WHY IT MATTERS: For patients struggling with alcohol use disorder who have not responded well to existing medications like naltrexone or acamprosate, ECS-targeted therapies in development could eventually offer a new pharmacological option that addresses the underlying neurobiology of craving and relapse. CLINICAL OVERVIEW: The endocannabinoid system plays a central role in regulating reward circuitry, stress response, and impulse control, all of which are disrupted in alcohol use disorder. Cannabinoid receptors, particularly CB1 and CB2, along with endogenous ligands like anandamide and 2-AG, modulate dopaminergic and GABAergic pathways that drive craving, withdrawal, and relapse behavior.