Does CBD Interact With Alcohol?

Is It Safe to Take CBD & Alcohol Together?

There are no long-term studies or data to determine the safety of taking CBD and alcohol together. The sedative and hypotensive actions of the two items could manifest more and cause abnormal side effects. Their interaction may differ from person to person as each individual’s bodies are different. So it is not recommended to take these two products together.

It’s wise to space the timing between them to minimize the chances of adverse reactions.

Is CBD a Viable Alternative to Alcohol?

No, CBD and alcohol are entirely different substances. CBD is not a viable alternative to alcohol.

With that said, both substances have some similarities in their effect profiles — especially in terms of their relaxing or sleep-supportive benefits.

What is Alcohol?

Alcohol or ethyl alcohol is a clear, colorless fluid obtained when yeast ferments the sugars in various foods. Its distillation process yields its clear, colorless form.

Alcohol is readily absorbed from the gastrointestinal tract and gets distributed throughout the body. It has bactericidal properties and can be used as a topical disinfectant, solvent, preservative, and a primary component in alcoholic drinks.

Alcohol Specs:

What Does Alcohol Do?

Alcohol affects the neurons in the brain in several ways. It can alter the ion channels, enzymes, and receptors in the brain. It is a CNS depressant and can slow down the brain and its functions. It can cause relaxation, lowering of inhibitions, difficulty in concentrating, and mood changes.

Alcohol works in the brain by increasing the effects of a neurotransmitter called γ-aminobutyric acid, or GABA. GABA is one of the major inhibitory neurotransmitters in the brain. Alcohol promotes GABA’s actions, leading to a suppression of the CNS. It then causes a sedative action.

Alcohol also affects other neurotransmitters such as glutamate, glycine, acetylcholine, and serotonin. It can also increase levels of dopamine and the endogenous opioids in the brain, causing a feeling of pleasure. Its toxic effects are due to its byproduct called acetaldehyde.

Alcohol causes injury to the cells by causing dehydration and precipitation of the cytoplasm. It acts as a dehydrating agent that upsets the osmotic balance across cell membranes. This action allows it to work as an antibacterial and antifungal. When alcohol is close to nerve tissue, it can cause neuritis and nerve degeneration.

Alcohol or ethanol can be used in the treatment of methanol poisoning. Ethanol is a competitive inhibitor of methanol. It binds to alcohol dehydrogenase, an enzyme in the liver, and saturates it so that methanol can’t. This process leads to the excretion of methanol from the kidneys with no chance of turning into toxic substances. 

Alcohol can relieve chronic pain in conditions like inoperable cancer, trigeminal neuralgia and for patients in whom neurosurgical procedures are contraindicated.

Alcohol is contraindicated in pregnancy as it can cause fetal alcohol syndrome, causing brain damage and growth problems. Alcohol can cause dependency with frequent use and can lead to alcoholism.

Side Effects of Alcohol

Drinking alcohol can cause different effects on the body. It largely depends on the level of intoxication in the body and the duration of alcohol consumption. 

Immediate effects on the body:

Low amounts

• Impairment of reflexes
• Slow reaction time
• Problems with coordination

Moderate amount

• Slurring of speech
• Changes in vision
• Sleepiness
• Increased urination
• Flushed skin
• Rashes or itching

Heavy amount

• Vomiting
• Bowel and bladder incontinence
• Breathing problems
• Loss of consciousness
• Coma
• Alcohol Poisoning
• Seizures

Long term effect of alcohol

• Damage to brain cells, lowering of the brain mass
• Liver damage
• Stomach and intestinal ulcers
• High blood pressure
• Decrease in male sperm production
• Low levels of vitamins and minerals like iron and vitamin B
• Alcoholism
• A higher risk of some cancers

Types of Drug Interactions With CBD

CBD, because of its chemical nature, can interact with other medicines. So if you are taking any medications and want to start CBD, you must always be aware of the possible interactions. Some of these may be mild ones, while some may be dangerous. Hence, constant vigilance is important.

There are three ways that CBD can interact with other drugs. They are:

1. Agonistic Interaction

Agonistic interaction happens when two medicines work on the same receptors in the body. It leads to the same direction of their effects.

Examples of medications that could cause agonistic interaction with CBD are:

• Antidiabetic medications — These include GLP-1 receptor agonists, meglitinides, SGLT-2 inhibitors, sulfonylureas, and insulin, alpha-glucosidase inhibitors, and DPP-4 inhibitors. CBD could increase the blood sugar-lowering ability of these medications.
• Anti-anxiety medications — These include drugs like benzodiazepines and barbiturates. CBD, with its anxiolytic properties, could make their effects last longer as well.
• Antihypertensive Medications — These include diuretics, ACE inhibitors, beta-blockers, calcium channel blockers, central agonists, alpha-blockers, and angiotensin II receptor blockers. CBD can cause a drop in blood pressure when used with these medications.

2. Antagonistic Interaction

This is the opposite of the agonistic interaction. It happens when two drugs have effects opposite of each other. If taken together, one drug would cross out the effects of the other, causing a decreased efficacy of the second drug.

Drugs that have antagonistic interaction with CBD are:

• Immunosuppressants — These include azathioprine, mycophenolate cyclosporine, methotrexate, etc. CBD’s immune-stimulating properties may cause diminished effects of these drugs.
• Stimulants — These include amphetamine, modafinil. CBD can cause a drop in its effects.
• Immunomodulators — These include antihistamines like carbinoxamine, desloratadine, levocetirizine. CBD could lessen their sedative action.
• Asthma Medications — These include drugs like albuterol, fluticasone, montelukast, ipratropium bromide, and theophylline. CBD may hinder their abilities, especially that of theophyllines.

3. Metabolic Inhibition

Some medications need similar enzymes to break down the drug molecules. It leads to both drugs competing against each other, causing their metabolism to slow down.

These include medications like

• Blood thinners — CBD could cause an increment in the availability of these drugs. Blood thinners include warfarin, enoxaparin, heparin, and others that could be very unsafe.
• NSAIDs — These include ibuprofen, naproxen, and high-dose aspirin. CBD could make them last longer with more side effects.
• Opiate analgesics — These include morphine, codeine, hydrocodone. CBD could make them last longer in the system and create complications.
• Antidepressants — CBD can make these drugs last longer in the body by diminishing their metabolism. Antidepressants include trazodone, mirtazapine, vortioxetine, and vilazodone, and others.

Key Takeaways: Is It Safe to Take Alcohol With CBD?

The interaction between CBD and alcohol is not fully understood. There are still many studies to be done. With its agonistic action on alcohol, CBD could increase the psychoactive effects of alcohol, leading to more side effects.

So the best thing is to avoid taking them together.

If you decide to take them both together, take only small doses of both and keep vigilance for any side effects. If you get any abnormal effects, seek medical attention immediately.

References

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2. Crippa, J. A. S., Derenusson, G. N., Ferrari, T. B., Wichert-Ana, L., Duran, F. L., Martin-Santos, R., … & Hallak, J. E. C. (2011). Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. Journal of psychopharmacology, 25(1), 121-130.
3. Gonzalez-Cuevas, G., Martin-Fardon, R., Kerr, T. M., Stouffer, D. G., Parsons, L. H., Hammell, D. C., … & Weiss, F. (2018). Unique treatment potential of cannabidiol for the prevention of relapse to drug use: preclinical proof of principle. Neuropsychopharmacology, 43(10), 2036-2045.
4. Parker, L. A., Rock, E. M., & Limebeer, C. L. (2011). Regulation of nausea and vomiting by cannabinoids. British journal of pharmacology, 163(7), 1411-1422.