Cannabidiol and Alcohol Use Disorders: An Updated Review of Therapeutic Potential.

Pince C.; Hetelekides E.; Schacht J.; Gowin J.; Bidwell L.; Karoly H. · Alcohol, clinical & experimental research · 2026

**Background & Methods** This is a narrative review synthesizing current clinical and preclinical evidence on cannabidiol (CBD) as a pharmacotherapy for alcohol use disorder (AUD). The review updates three prior 2019 reviews by evaluating the expanded clinical research literature on CBD's effects on alcohol-related outcomes, consumption patterns, craving, and alcohol withdrawal symptoms. **Key Findings** • Strong preclinical evidence supports CBD isolate in reducing alcohol consumption; however, clinical trials have yielded largely null or inconsistent findings, particularly regarding effects on alcohol craving and reward across human and animal studies. • Emerging observational data suggest plant-derived CBD formulations containing small amounts of THC and other cannabinoids may reduce both alcohol consumption and craving, warranting further investigation through randomized controlled trials. • Growing preclinical evidence indicates CBD reduces alcohol withdrawal symptoms and attenuates alcohol-induced liver disease and neurodegeneration, though clinical evidence remains limited in these therapeutic domains. **Dosage & Administration** Not reported. The review notes that CBD has poor oral bioavailability and identifies alternative formulations and routes of administration as potential improvements for therapeutic efficacy, but specific dosing regimens are not detailed. **Safety & Adverse Effects** Not reported. The review does not discuss adverse effects or safety profiles of CBD in the context of AUD treatment. **Evidence Quality** This narrative review demonstrates significant limitations in current evidence. The authors identify multiple methodological concerns accounting for mixed findings: poor oral bioavailability of CBD, lack of transparent reporting of cannabinoid content (including THC levels), and absence of plasma CBD level measurements in clinical trials. The review notes a critical gap between robust preclinical evidence and inconsistent human clinical data. Level of evidence is modest, as most clinical trials yield null findings while observational studies show promise. The authors recommend future trials prioritize standardized cannabinoid reporting, bioavailability optimization, plasma level monitoring, and biobehavioral phenotyping to identify treatment responders. Overall, while preclinical support remains strong, rigorous, methodologically refined clinical trials are needed to establish CBD's therapeutic utility for AUD.

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