TL;DR: Alcohol, or ethanol, is a popular depressant drug made through the fermentation of sugars in plants. It stimulates the release of serotonin and dopamine, as well as inhibits neural activity leading to feelings of euphoria and reduced motor control. Despite its pervasiveness, alcohol is highly dangerous, being responsible for 5.3% of all global deaths.
Let us just start by saying that, we are not doctors. This article is not medical advice, nor should it be treated as such. This article is purely for educational purposes. Finally, we do not condone the use of any illegal substances nor the use of any prescription drug without a say-so from your physician.
Intro
Beers on the patio, wine & cheese parties, drinking games, nightcaps and birthday shots. Alcohol plays such a large part in day to day life that most people don’t even consider it to be a drug, and of those that do, many still consider it as wholly other to the conventional “harder” drugs.
The reality is that, despite being consumed by a whopping 85% [4] of the world’s adult population, alcohol is a drug much like all the others, and a very harmful one at that.
This article will provide an overview of alcohol. It will give a description of what alcohol is and how it works. It will also discuss hangovers and overview some of the health concerns involved with using alcohol.
What is Alcohol?
Alcohol, known by its chemical name of ethanol, is the active drug in alcoholic drinks including beer, wine and liquor. Ethanol is produced through the fermentation of sugars in various plants. For example, beer is made through the fermentation of the sugars in barley, wine is made through the fermentation of the sugars in grapes and vodka is made through the fermentation of the sugars in potatoes. [1]
Even though it is the most popular party drug in the world, notorious for getting people fired up and crazy, alcohol is actually classified as a depressant. This is because it slows down the central nervous system, slowing down motor function, leading to reduced motor control, slurred speech and reduced reaction time. [2]
For more information on depressants and other drug classifications check out our intro to drugs article here.
How Does Alcohol Work?
When you drink an alcoholic beverage, small blood vessels begin to absorb the alcohol into your bloodstream as it moves through your digestive tract. It is estimated that about 20% of the alcohol is absorbed in your stomach and 80% is absorbed through your small intestine. [2]
Alcohol is then taken through your bloodstream to be metabolized by your liver, converting it into water and carbon monoxide. Your liver can process, on average, about 1 oz of alcohol per hour. Drinking in excess of 1oz of alcohol per hour exceeds the rate in which you liver can process it so the alcohol will remain in your blood as it waits to be processed, raising your Blood Alcohol Content (BAC).
Since your blood now contains a quantity of alcohol in it, the alcohol gets distributed all over your body to your various organs. When alcohol reaches your brain it affects it in various ways, leading to the commonly known state of being drunk. Alcohol stimulates the release of both serotonin and dopamine in the brain, commonly known as the “feel-good” chemicals, which leads to an excited and euphoric feeling as your BAC begins to rise. This release of dopamine is what makes alcohol potentially addictive to users.
Alcohol also affects the functioning of neurotransmitters throughout the brain, impeding functioning. The exact interactions of alcohol with neurotransmitters is not currently fully understood, however it has been shown to increase the activity of the GABA neurotransmitter, the brain’s major inhibitory neurotransmitter. It has also been shown to inhibit the action of glutamate receptors, the major excitatory neurotransmitter in the brain [3]. The combination of these two effects leads to a reduction of neural activity. This reduction leads to the slowing effects of alcohol, such as loss of motor control and balance, slurred speech and impaired judgement.
The higher the BAC, the more pronounced the symptoms will be. Below is a list of common symptoms experienced at various BAC levels: [2]
0.02 – 0.03 Few obvious effects; slight intensification of mood.
0.05 – 0.06 Feeling of warmth, relaxation, mild sedation; exaggeration of emotion and behavior; slight decrease in reaction time and in fine-muscle coordination; impaired judgment about continued drinking.
0.07 – 0.09 More noticeable speech impairment and disturbance of balance; impaired motor coordination, hearing and vision; feeling of elation or depression; increased confidence; may not recognize impairment.
0.08 Legal definition of intoxication in California for people 21 years and older.
0.11 – 0.12 Coordination and balance becoming difficult; distinct impairment of mental faculties and judgment.
0.14 – 0.15 Major impairment of mental and physical control; slurred speech, blurred vision and lack of motor skills; needs medical evaluation.
0.20 Loss of motor control; must have assistance moving about; mental confusion; needs medical assistance.
0.30 Severe intoxication; minimum conscious control of mind and body; needs hospitalization.
0.30 – 0.60 This level of alcohol has been measured in people who have died of alcohol intoxication.
0.40 Unconsciousness; coma; needs hospitalization.
There are various factors that will affect your BAC. Firstly, women usually have their BAC raised faster than men, as they have less water content in their bodies. This causes alcohol to get less diluted. Your body weight is also a factor, as less body mass means there is less area for the alcohol to be distributed, leading to a faster raise in your BAC. The amount of food in your stomach is also a factor, as if you have an empty stomach the alcohol will pass quickly through to your small intestines, where it is absorbed at a much higher rate. Alternatively, if you have food in your stomach, the alcohol will stay there for longer, giving your liver more time to process the alcohol already in your blood.
Hangovers
That dreaded tired, achey, nauseous feeling of a hangover you get from a night of heavy drinking is a combination of dehydration, withdrawal (from alcohol) and in more serious cases even poisoning.
The severity of a hangover can be reduced by eating food before you drink, mixing in water in between your drinks and pacing yourself. A bad hangover can also be partially remedied the morning of by drinking lots of water and eating a large meal as processing alcohol leads to a drop in blood-sugar, leading to headaches. [2]
Another more controversial method for treating hangovers is known as “the hair of the dog (that bit you)”, where you have another alcoholic drink the morning after a night of heavy drinking. The idea of this is that the extra alcohol will treat your withdrawal portion of your hangover, thus reducing the severity of the hangover. The jury is still out on this one however, as some make the counterpoint that drinking more will just prolong the amount of time that your body has to work on processing the alcohol, prolonging hangover symptoms.
A common misconception is that caffeine (check out our article HERE (LINK)) is a solid hangover remedy. Unfortunately, it actually does more harm than good as a hangover cure. While a nice hot cup of coffee may make you temporarily feel more awake and alert after a night of heavy drinking, consuming caffeine is actually dehydrating, which will only serve to worsen hangover symptoms. Thus, after a night of partying it’s best to just stick to a big old glass of water.
Health Concerns of Alcohol
Despite its legal status and broad pervasiveness across most cultures, alcohol is actually quite a harmful and destructive drug. In 2016 3 million deaths, an incredible 5.3% of ALL global deaths, was attributed to alcohol consumption. This makes it globally the seventh leading cause of premature death and disability. In 2010 alcohol misuse in the US was estimated to cost $249 billion dollars, with ¾ of the cost being directly related to binge drinking. Alcohol is the third leading cause of preventable death in the United States, trailing only behind tobacco and poor diet/physical activity [4].
Below, some of the common health concerns that come from alcohol consumption.
Poisoning
The definition of a poison is as follows: a substance that is capable of causing the illness or death of a living organism when introduced or absorbed. [5] Alcohol, especially at high doses, fits the bill. In the US there are an estimated 2,200 [6] alcohol poisoning deaths per year, which translates to about 6 per day.
The American Addictions Center [6] provides the following ways in which alcohol can poison you:
- Slowing brain functions, starting with balance and coordination, but eventually affecting other body systems
- Irritating the stomach and causing vomiting
- Stopping gag reflex as muscles lose sensitivity and coordination, which can lead the individual to choke on their own vomit
- Affecting the nerves that control heartbeat and breathing, which can cause these functions to slow down, become irregular, or stop altogether
- Drastically lowering blood sugar, leading to seizures
- Lowering body temperature, which can cause hypothermia
- Dehydrating the body, which can lead to brain damage
In short, alcohol poisoning can be quite deadly and should be taken seriously. If one of your friends seems to have crossed the threshold from “hammered” to “poisoned”, you should call emergency services or take them to the hospital to get their stomach pumped (if you haven’t also been drinking, that is!). Symptoms of alcohol poisoning include inability to stay conscious, vomiting while unconscious, cold, clammy skin that’s blue around the lips or under the fingernails, irregular pulse, depressed breathing and seizures.
Addiction/Long Term Damage
As mentioned above, alcohol causes your brain to release dopamine, which gives it the potential to be highly addictive. Alcohol addiction, more commonly referred to as alcoholism, is a disease that plagues many people around the world. Along with screwing up your life, due to your inability to hold down a job, a relationship, or really anything because you’re drunk all the time, alcoholism can have some serious long-term health complications.
The Mayo Clinic [7] sites the following health complications that arise with long term alcohol use:
- Liver disease. Heavy drinking can cause increased fat in the liver (hepatic steatosis), inflammation of the liver (alcoholic hepatitis), and over time, irreversible destruction and scarring of liver tissue (cirrhosis).
- Digestive problems. Heavy drinking can result in inflammation of the stomach lining (gastritis), as well as stomach and esophageal ulcers. It can also interfere with absorption of B vitamins and other nutrients. Heavy drinking can damage your pancreas or lead to inflammation of the pancreas (pancreatitis).
- Heart problems. Excessive drinking can lead to high blood pressure and increases your risk of an enlarged heart, heart failure or stroke. Even a single binge can cause a serious heart arrhythmia called atrial fibrillation.
- Diabetes complications. Alcohol interferes with the release of glucose from your liver and can increase the risk of low blood sugar (hypoglycemia). This is dangerous if you have diabetes and are already taking insulin to lower your blood sugar level.
- Sexual function and menstruation issues. Excessive drinking can cause erectile dysfunction in men. In women, it can interrupt menstruation.
- Eye problems. Over time, heavy drinking can cause involuntary rapid eye movement (nystagmus) as well as weakness and paralysis of your eye muscles due to a deficiency of vitamin B-1 (thiamin). A thiamin deficiency can also be associated with other brain changes, such as irreversible dementia, if not promptly treated.
- Birth defects. Alcohol use during pregnancy may cause miscarriage. It may also cause fetal alcohol syndrome, resulting in giving birth to a child who has physical and developmental problems that last a lifetime.
- Bone damage. Alcohol may interfere with the production of new bone. This bone loss can lead to thinning bones (osteoporosis) and an increased risk of fractures. Alcohol can also damage bone marrow, which makes blood cells. This can cause a low platelet count, which may result in bruising and bleeding.
- Neurological complications. Excessive drinking can affect your nervous system, causing numbness and pain in your hands and feet, disordered thinking, dementia, and short-term memory loss.
- Weakened immune system. Excessive alcohol use can make it harder for your body to resist disease, increasing your risk of various illnesses, especially pneumonia.
- Increased risk of cancer. Long-term, excessive alcohol use has been linked to a higher risk of many cancers, including mouth, throat, liver, esophagus, colon and breast cancers. Even moderate drinking can increase the risk of breast cancer.
In 2016, 21.3% of global alcohol related deaths were due to digestive issues (mainly cirrhosis and pancreatitis), 19% were due to cardiovascular disease, 12.9% were due to infectious diseases and 12.6% were due to cancers (most commonly in the aerodigestive tract) [4].
Unfortunately, kicking alcoholism is often a bit more complicated than just quitting drinking cold-turkey. Many alcoholics experience severe, physical withdrawal symptoms including shaky hands, night-sweats, intense head-aches and discomfort, fever, strong cravings and insomnia. In more severe cases, alcohol withdrawal can even cause seizures or hallucinations.
Thankfully, there are many rehabilitation centers, as well as support groups, like Alcoholics Anonymous, that assist people in getting past their withdrawal and on with their lives.
Stupidity
It can be lots of fun to go out, get some drinks and get a little stupid with your friends every once in a while. The problem is that far too many people get far too stupid. Thought you were finished with all the mind-blowingly tragic stats about alcohol? Think again! In 2015 there were 10,265 deaths from drunk driving in the United States. That’s an insane 29% of ALL driving related fatalities. [4] Over 10k people could be alive today, but aren’t because others decided to be stupid and get behind the wheel while drunk.
I’m sure you’ve been lectured to death by parents, teachers and other pillars of society, but the data makes the message clear: don’t drink and drive.
Health Benefits of Alcohol
So far we have painted a pretty grim picture of the dangers of alcohol, especially when consumed in excess. Many are probably left wondering if there are any actual upsides, from a health standpoint, to cracking open a nice cold beer after a long day.
Unfortunately, the research in this area is rather limited, and findings are often disputed. However, there does appear to be some health benefits to moderate drinking.
To start, we should probably define exactly what moderate drinking really is. There is, yet again, not a clear consensus on what moderate drinking really is, although it seems to be widely accepted as 1-2 drinks per day for men and 1 drink per day for women. It is important to note here, that 1-2 drinks per day is not equivalent to not drinking throughout the week and then having 7- 14 drinks on Friday. Although the weekly totals both end up the same, the detriments of the latter will greatly outweigh any possible benefits.
The Mayo Clinic [8] sites the following potential health benefits of moderate alcohol consumption:
- Reducing your risk of developing and dying of heart disease
- Possibly reducing your risk of ischemic stroke (when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow)
- Possibly reducing your risk of diabetes
It is important to note here that even with strictly moderate drinking, some negative health effects can still be experienced. For example, it has been found that in people who drink no more than one drink per day, there is still a small, yet real, increase in contracting esophageal cancer [8].
If you are genuinely looking to improve your health, there are likely a million better options to use than alcohol.
Conclusion
Although drinking booze is a favorite pastime of people of all ages and walks of life, it should be remembered that alcohol is in fact a dangerous and potentially deadly drug, and should be treated as such. Enjoy your partying, but also remember to stay within your limits.
References:
[1] https://www.healthline.com/health/why-does-alcohol-make-you-drunk#ethanol
[2] https://shop.ucsc.edu/alcohol-other-drugs/alcohol/your-body.html
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065474/
[4]https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics#:~:text=Prevalence%20of%20Drinking%3A%20According%20to,in%20this%20age%20group%20and
[5] Oxford Languages
[6] https://americanaddictioncenters.org/alcoholism-treatment/overdose
[7] https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243#:~:text=Excessive%20alcohol%20use%20can%20make,esophagus%2C%20colon%20and%20breast%20cancers.
[8]https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/alcohol/art-20044551
