Alcohol can be both a stimulant and a depressant. Alcohol in small doses will initially have a stimulating effect, increasing dopamine levels, heart rate, etc. Once the stimulant effect wears off, it will act as a depressant, slowing down the central nervous system and heart rate and decreasing mental clarity. Alcohol also becomes a depressant when large quantities are ingested. How alcohol affects a person mentally and physically depends on many biological factors.
Here is a list of the different types of alcoholic beverages available and information on them:
|Name||Main ingredient(s)||Category||Typical ABV|
|Absinthe||Botanicals||Distilled||40% to 90%|
|Beer||Cereal grains (barley, wheat, etc.)||Undistilled||4% to 6%|
|Brandy||Wine||Distilled||35% to 60%|
|Gin||Juniper berries||Distilled||35% to 50%|
|Cider||Apple juice||Undistilled||4% to 8%|
|Mead||Honey||Undistilled||8% to 16%|
|Vodka||Grains and potatoes||Distilled||40%|
|Wine||Grapes||Undistilled||5% to 16%|
History of Alcohol
It has been discovered that some fermented beverages were produced and consumed as early as the Stone Age. There was also the discovery of beer pictographs from ancient Egypt. Greece, India, Babylon, and China all have traces of alcoholic beverages in their history. Liquor has been distilled for thousands of years in the U.K. and other parts of Europe. Historically, alcohol has also played a big role (not always a positive one) in colonization.
Puritans, who became settlers of the "new world," borrowed a practical use for alcohol from their cultural context and background. You may be interested that drinking wine and beer at that time was safer than drinking water, generally taken from sources used to dispose of sewage and garbage. The experience proved that it was safer to drink alcohol than the usually polluted water in Europe. Alcohol was also an effective analgesic, providing the necessary energy for hard work and enhancing life quality. Unfortunately, these cultural practices were brought to the new world and took root there.
On January 28th, 1919, the 18th amendment to the Constitution of the United States was passed. It stated: "After one year from the ratification of this article, the manufacture, sale, or transportation of intoxicating liquors within, the importation thereof into, or the exportation thereof from the United States and all territory subject to the jurisdiction thereof for beverage purposes is at this moment prohibited." This amendment came about as a solution for crime, corruption, and social problems, which had been attributed to alcohol consumption.
In 1920, the Prohibition era began. Although alcohol consumption decreased at the beginning, it soon increased and brought on many other problems. Illegal import and production of alcohol started flourishing. This was tightly connected to organized crime and brought a lot of other criminal activity. The Great Depression that began in 1929 compounded the issue, and it became clear that prohibition was unenforceable. On December 5th, 1933, the 21st amendment to the Constitution of the United States was passed, and it stated in part:
The eighteenth article of amendment to the Constitution of the United States is hereby repealed.
The transportation or importation into any State, Territory, or possession of the United States for delivery or use of intoxicating liquors, in violation of the laws thereof, is hereby prohibited."
From this point, alcohol was no longer prohibited in any state, so long as the state legislature did not prohibit it. Once prohibition was over, yearly alcohol consumption per capita remained below 2.0 gallons for most years until the 70s and 80s. Around 1985, alcohol consumption peaked at almost 2.8 gallons per capita. It has recently stabilized between 2.2 and 2.3 gallons per capita.
What Does Alcohol Look like?
There are different types of alcoholic drinks. Here are a few examples:
Effects of Alcohol
Alcohol, once ingested, goes through the stomach, where some of the alcohol gets into the bloodstream, but most of it will go through the small intestine. Once there, alcohol enters the bloodstream through the walls of the small intestine. At this point, alcohol will start affecting the body, including the brain. Here are some of the effects of alcohol.
Alcohol in small doses will produce the following effects:
- Reduced tension
- Lowered inhibitions
- Impaired concentration
- Slowed reflexes
- Impaired reaction time
- Reduced coordination
Alcohol in medium doses will produce the following effects:
- Slurred speech
- Altered emotions
Binge drinking, heavy drinking, and chronic alcohol use can have many adverse effects on different body parts. The more a person drinks, the higher the risk of damaging their body and mind. Some problems can happen because of heavy or chronic alcohol use.
Brain: Chronic drinking can cause an overall reduction in brain size and increase the size of the ventricles. It can also damage the frontal lobes of the brain responsible, leading to difficulty solving problems, changes in personality, inability to focus, and difficulty controlling impulses, among others. Alcohol interferes with the body's stores and uses the B1 vitamin (thiamine). This can create a thiamine deficiency, leading to further brain damage and causing impaired memory, confusion, lack of coordination, apathy, disorientation, and a disease called Wernicke-Korsakoff syndrome. This is sometimes called alcoholic dementia or alcohol-related dementia. If a person stops drinking and makes lifestyle changes early, there can be an improvement, but some brain damage could be permanent.
Heart: Drinking a lot of alcohol over time or binge drinking can cause damage to the heart. It can create a condition called cardiomyopathy, where the heart muscle is stretched and begins having difficulty pumping blood to the rest of the body. Symptoms such as swelling of the legs, ankles, and feet, fatigue, discomfort in the chest, and dizziness can occur when this condition is present. It can lead to heart failure if left untreated. Long-term alcohol abuse can also lead to high blood pressure and a stroke as well as arrhythmias, a condition where the heartbeat becomes irregular. The longer the heavy drinking goes on, the more damage the heart will sustain. The sooner the person stops drinking, the better the chances of recovery without medical intervention.
Liver: The liver's primary function is to filter the blood from the digestive tract before it goes back into the rest of the body. As such, it detoxifies and purifies the body. Heavy alcohol consumption damages the liver because alcohol, as it gets processed by the liver, releases exceptionally toxic chemicals. This can lead to different conditions that carry their consequences. Steatosis (commonly known as fatty liver) will not necessarily carry symptoms but can lead to liver fibrosis (liver scarring). Fibrosis can lead to cirrhosis. Cirrhosis is severe liver scarring with symptoms such as weakness, abdominal pain, yellow skin and eyes, confusion, nose bleeds, etc. Another condition that can occur is alcoholic hepatitis. Liver damage caused by alcohol consumption can be treated if the condition is caught early on and the person stops drinking. However, if this goes on too long, the damage can be permanent and can lead to liver failure in severe cases.
Pancreas: The pancreas is the organ responsible for producing and releasing enzymes to help digestion and release substances such as insulin to help the body use energy. When a person drinks alcohol over a long period, the pancreas can start producing toxic substances that can lead to pancreatitis. This is a condition where the pancreas becomes inflamed, and its blood vessels become swollen. When a person develops this, they can have the following symptoms: fever, increased heart rate, nausea, vomiting, constant pain in the upper belly that radiates to the back, diarrhea, and weight loss. This is a severe condition, and once it is chronic, it cannot be cured, although symptoms can be managed.
Immune system: According to the National Center for Biotechnology Information, research has shown that alcohol disrupts the immune pathways in the body. This can keep the body from defending against infection or recovering normally from injury. According to research, acute binge drinking, as well as chronic heavy drinking, can both affect the immune system.
Cancer: According to the National Cancer Institute, heavy alcohol use can increase cancer risk over time. In 2009, data compiled estimated that 3.5% of cancer deaths were related to alcohol consumption. Alcohol consumption was associated with the following types of cancer: head and neck cancer (such as throat cancer), esophageal cancer, liver cancer, and colorectal cancer.
Understand Blood Alcohol Concentration (BAC)
Blood alcohol concentration is a standard measure of the amount of alcohol in your system. It is measured as a percentage where 0.01% would represent one part ethyl alcohol per 10 000 parts of blood. Driving with a BAC of 0.08% or higher in the United States is illegal. For people under the age of 21, the legal limit is between 0.0 and 0.2%, depending on the state. Although 0.08% is where driving becomes illegal, a much lower BAC could impair someone to the point where driving becomes dangerous. Different factors can impact blood alcohol concentration, including:
- Number of drinks
- How fast one drinks them
- How much a person weighs
- The digestive system of the individual
- The sex of the person as well as hormone levels
- Medications the person is on
- Food intake before and while drinking
Below are the different levels of impairment corresponding to the BAC. However, each person is different, and the level of impairment could be worse even if the BAC is relatively low.
0.0% to 0.5%: At this level, one might experience mild speech, memory, attention, and coordination impairment. A person might feel more relaxed, and they can start feeling sleepy. Depending on how affected the individual is, it can be dangerous to get behind the wheel even at this stage.
0.06% to 0.15%: The relaxation begins to become intoxication, and speech, memory, attention, and coordination are further impaired. One experiences severe impairment in the skills required to drive. A person could start displaying some aggression. At this point, there is an increased risk of the person injuring themselves or others.
0.16% to 0.30%: A person becomes severely impaired (memory, speech, coordination, attention, reaction time), and other driving skills are also dangerously impaired. At this point, a person might have blackouts (they can do things and will not remember any of it when they sober up). They might start vomiting and exhibiting other symptoms of alcohol overdose. At this level, one can lose consciousness.
0.31% to 0.45%: This level of intoxication is life-threatening, and there is a risk of life-threatening alcohol overdose. A person can lose consciousness at this stage. Alcohol suppresses vital life functions in the drinker's body and can be fatal if left untreated.
Alcohol Use and Abuse
People always say that one should drink in moderation. However, it can be hard to know precisely what that means, especially when one is younger and inexperienced. The Dietary Guidelines for Americans give some information to help clarify this subject. They define a standard drink as an alcoholic drink containing 14 grams of pure alcohol. For example, 12 fluid ounces of a 5% beer would equate to one drink, and for a 12% wine, five fluid ounces would equate to one drink. According to the guidelines, drinking in moderation is a maximum of one drink per woman and two drinks per day for men.
What Is Considered Heavy Drinking?
Heavy drinking is considered 15 or more standard drinks per week for men and eight or more standard drinks per week for women. Drinking heavily can lead to serious health issues delineated in this page's Effects of alcohol section. Continued heavy drinking can lead to developing a tolerance for it and addiction.
What Is Binge Drinking?
According to the Dietary Guidelines, binge drinking is drinking 4 (women) or 5 (men) drinks or more in about two hours. It is a type of drinking that brings the blood alcohol concentration to 0.08% or above. Binge drinking carries health risks outlined earlier but also behavioral problems. It is associated with violent behavior like homicide, suicide, domestic violence, and sexual assault. It is also connected to sexually transmitted diseases, unintended pregnancies, and pregnancy issues. Engaging in binge drinking doesn't mean these things will happen but drinking this often leaves the person's judgment severely impaired, increasing the risks of these events occurring. This type of drinking can also easily lead to an overdose if one isn't careful. Binge drinking is often a pattern associated with younger people. According to the CDC, one in six adults in the United States binge drinks around four times a month. Here are the percentages of those who binge drink broken down by age group.
- High School Students (Grades 9 to 12): Between 15 and 20%
- 18 to 24 years old: Around 25%
- 25 to 34 years old: Over 25%
- 35 to 44 years old: Around 20%
- 45 to 64 years old: Around 15%
- Over 65 years old: Around 5%
Alcohol and Pregnancy
No amount of alcohol is safe while pregnant. A childbearing woman drinks alcohol and passes through the umbilical cord (the blood conduit from the placenta to the fetus). This can cause a miscarriage or stillbirth, or the baby can be born with disabilities known as fetal alcohol spectrum disorders (FASDs). Here are some of those disabilities:
- Abnormal facial features
- Bone problems
- Difficulty with attention
- Hearing problems
- Heart problems
- Intellectual disability or low IQ
- Kidney problems
- Learning disabilities
- Poor coordination
- Poor memory
- Poor reasoning and judgment skills
- Sleep problems as a baby
- Small head size
- Speech and language delays
- Vision problems
Although illegal, underage drinking is a big problem in the United States. This is probably because alcohol is so easily accessible to teenagers. One of the most dangerous drinking patterns associated with teenagers is binge drinking. Teenagers and young adults (12 to 20 years old) account for about 11% of all the alcohol consumed in the United States. Although they drink less often, they usually drink a lot more than adults. More than 90% of all drinking devolves into binge drinking. Millions of young Americans binge drink every month. Young people often drink because of peer pressure and stress. Some can also desire more independence, doing things that adults do. However, drinking while underage can cause many problems, some even long-term. Heavy, continued alcohol consumption can interfere with brain development. The brain continues developing through adolescence, and alcohol can cause cognitive or learning problems. There is also an increased risk of developing an alcohol use disorder at some point in their lives.
Here are some signs of underage drinking:
- Changes in mood, including anger and irritability
- Academic and/or behavioral problems in school
- Changing groups of friends
- Low energy level
- Less interest in activities and/or care in appearance
- Finding alcohol among a young person's things
- Smelling alcohol on a young person's breath
- Problems concentrating and/or remembering
- Slurred speech
- Coordination problems
A big part of helping curb underage drinking is the parents. Parents can help prevent underage drinking by:
- Talking about the dangers of drinking
- Drinking responsibly, if they choose to drink
- Serving as positive role models in general
- Not making alcohol available
- Getting to know their children's friends
- Having regular conversations about life in general
- Connecting with other parents about sending clear messages about the importance of not drinking alcohol
- Supervising all parties to make sure there is no alcohol
- Encouraging kids to participate in healthy and fun activities that do not involve alcohol
Alcohol poisoning or alcohol overdose occurs when so much alcohol is consumed that the body can no longer break it down and metabolize it. When this happens, alcohol depresses and shuts down various brain functions, such as breathing, heart rate, and body temperature. Many factors can increase the risk of overdosing when consuming alcohol. These include one's height and weight. People with smaller bodies can experience alcohol poisoning with a smaller amount than others. People who are used to drinking and have developed a physical tolerance are more at risk of consuming alcohol. Other health conditions like diabetes can increase the risk of someone overdosing. Combining drugs with alcohol can cause a person to overdose more quickly, either because the person won't feel the effect of the alcohol or because the drug will interact with alcohol in some way to overwhelm their system. Someone who participates in binge drinking is also at risk of overdosing as it might be hard to gauge how much is too much since the person drinks so fast.
What are the Symptoms of Alcohol Poisoning?
It is very important to watch out for the following symptoms because alcohol overdose can be fatal. A person overdosing on alcohol may not have all these symptoms, especially if treated quickly.
- Blue skin
- Cardiac arrest
- Clammy skin
- Difficulty remaining conscious or inability to wake up
- Hypothermia (very low body temperature)
- Irregular breathing
- Lack of gag reflex (which can lead to choking)
- Mental confusion
- Pale skin
- Slow breathing
- Slow heart rate
- Stopped breathing
What to Do When Alcohol Overdose Is Suspected
The first step is to notice that there is a problem. Too often, people may not realize that a person is overdosing before some more severe symptoms present themselves. For example, if someone passes out after binge drinking, some might think they are just sleeping it off. But an overdose should be suspected if the individual cannot be awakened. Also, if the person drinks a lot of alcohol very quickly, even after they pass out, alcohol is still being processed in their digestive system. So their BAC can continue to rise while unconscious, which can precipitate the overdose and bring about even more complications. At the first suspicion of an overdose, call 911 for help immediately. Give them as much information as possible about what they drank, how much, if drugs were involved, etc. The more information they have, the faster they can treat the person once they get on the scene. While waiting for help, do not leave the person unattended. They could easily injure themselves, or their situation could worsen and require your immediate attention. Having the person sitting on the ground can keep them safe from falling. If the person is vomiting, placing them so they are leaning forward will prevent them from coking. If the person is passed out, placing them on their side (with an ear toward the ground) will keep them from choking.
Once help arrives, they will often be taken to the emergency room, where their vitals can be monitored and treated adequately. The quicker the person gets treatment, the lower the risk of permanent damage. Lack of oxygen to the brain can lead to permanent brain damage. It is essential to act quickly where alcohol poisoning is concerned, as it is a matter of life and death.
Alcoholism (often referred to as alcohol use disorder, AUD) afflicts millions of Americans. It can be hard to realize when alcohol consumption has become a problem. Alcohol addiction can be insidious since drinking is a socially accepted activity. Alcoholism is often sensationalized on TV or in movies, but alcohol use disorder can be much more subtle in real life. Some people are colloquially referred to as a 'functional' or 'high-functioning' alcoholic. In this instance, although the person has a drinking problem, they can have a good job and family life. This can make it much easier for someone to deny or not realize that they have a problem. An alcohol use disorder is much easier to handle if caught early and dealt with swiftly. The first step is to realize that the problem exists.
What Are the Signs of Alcohol Addiction?
Alcohol addiction is not necessarily dependent on the frequency or amount of drinking. Different people can have different drinking patterns. But there are some signs to look out for when trying to figure out if one's drinking has become a problem.
Lack of control: This could be an uncontrollable urge to drink or when a person cannot stop thinking about drinking. A person may have tried to stop drinking and failed. It can also manifest in an inability to limit the quantity of alcohol one drinks. If someone says they will only have one drink but often end up drinking a lot more, it can be a sign of a problem.
Dangerous situations: When one's drinking becomes dangerous, this can be a sign that it needs to be addressed. For example, if someone drinks in risky situations, including when someone is driving or has to drive after, or when a woman is pregnant or caring for young children. Another risky situation is to mix the medication with alcohol, no matter the reason. A red flag for this kind of behavior is when a person's drinking gets them into legal trouble.
Necessity: When a person needs alcohol to perform certain activities, it can indicate an alcohol use disorder. Some people start needing alcohol to relax or fall asleep at night. Inversely, some people need a drink in the morning to get going and have a good day. Others might need alcohol to be social or feel confident when meeting other people. And when a person does not drink, they can start having negative thoughts or feelings and will use alcohol to escape those.
Life problems: When drinking becomes a problem in one's life, it indicates a problem exists. It is even more apparent when the person continues drinking despite those problems. Here are some examples of the problems drinking can create:
- It interferes with things the person used to enjoy doing
- Dropping important activities or doing them less often because of their drinking
- Lessening of responsibilities or dropping responsibilities
- Losing friendships or having other related issues because of their drinking
- Becoming angry and hurting people when drinking
Lies: A common aspect of denying an alcohol problem is lying. If someone close to them asks them how much they drink, they lie to make it seem like less of a problem. They can also deny drinking altogether. This can also manifest in hiding alcohol in different places so people won't find it. Another sign of this can be making excuses for drinking and even causing their loved ones to make those excuses.
Tolerance and withdrawal: These physical aspects could mean a person has an alcohol addiction. If a person develops a tolerance, they will need to drink more to feel the intended effects of alcohol. And this tolerance compounds the withdrawal problem. When a person stops drinking alcohol, they will start getting withdrawal symptoms, which can be very hard for them and make them drink again.
Alcohol Use Disorder Diagnosis
Although alcohol use disorder can present differently, some criteria have been delineated to make assessment easier. If a person has two or more of the following criteria, an alcohol use disorder is present. A person can have mild, moderate, or severe AUD, depending on how many of these are true. Here are the criteria:
- Alcohol use in larger amounts or for a longer time than intended
- A lasting desire or unsuccessful effort to cut down or control alcohol use
- A lot of time spent getting alcohol, drinking it, or recovering from its effects
- A craving for alcohol
- Alcohol use that causes a failure to meet obligations at work, school, or home
- Alcohol use that continues even though it leads to lasting or repeated personal problems
- Giving up or cutting back on important activities because of alcohol
- Repeatedly using alcohol in dangerous situations
- Using alcohol even though you know it causes physical or psychological problems or makes them worse
- Alcohol tolerance, when you need more to have the same effect
- Alcohol withdrawal
What to do and not to do when someone is struggling with alcoholism
When someone you love is struggling with alcoholism, it is vital to take the necessary steps to help them. It can cause a lot of strain in a relationship, and specific patterns of behaviors come up, and they should be identified so that you can successfully help the person. One of the first things to realize is that it is not your fault, even if the alcohol says so. Their actions are their own, and blaming yourself or taking things personally just focuses on the actual problem, their drinking.
Don't Enable the Alcoholic
Dealing with an alcoholic can be very strenuous for a person. When starting to address the problem, some overwhelming emotions and feelings can come up. Recognizing some of those emotions can help you control them when they happen. The first doesn't have to do with enabling the behavior of an alcoholic. Enabling refers to behavior making it easier for the person to keep drinking and for their addiction to worsen. Your intentions might be good, and you might be trying to help the person, but it keeps them from facing the real problem and realizing the severity of it. Enabling can take on many forms, but some classic enabling behavior is here.
Ignoring the person's alcohol-related behavior. Acting like nothing is wrong and not saying anything is a form of enabling. Things such as missing work and unexplained absences when you know alcohol is at play should not be ignored. Although it may seem like confronting the problem head-on will make it worse, not addressing will just let it develop.
Shifting blame so that the alcoholic's actions are not their responsibility. An addict will often blame situations or other people for their drinking. Going along with that is not helping them in any way. It gives them a pass to keep doing it. Another point is that blaming their general behavior on things other than their drinking covers up the problem. For example, if a person has become more aggressive or violent now that they drink, blaming their stressful work life or even yourself for this behavior is not helping the alcoholic. Aggression and violence are never okay and should never be accepted or excused.
Making up excuses or lying about your loved one's drinking or actions is never the solution. Sometimes pride or fear of consequences for your loved one can cause you to lie about what is happening with them. This behavior again gives them free rein to keep drinking and behaving as they do. It keeps the person away from the consequences of their action and the pain caused by their drinking.
Don't Try to Control the Alcoholic or Cure Them
People can sometimes put off getting the alcoholic professional help thinking that they can get the person to stop drinking. The truth of the matter is that professional help is needed. You can try to stop the person from drinking by all means, but controlling the alcoholic does not handle their alcoholism. There are often under