding than natural behaviors such as eating or sex.

CBD has been shown by researchers to lower the reward potential for opioids and stimulants (at least in murine models) and may act in a similar way with regard to alcohol.

On to metabolism. Alcohol is broken down, in part, by an enzyme known as CYP450 . CBD has been reported to act as a competitive inhibitor of CYP450 , meaning that when someone takes CBD before drinking alcohol, it may take longer for the alcohol to be metabolized by the body than normal. This could potentially result in feeling drunker than normal. Importantly, this effect of CBD depends on the magnitude of the dose and on the formulation - whole-plant CBD and pure CBD isolate have been observed to affect this enzymatic process differently. More research is needed to determine the dose range that produces this inhibitory effect and tease apart the practical differences in the type of CBD extract ingested.

Alcohol is a central nervous system depressant . While CBD is not, some people do experience sleepiness with CBD, especially at higher doses. Using CBD and alcohol together may cause an individual to feel more tired than they normally would from either substance by itself, independent of any potentiation mechanism. This type of drug interaction is known as an “additive effect”.

Lastly, research into binge-drinking adolescents found that those who were heavy cannabis users had higher white matter integrity than non-users. While this suggests that cannabis (of which CBD is a major constituent) may have some efficacy in preventing binge-drinking induced brain damage, subsequent investigations have revealed some potential limitations of the research methods used.

Most of these synergistic effects can be easily avoided by waiting until after drinking to take CBD. Those taking CBD may find that they don’t want to drink as much as they did prior to beginning CBD. Obviously, if you abstain from alcohol while taking CBD, the interaction between the two becomes irrelevant. Moreover, people recovering from alcoholism or drug addiction may benefit from CBD supplementation in sobriety .