After it is consumed, alcohol is rapidly absorbed by the gastrointestinal tract, enters the bloodstream, and begins to affect the brain very quickly.
The degree to which alcohol affects the brain varies depending on:
- Amount of alcohol consumed
- User’s age
- Physical condition
- Various other factors
While it is not an exact measure, the effects of alcohol are often discussed in terms of blood alcohol concentration or BAC. BAC roughly corresponds to the amount of alcohol consumed over a certain period of time.
Short Term Effects of Alcohol
At a low BAC (blood alcohol level), people may:
- Experience feelings of euphoria and increased self-confidence
- Have reduced inhibitions
As self confidence increases and inhibitions decrease, your judgment becomes clouded. This frequently leads to poor decision-making.
One poor decision that occurs is the decision to consume additional alcohol in excess.
Effects of a Slightly Higher BAC Level
When your BAC becomes only slightly higher, the following may occur:
- Coordination starts to fail, making simple tasks like walking more difficult
- Loss of sensation in your skin
- Vision impairment
Another increase in BAC and the regions of the brain that control emotion can be affected. You may become sad, violent or inappropriately affectionate. You will feel increasingly dizzy, sleepy, and unable to fully participate in their environment.
Short Term Damage
Generally speaking, the effects of alcohol intoxication on behavior only last as long as alcohol is present in the bloodstream. As the liver metabolizes the alcohol, the BAC drops, and the effects on the brain diminish.
Unfortunately the liver pays a price for detoxifying the blood of alcohol. On a small scale, the liver can be damaged by a single episode of moderate to heavy drinking. On a larger scale, these tiny issues accumulate over time, leading to serious liver disease.
One of the most destructive aspects of acute alcohol intoxication occurs when people insist on driving while intoxicated. Since alcohol impairs judgment, slows reflexes, and makes you drowsy, alcohol contributes to an more than 6 million motor vehicle accidents and an astonishing 6 million deaths, each and every year.
Long Term Damage
The tiny individual insults to the liver that occur from drinking add up over time.
- First the liver becomes “fatty,” that is, useful liver tissue is destroyed and replaced with useless fat deposits.
- As the liver is further damaged by alcohol abuse, it scars and shrinks, in a process called alcoholic cirrhosis.
- A cirrhotic liver does not function properly—it causes a host of problems including blood clotting disorders, jaundice, impotence in men, and chronic confusion. The veins inside the body dilate, increasing the risk of them rupturing and causing hemorrhage.
- Eventually alcoholic liver disease gives rise to liver cancer (hepatocellular carcinoma).
Chronic alcohol abusers become dependent on alcohol. Alcohol abusers must drink alcohol simply to stave off withdrawal symptoms. They neglect food and other nutrition and often suffer from vitamin deficiencies. Alcohol withdrawal in chronic abusers can cause tremors, hallucinations, seizures, and death.
Alcohol overdose is commonly known as alcohol poisoning. Alcohol poisoning is often the result of binge drinking, that is, drinking five or more drinks in a single sitting.
Consider why those two things are linked. The liver is constantly trying to metabolize alcohol and detoxify the blood. Unfortunately the liver can only process alcohol so fast, which is why it can enter the brain and cause drunkenness.
As the BAC increases, the user will experience drowsiness, then stupor, then coma, and if alcohol levels are sufficiently high, death.
If one drinks slowly, presumably sleep or stupor will kick in and stop the person from drinking more. In binge drinking, massive quantities of alcohol are consumed in a short period of time, which completely overwhelms the liver’s capacity to metabolize it.
Even if stupor sets in and the person stops drinking, it is too late. The ingested alcohol will eventually overwhelm the liver and BAC will become dangerously or lethally high.
There are many ways that alcohol poisoning can be lethal.
- One of the most common is through a process called aspiration. The body views alcohol like a poison—it is especially irritating to the stomach. The stomach will try to purge the alcohol by inducing vomiting, but since people with high BAC fade in and out of consciousness, they are likely to draw that vomit into their lungs (aspiration). This can be immediately lethal.
- Alcohol has direct toxic effects on the brain as well. At high concentrations it is a neurotoxin (i.e. alcohol kills brain cells).
- Massive alcohol consumption changes the water and electrolyte balance in the body and blood, which can have brain damaging effects.
Symptoms and Signs of Abuse
It is fairly easy to spot someone that has been abusing alcohol for a long time. The person will:
- Have gained weight, especially in the torso
- Appear jaundiced (a yellowing of the skin from bilirubin)
- Have small, red blood vessels appear on the skin (look like spiders)
- Have reddened palms
- Show a splotchy red nose (gin blossoms)
- Suffer from recurrent nosebleeds or bleeding gums
It is much more difficult, however, to detect early signs of alcohol abuse. Many people binge drink on the weekends, but maintain performance in work and school. In fact, many can continue problem drinking for quite some time without being noticed.
However, there may be subtle hints, if you know what to look for.
Behaviors that should raise concern include:
- Routinely underestimating the number of drinks consumed
- An apparent preoccupation with drinking (always suggesting to start drinking, prodding others to drink more, etc.)
- Blacking out from drinking
- Increased tolerance to alcohol
- Hangovers that interfere with normal functioning (job, school, church, etc.)
One of the best ways to detect problem drinking is by asking the person a few simple questions (based on the CAGE questionnaire):
- Have you ever wanted to Cut down on drinking?
- Have you ever been Annoyed by someone that criticized your drinking?
- Have you ever felt Guilty about your drinking behavior?
- Have you ever had an Eye-opener (drink in the morning to combat a hangover; “hair of the dog the bit you”)?
A “yes” to any of these questions is a red flag and could indicate the need for a more formal evaluation by a professional.
Alcohol interacts with dozens of prescription medications including:
- Diabetes medicine
- Epilepsy drugs
- Blood pressure medicine
- Pain medications
In truth there are very few medicines that do not interact with alcohol.
Most interactions cause sedation and drowsiness. In some cases, taking alcohol with another medicine may make the prescribed medicine less effective.
For example, if the prescribed medicine is for epilepsy, a seizure could occur. In other instances, the combination can make the prescribed drug more potent, leading to medication-specific side effects.
One of the most feared alcohol-drug interactions are those that are especially toxic to the liver. In some cases this interaction, such as happens with acetaminophen (Tylenol) can lead to liver failure.
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