Alcohol is the intoxicating ingredient that is present in wine, beer, and spirits. It is a depressant, which means that when it reaches the brain, it slows down the body's systems.
It can also be difficult for the body to process, putting extra pressure on the liver, the digestive system, the cardiovascular system, and other functions.
Alcohol is a legal recreational substance for adults and one of the most commonly used drugs in the United States. People consume alcohol to socialize, to relax, and to celebrate.
It is commonly misused among individuals of all ages, resulting in significant health, legal, and socio-economic damage.
In 2017, around half of all Americans aged over 18 years had consumed alcohol in the last month. Just over 9 percent of those aged 12 to 17 years had done so.
According to the National Survey on Drug Use and Health (NSDUH), 15.1 million people aged 18 years and over in the U.S. had alcohol use disorder (AUD), or 6.2 percent of this age group.
Fast facts about alcohol
- Pure alcohol is a colorless, odorless, and flammable liquid.
- Fruits and grains are the foods most commonly used foods to make alcohol.
- Alcohol is the number one abused drug by minors in the U.S.
- The liver can only oxidize about one drink per hour.
- Alcohol is known to be harmful to developing brains, from before birth to adolescence.
- No amount of alcohol consumption can be considered safe during pregnancy.
- Combined with other medications, whether over-the-counter (OTC) or prescribed, alcohol's effects can be deadly.
Within minutes of consuming alcohol, it is absorbed into the bloodstream by blood vessels in the stomach lining and small intestine.
It then travels to the brain, where it quickly produces its effects.
The short-term effects of alcohol depend on:
- how much is consumed
- how quickly
- the weight, sex, and body fat percentage of the individual
- whether or not they have eaten
Drinking with a meal slows the rate of absorption, resulting in fewer side effects and less intoxication.
Signs of intoxication
At first, the person may feel relaxed, uninhibited, or giddy. As they consume more alcohol, intoxication may result.
Other signs of intoxication include:
- slurred speech
- clumsiness and unsteady gait
- distortion of senses and perception
- loss of consciousness
- lapses in memory
How much alcohol?
One drink is the equivalent of:
- 12 ounces of beer that is around 5 percent alcohol, depending on the type
- 5 ounces of wine that is around 12 percent alcohol
- 1.5-ounces of spirits, or a "shot," at about 40 percent alcohol
- 8 ounces of malt liquor, at around 7 percent alcohol
In other words, these servings all contain the same amount of alcohol: 0.6 ounces.
Blood alcohol concentration (BAC) is the amount of alcohol in the bloodstream. It is expressed as the weight of ethanol in grams per 100 milliliter (ml) of blood.
The University of West Virginia suggests that a person may experience the following, depending on individual factors:
|Number of drinks||BAC||Effect|
|1-2||Up to 0.05||The person feels relaxed, less inhibited, with a slower reaction time and reduced alertness.|
|3-4||0.05 to 0.10||Fine motor skills, reaction time, and judgment are reduced.|
|5-7||0.10-0.15||Vision, perception, reaction times, and judgment are affected; the person may become argumentative or emotionally irrational.|
|8-10||0.15-0.30||The person may stagger, speech become slurred, and vision blurred. Motor skills are severely affected, and the person may vomit or feel nauseated.|
|Over 10||0.30 and above||The person may lose consciousness or be conscious but unaware of what is happening. Breathing rate is slow.|
The body absorbs alcohol relatively quickly, but it takes longer to get the alcohol out of the body. The liver needs about 1 hour to process one drink. Consuming several drinks in a short time causes the alcohol builds up in the body. This puts the body's systems under pressure. It can lead to illness and, in severe cases, death.
It also increases the risk of blackouts, especially on an empty stomach. During this time, a person may do things that they do not remember later.
Binge drinking is defined as drinking within 2 hours:
- Five or more drinks for a man
- Four or more drinks for a woman
This is because women and men metabolize alcohol differently.
Intoxication impairs judgment and can result in inappropriate and illegal behaviors such as sexual promiscuity, disorderly conduct, driving while intoxicated and acts of violence.
In 2014, 31 percent of all driving fatalities in the U.S. were alcohol-related.
When the amount of alcohol in the blood exceeds a certain level, this can lead to alcohol toxicity, or poisoning. This is a dangerous condition.
Since alcohol is a depressant, it can slow the breathing, leading to a lack of oxygen to the brain.
Signs and symptoms include:
- slow breathing
- blue tint to the skin
- low body temperature
- loss of consciousness
If blood alcohol concentration is higher than 0.4, there is a 50 percent chance of death.
Some people will feel unwell immediately after drinking alcohol. They may have an intolerance, insensitivity, or allergy to alcohol or another ingredient in a drink.
Combining alcohol with other depressant-type medications—whether over-the-counter preparations, prescription, or recreational drugs—can have serious effects on the respiratory and central nervous systems.
It is especially dangerous to mix alcohol with GHB, rohypnol, ketamine, tranquilizers, and sleeping pills.
After drinking too much in an evening, a person may continue to feel the effects of the alcohol on waking up, with what is commonly called a "hangover."
This is because alcohol is toxic to the body, and the body is still working to get rid of the toxin.
Around 20 percent of alcohol is absorbed through the stomach. Most of the remaining 80 percent is absorbed through the small intestine. Around 5 percent of the alcohol consumed leaves through the lungs, kidneys and the skin. The liver removes the rest.
Since the liver can only process the equivalent of one drink at a time, the body may remain saturated with the alcohol that has not yet left the body.
It can take from 2 to 3 hours for the body to metabolize alcohol from one to two drinks, and up to 24 hours to process the alcohol from eight to ten drinks.
A hangover can last up to 24 hours. Doctors advise not drinking again within 48 hours of a heavy drinking session, to allow the body to recover.
Alcohol contributes to over 200 diseases and injury-related health conditions including dependence and addiction, liver cirrhosis, cancers, and unintentional injuries such as motor vehicle accidents, falls, burns, assaults, and drowning.
Around 88,000 people in the U.S die from alcohol-related causes every year. This makes it the third leading preventable cause of death.
Long-term alcohol misuse is associated with the following health problems:
- liver disease
- cardiomyopathy, or damage to the heart muscle
- other cardiovascular problems
- peripheral neuropathy
- stomach ulcers
- immune system dysfunction
- brain and nerve damage
- vitamin deficiencies
- mental health problems such as anxiety and depression
Alcohol affects every body system, so it can cause health problems throughout the body.
Research shows that women who drink more alcohol than is recommended on a regular basis tend to develop liver disease, cardiomyopathy and nerve damage after fewer years than men who do the same.
Of major concern is the number of young people who consume alcohol. Research suggests that 20 percent of college students meet the criteria for AUD, and the condition affects some 623,000 adolescents aged 12 to 17 years.
Alcohol can have a serious effect on the developing brain, from fetal development to the end of adolescence. If a woman consumes alcohol during pregnancy, the child may be born with fetal alcohol syndrome (FAS). In 2015, this was believed to affect between 2 and 7 newborns in every 1,000.
Symptoms can be similar to those of ADHD.
Addiction and withdrawal
If a person consumes large amounts of alcohol regularly, their tolerance can increase, and the body requires more alcohol to achieve the desired effect.
As the body adapts to the presence of the drug, dependency and addiction can result. If consumption stops suddenly, the person may experience withdrawal symptoms.
Alcohol addiction is a disease characterized by a strong craving for alcohol, and continued use despite a negative impact on health, interpersonal relationships, and ability to work. If the person stops drinking, they will experience withdrawal symptoms.
Signs and symptoms of withdrawal generally occur between 4 and 72 hours after the last drink or after reducing intake. They peak at about 48 hours and may last up to 5 days.
They may include:
- mild tremors
- depressed mood
Many people will take a drink to stop the discomfort of withdrawal.
In more severe cases, the person may experience Delirium tremens, or "the DTs."
This condition involves:
- body tremors (shaking)
- hallucinations or changes in mental status
- extreme sleepiness
- seizures that can result in death
Delirium tremens is a medical emergency. Anyone with an alcohol dependency disorder who desires to stop drinking should seek professional medical care or a treatment center specializing in safe alcohol detoxification.
The treatment of alcohol dependency involves a variety of interventions, and it requires medical, social, and family support.
- individual and group counseling
- medication, such as disulfiram (Antabuse), naltrexone and acamprosate (Campral)
- participation in support networks such as Alcoholics Anonymous
- A detoxification program in a hospital or medical facility is another option for those who need a higher level of care.
Contacts for help
If anyone who is concerned about their own or a loved one's drinking habits, they can call or contact the following organizations for confidential help:
- Alcohol and Drug Helpline: 800-527-5344
- National Council on Alcoholism and Drug Dependence, Inc.: 800-622-2255
- Alcoholics Anonymous (AA)
Making screening part of regular health visits can help with making an early diagnosis.