What Are the Effects of Alcohol Consumption on the Brain?

Some of the effects, like slurred speech and loss of balance, can be very obvious. Others, like cell death, are harder to notice.

Alcohol is deeply intertwined with American culture, finding its place at dinner tables, post-work gatherings, and vacation festivities. Nonetheless, a 2018 study reported in The Lancet challenges the notion of a safe level of alcohol consumption, revealing that even minimal intake can be detrimental to health, with escalating harm at higher consumption rates. While some consequences such as impaired speech and memory loss are apparent, there are subtler effects, like enduring cellular damage, that may go unnoticed.

The 2020-2025 Dietary Guidelines for Americans by the U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services (HHS) define moderate drinking as one or fewer drinks per day for women and two or fewer drinks per day for men. As per the Centers for Disease Control and Prevention (CDC), heavy drinking is outlined as eight or more drinks weekly for women and 15 or more for men. Binge drinking is categorized as consuming four or more alcoholic drinks for women or five or more for men on a single occasion.

To understand the neurological consequences of excessive alcohol intake, a succinct overview follows.

Short-Term Effects of Alcohol

Neurotransmitters

Drinking alcohol impacts neurotransmitter levels in the brain. Dr. Maria Pagano, an addiction researcher and associate professor of psychiatry at Case Western Reserve University School of Medicine, elucidates that neurotransmitters function as messengers transmitting signals that govern behavior, emotion, and physical activity.

Alcohol decelerates the neurotransmitter GABA, leading to impaired movement, slurred speech, and reduced reaction time during intoxication. Simultaneously, alcohol accelerates glutamate, another neurotransmitter that influences dopamine regulation in the brain’s reward center. This acceleration results in pleasurable sensations and a sense of contentment while drinking.

Judgment

Alcohol also diminishes inhibitions and muddles judgment, prompting individuals to partake in risky behaviors like unprotected sex or drunk driving. For those grappling with underlying mental health conditions such as depression or bipolar disorder, alcohol can exacerbate symptoms and intensify mood fluctuations.

Binge drinking affects the cerebellum, crucial for balance regulation, and the cerebral cortex, responsible for processing new information. Slowing down these brain regions leads to dizziness, unsteady walking, blurred vision, and difficulty focusing on surroundings. The dulled sensory uptake impedes the absorption of new information.

Memory

The hippocampus, a brain region pivotal for memory formation, is also affected by alcohol, contributing to blackouts and short-term memory lapses during drinking episodes. Notably, a 2020 Alcohol Research review highlights that alcohol-induced blackouts are equally prevalent among men and women, even though men generally drink more frequently and heavily than women.

In extreme instances, rapid and excessive alcohol consumption can result in loss of consciousness. According to Dr. Lara Ray, a professor of psychology at the University of California Los Angeles Brain Research Institute, this may signify cell death, potentially leading to brain damage with repeated episodes of heavy drinking, causing enduring impacts on learning and memory.

These effects predominantly stem from rapid increases in blood-alcohol content over short durations. Dr. Ray recommends moderate consumption, interspersed with breaks between drinks, and ensuring intake of food to mitigate the risk of experiencing these repercussions.

Long-Term Effects of Alcohol

While binge drinking exposes you to risks like embarrassment, injury, and poor decision-making, the consistent consumption of alcohol can inflict lasting damage on your overall health.

Shrinks Your Brain

A recent study published in Scientific Reports in 2021 underscores the connection between heavy drinking and the reduction of brain volume. Individuals with alcohol use disorder (AUD) displayed notably less brain matter compared to those without this disorder. The affected brain regions govern vital abilities such as attention, language, memory, and reasoning. Through this alteration, alcohol impairs memory, distorts judgment, and induces other cognitive changes.

Multiple investigations support the notion that alcohol detrimentally impacts memory. Furthermore, a 2014 Neurology journal study found that prolonged heavy drinking might hasten memory loss in early old age, primarily in men. Male participants consuming over two and a half drinks daily exhibited cognitive decline signs nearly six years earlier than abstainers, light, or moderate drinkers (outcomes for women were inconclusive, the authors noted).

Increased Tolerance and Dependence

Regular drinkers often experience a decline in alcohol’s impact, attributed to alterations in the brain’s reward system. Dr. Pagano explains that prolonged alcohol consumption can wear down the brain’s reward wiring and its typical functionality. Consequently, tolerance builds up, diminishing the pleasurable effects of alcohol with the same quantities as before.

These neural adaptations lead to shifts in behavior concerning alcohol. Dr. Ray points out that individuals are more prone to seek solace in alcohol to cope with negative emotions as they grapple with chronic drinking. The progression from drinking for pleasure to drinking for emotional relief is characteristic of this transition.

Cell Death and Brain Damage

Drinking as an escape mechanism contributes to heightened alcohol consumption, causing escalated harm to the brain and body. Alcohol inflicts cellular destruction and disrupts neural networks within the brain, and the extent of their regrowth remains uncertain. Notably, “wet brain,” formally termed Wernicke-Korsakoff syndrome, arises from a deficiency of thiamine (vitamin B1) due to alcohol interference with absorption and enzyme conversion.

Dr. Pagano explains the stark impact of chronic drinking on a person’s personality, sometimes leading to unrecognizable behavior. Furthermore, cirrhosis of the liver—a common outcome of long-term, heavy drinking—can trigger brain damage and cognitive impairment. Dr. Pagano mentions that brain regions can show signs of revival in brain scans after reducing alcohol intake, but true recovery demands sustained abstinence and time for the brain to heal.

The toll on the brain and body can extend to fatal outcomes. A 2018 Lancet study uncovered that individuals consuming 10 or more drinks per week exhibited one to two years of reduced life expectancy compared to those consuming fewer than five drinks weekly. For those with 18 or more drinks weekly, this difference increased to four or five years. Alcohol consumption is correlated with diverse cardiovascular problems, including stroke—a potentially deadly blockage of cerebral blood flow.

In conclusion, while alcohol’s immediate effects can be evident, the enduring impact on cognitive function, behavior, and overall health underscores the critical importance of moderation and awareness.

How Much Is Too Much?

The decision to incorporate alcohol into one’s lifestyle is a personal choice, ideally reached individually or in consultation with medical or mental health experts. According to Dr. Pagano, for individuals without a history of dependency or addiction, consuming alcohol at low or moderate levels—up to seven drinks per week for women and up to 14 for men—can be a reasonable and healthy inclusion in life.

However, Dr. Pagano cautions that if your response to alcohol markedly differs from others, it might be prudent to reassess your relationship with drinking. For instance, an ability to outdrink peers or an inability to leave alcohol unfinished in a glass might indicate a genetic predisposition toward addiction.

Dr. Ray adds that although some individuals can comfortably adhere to the recommended low-risk drinking guidelines of one or fewer drinks per day for women and two or fewer for men, there are those whose genetics, stressors, or other risk factors hinder adherence to such limits. This recognition is crucial, given the rising incidence of alcohol-use disorders and heavy drinking, primarily among women, as noted by researchers.

It’s important to recognize that the 2020-2025 Dietary Guidelines for Americans identify certain groups who should abstain from alcohol, including those who are:

• Pregnant or suspect they are pregnant
• Operating vehicles or machinery
• Engaging in activities demanding coordination, skill, or alertness
• Using medications with alcohol interactions
• Managing medical conditions exacerbated by alcohol
• Recovering from alcohol use disorder (AUD)
• Below the legal U.S. drinking age of 21

While alcohol can facilitate social interactions and offer “liquid courage” for those who experience anxiety or shyness, Dr. Pagano advises against heavy reliance on it. Overreliance on alcohol to stimulate certain behaviors or guarantee a good time can hinder the development of genuine social skills.

For individuals considering cessation, Dr. Pagano assures that positive prospects abound. Embracing healthier choices can enhance experiences without a foggy lens. “Many people fear the idea of giving up alcohol and losing the ability to drink,” she explains, “but in truth, life often improves when you’re making conscious choices and fully immersing yourself in experiences without any haze.”

While acknowledging that alcohol can present challenges, including social integration and occasional health benefits in moderation, it’s vital to address its potential negative repercussions when consumed excessively or in specific contexts. If you believe alcohol is adversely affecting your well-being or health and wish to regain control or halt consumption, reach out to your healthcare provider or contact the Substance Abuse and Mental Health Services Administration (SAMHSA) national helpline at 1-800-662-HELP (4357) a proactive step.