Abstract
Alcohol use disorder (AUD) affects more than 10% of the United States population. AUD is a psychiatric
disorder characterized by escalated alcohol drinking and the emergence of profound negative affective states,
including persistent pain. Alcohol is also known for its analgesic effects, although excessive use facilitates pain
sensitivity (or hyperalgesia) during withdrawal. While chronic pain affects over 20% of the global population
and contributes to the development and severity of both psychiatric illness and AUD, effective pharmacological
treatments for these conditions remain very limited. In recent years, many people have turned to cannabis for
management of chronic pain and various negative emotional symptoms associated with mental illness.
However, there is a significant gap in knowledge regarding the analgesic efficacy of primary cannabis
constituents in the context of alcohol dependence and how use may either mitigate or worsen the risk of
substance use disorders. Specifically, delta-9-tetrahydrocannabinol (THC), the main psychoactive component
of cannabis, may offer a promising avenue for pain management, a common cause of excessive drinking in
individuals with AUD. From a neurobiological perspective, the extended amygdala (EA) plays an important role
in stress- and pain-related components of AUD and is a site where the endocannabinoid (eCB) system
appears critical for modulating the reinforcing effects of ethanol and transition to dependence. Our previous
preclinical work has shown a functional role for the central amygdala (CeA), a constituent of the EA, as a key
brain region underlying hyperalgesia and escalation of alcohol drinking in alcohol-dependent animal models.
Our preliminary data indicate an eCB system dysregulation generated by chronic alcohol exposure, which may
promote the use of alcohol and imply the therapeutic efficacy of cannabis/THC in individuals suffering from
AUD and AUD-related hyperalgesia. The main research objective of the current proposal is to investigate the
intricate interplay between the endocannabinoid system, pain, and alcohol use. The studies outlined in this F30
training proposal incorporate both animal modeling and clinical investigation to examine the predictions that: 1)
delta-9-THC administration alleviates hyperalgesia and reduces escalated alcohol self-administration in
alcohol-dependent male and female rats, and 2) increased cannabis use is associated with overall reductions
in pain symptoms and at-risk alcohol use in men and women. This proposal will provide a promising future
physician-scientist with vital research training to become an independent scientist in the field of alcohol and
clinical neuroscience research.