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To assess the short-time effects of a binge drinking episode on CB<jats:sub>1<\/jats:sub>R availability, 20 healthy social drinkers underwent [<jats:sup>18<\/jats:sup>F]MK-9470-positron emission tomography (PET) at baseline and after intravenous ethanol administration (ALC ACU). Moreover, 26 alcoholic patients underwent sequential CB<jats:sub>1<\/jats:sub>R PET after chronic heavy drinking (ALC CHR) and after 1 month of abstinence (ALC ABST). Seventeen healthy subjects served as controls.<\/jats:p><jats:p>Compared with baseline, ALC ACU resulted in a global increase of CB<jats:sub>1<\/jats:sub>R availability (+15.8%). In contrast, a global decreased CB<jats:sub>1<\/jats:sub>R availability was found in ALC CHR patients (\u221216.1%) compared with controls, which remained unaltered after abstinence (\u221217.0%). Voxel-based analysis showed that ALC CHR patients had reduced CB<jats:sub>1<\/jats:sub>R availability, especially in the cerebellum and parieto-occipital cortex. After abstinence, reduced CB<jats:sub>1<\/jats:sub>R availability extended also to other areas such as the ventral striatum and mesotemporal lobe.<\/jats:p><jats:p>In conclusion, whereas the acute alcohol effect is an increase in CB<jats:sub>1<\/jats:sub>R availability, chronic heavy drinking leads to reduced CB<jats:sub>1<\/jats:sub>R availability that is not reversible after 1 month of abstinence. Longer follow-up is required to differentiate whether this is a compensatory effect of repeated endocannabinoid overstimulation or an enduring trait-like feature. 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