Alcohol is commonly considered in a separate class from drugs. However, even though it is legal, alcohol falls into the category of drugs. It can surprise people that alcohol is in fact a drug, potentially because of its mainstream usage. Cultural celebrations often are centered around alcoholic beverages and moderate consumptions of alcohol may not have damaging effects. However, when alcohol is misused or overused, the impact can be severe. It is important to understand the risk factors involved in drinking alcohol. Drinking too much is dangerous and will harm your health.
There is also often confusion if alcohol is considered a stimulant or depressant drug type. Alcohol can have a stimulating effect when consumed in small amounts, yet, it is identified in the class of depressant drug types. When people first start drinking, it can have a stimulating impact on your brain. However, with continued use, alcohol acts more as a depressant, slowing down the central nervous system. How alcohol impacts us is connected to the amount consumed but also to the blood alcohol content (BAC) in the body. In sum, as the BAC is rising, alcohol can function as a stimulant, but as the BAC falls, it acts in a more sedating manner.
To sort through the complexities of the impact of alcohol, it is important to consider the neuroscience of the effect of drinking on our brains. Alcohol directly impacts the chemistry of the brain by changing neurotransmitter levels. Neurotransmitters are chemical messengers that send signals to the body controlling thoughts, behaviors, and emotions. The structure of the brain remains the same, yet, alcohol significantly alters brain activity. Medical imaging scans conducted while people are consuming alcohol indicate decreased brain activity in the prefrontal and temporal cortex, which explain gaps in judgment and rational thinking. The memory loss or “blacking out” can be attributed to the reduced activity in the hippocampus (temporal cortex). Drinking can also increase norepinephrine levels, the neurotransmitter that produces arousal feelings that one experiences when beginning drinking. Increased levels of norepinephrine can also have a negative impact on judgment and decision making. Also, alcohol decreases the release of glutamate, an excitatory neurotransmitter, resulting in a general slowdown of the messaging process. Alcohol is thought to increase GABA, an inhibitory neurotransmitter. GABA is the primary inhibitory neuron in our brains, so alcohol will subsequently impact many physiological and psychological functions.
The level of impact alcohol will have on one’s health and body depends on the amount consumed.
How much is too much? According to the National Institute of Alcohol Abuse and Alcoholism, there are general guidelines suggesting how much alcohol consumption is dangerous. The following criteria are suggested:
- For women, consuming seven or more drinks per week or more than four alcoholic beverages in a day is considered risky.
- For men, risky intake is drinking 14 alcoholic beverages weekly or five per day.
There is no shortage of health risks associated with drinking alcohol. According to the Center of Disease Control, short term health risks include the following:
- Violence and domestic assault
- Alcohol poisoning from high blood alcohol levels
- Injuries including vehicles, drowning, falling
- Risky sexual behaviors resulting in disease or unintended pregnancy
- Fetal alcohol spectrum disorders in pregnant women.
There is a long list of long-term health risks linked to excessive alcohol use as well. The CDC highlights these risks including but not limited to:
- Heart disease, high blood pressure, stroke, liver disease
- Digestive problems
- Dementia and memory impairment
- Increased mental health diagnoses, depression, and anxiety
- Social problems including loss of work and family
In addition to the health risks noted, scientific researchers are also exploring the link of consuming alcohol to cancer, as it is considered a carcinogen. Studies indicate that increased consumption of alcohol puts people at greater risk of certain types of cancer including: colon, liver, mouth, breast, and throat.
Excessive intake of alcohol can also lead to death from overdose. Drinking alcohol is particularly dangerous when combined with other drugs, especially sedatives and painkillers. The interaction of substances is dangerous and everybody experiences this differently. What is not as harmful for one person could prove to be deadly for another. The CDC reports that roughly 2,221 people over the age of 15 die annually from alcohol poisoning, which averages to six deaths every day.
The overconsumption of alcohol also presents psychological risks. Drinking can lead to initial increases in energy, extroversion, and risk taking as it impacts the pleasure center of the brain. At the same time, it has inhibitory effects as well, slowing down the central nervous system. Similar to sedating drugs, it can contribute to a relaxing, calming feeling. Drinking alcohol also increases dopamine levels in the brain, which is considered a “feel good” neurotransmitter. People often use alcohol to help cope with stress and anxiety, as it can also have a numbing impact on emotion. Excessive use can be an unhealthy outlet for people struggling with anxiety, stress, or depression. Drinking can serve as a temporary yet damaging escape for psychological or emotional pain.
The neurological impact of drinking too much alcohol can also be significant. Extreme intake of alcohol can lead to loss of consciousness, vomiting, and memory impairment. Extreme drinking alters arousal, behavior, mood, and neuropsychological functioning, and negatively impacts sense of balance and coordination. Excessive alcohol intake also produces damage to the ends of neurons (dendrites), making it challenging for neurons to deliver messages back and forth.
Like all drugs, there are risks to consuming alcohol, including its addictive quality. People can become dependent on alcohol and withdrawal symptoms can be severe. Many people abuse alcohol instead of other drugs, potentially due to its accessibility, lower cost, and legality. However, as mentioned, drinking can be dangerous when abused or consumed in large quantity. Alcohol actually kills more people annually than all other drugs combined. It has been estimated to contribute to approximately 88,000 deaths in the U.S. As alcohol addiction develops, a person begins to crave and desire the substance to feel “normal.” Addicts continue to use the drug of choice despite the damage and dangerous consequences.
It can be helpful to note the differences between alcohol abuse and dependence. Abusing alcohol is binge drinking, despite the social and personal consequences that can be faced as a result. Alcohol dependence can also include symptoms such as: increased tolerance for alcohol, seeking out contexts that primarily include drinking, withdrawal symptoms, drinking to avoid hangover symptoms, and problems quitting drinking after concerted efforts.
Research indicates that individuals who start drinking alcohol at a young age are at higher risk to develop addiction issues later in life. Heavy underage drinking is considered even higher risk, as alcohol can impact cognitive brain development. Underage drinking also contributes to alcohol-related accidents and deaths. Considering alcohol impacts judgment and discernment, this puts adolescents at even more risk for making harmful mistakes with negative consequences.
Alcohol addiction is understood by most as a chronic disease. The American Society of Addiction Medicine defines alcoholism as a type of substance addiction, which impacts the reward, memory, and motivation systems of the brain. The American Medical Association (AMA) identified that alcoholism was an official illness in 1956. It was further specified in 1991 that alcoholism was classified as a psychiatric and medical disorder. Scientists identify chronic disease as a long-lasting condition that can be controlled, yet not cured.
While the risk factors are clear, alcoholism can be managed and some of the health damage can be reversed. Research indicates that abstinence from alcohol can lead to some improvement in brain functioning. While some effects on the liver can be reversed, advanced liver disease (cirrhosis) is often fatal in chronic alcoholics. Similarly, damage to the pancreas can sometimes be irreversible, people can reduce the risk of additional attacks by quitting alcohol intake. Finally, high blood pressure and other various health concerns can be reduced, improved, or reduced as well if one stops drinking.
Addiction experts believe that early decisions for excessive alcohol intake are of conscious choice. However, the brain changes as a result of addictive behaviors, leading to impairment. A defining symptom of alcoholism is the loss of control over the alcohol use. It is understood that some people are more susceptible to substance addiction than others. While addicts and alcoholics can stop using, it typically requires treatment and support to maintain their sobriety.
Critics suggest that addiction and alcoholism are not a disease, but a choice to use. However, the ability to make a choice does not necessarily determine if an illness is a disease. For example, sun exposure can increase risk of skin cancer, diet and exercise can impact heart disease and high blood pressure. The disease is what occurs in our bodies as a result of our decisions and actions. As a drug addiction, alcoholism contributes to changes in how the brain and the body function and if untreated, over time, it becomes more severe and life threatening. Similar to other medical diseases, addiction is considered to be caused by various behavioral, environmental, genetic, and biological variables.
It is clear that harmful amounts of alcohol consumed can be devastating and dangerous. This drug is to be taken seriously. While some people can quit using drugs and alcohol, most people with addiction challenges require support, intervention, and ongoing resources. If you or someone you know who suffers from alcohol addiction, dependence, or abuse, please reach out for help.