Noah Vinter
Alcohol is a central nervous system depressant that affects many parts of the brain, including the medulla, cerebellum, frontal lobes, hippocampus, hypothalamus, and pituitary. It interferes with the brain's communication pathways, affecting how the brain processes information and how the body moves and maintains balance. Alcohol also enhances the release of dopamine, producing feelings of euphoria and well-being, which is why alcohol can be addictive. Excessive drinking can lead to mental health problems, such as depression and anxiety, and can cause reversible and irreversible brain damage.
| Characteristics | Values |
|---|---|
| Brain parts affected | Medulla, cerebellum, frontal lobes, hippocampus, hypothalamus, pituitary, nucleus accumbens, glutamate receptors, thalamus, basal forebrain, cerebral cortex, subcortical areas |
| Effects | Blocks/enhances brain's communication pathways, affects memory, balance, speech, judgment, cognition, thought, behaviour, coordination, mental health, heart rate, body temperature, consciousness, breathing, hormone release, sexual performance, risk of injury, pain threshold |
| Risks | Brain damage, Wernicke-Korsakoff syndrome (WKS), alcohol overdose, alcohol use disorder (AUD), progressive changes in brain structure and function, prenatal alcohol exposure, malnutrition, shrinkage of hippocampus, atrophy of cerebral cortex and white matter, atrophy of basal forebrain regions |
| Reversibility | Most cognitive damage can be reversed or improved within a year of stopping drinking |
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What You'll Learn
Brain damage and mental health
Alcohol abuse can have severe consequences for brain health, and can lead to mental health problems such as depression and anxiety. Alcohol interferes with the brain's communication pathways, affecting areas of the brain that control balance, memory, speech, and judgment. This results in a higher likelihood of injuries and other negative outcomes.
Intoxication occurs when alcohol intake exceeds the body's ability to metabolize it. Alcohol reaches the brain in just five minutes and starts to affect the drinker within 10 minutes. With a blood alcohol content (BAC) between 0.01 and 0.05, an individual will enter the first stage of intoxication, or the "subliminal intoxication" stage. At this stage, a person may not look like they have been drinking, but their reaction time, behavior, and judgment may be slightly altered. As BAC increases, the brain releases more dopamine, leading to feelings of relaxation and confidence, but also impairing reasoning and memory.
At a BAC of 0.18 to 0.3, an individual will experience disorientation and may need help walking or standing due to the impact on the cerebellum. Blackouts, or the temporary loss of consciousness or short-term memory, are also likely to occur at this stage as a result of the hippocampus not functioning properly. A BAC of 0.25 is indicative of alcohol poisoning, with all mental, physical, and sensory functions severely impaired. At a BAC of 0.35, the drinker is at risk of falling into a coma due to compromised respiration and circulation, motor responses, and reflexes.
Long-term heavy drinking can cause alterations in neurons, such as reductions in their size. Progressive changes can occur in the structure and function of the brain, compromising brain function and driving the transition from controlled, occasional use to chronic misuse, or alcohol use disorder (AUD). Alcohol-related brain damage (ARBD) affects men more often than women, but women tend to develop it at a younger age and after fewer years of alcohol misuse. ARBD can cause mild cognitive impairment or more serious problems with memory and thinking, and can lead to alcohol-related "dementia", or Wernicke-Korsakoff syndrome, which is caused by a thiamine (vitamin B1) deficiency. An alcohol overdose occurs when there is so much alcohol in the bloodstream that areas of the brain controlling basic life-support functions, such as breathing, heart rate, and temperature control, begin to shut down. This can lead to permanent brain damage or death.
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Interference with communication pathways
Alcohol interferes with the brain's communication pathways and can affect the way the brain looks and works. These disruptions can change mood and behaviour and make it harder to think clearly and move with coordination.
Alcohol affects the brain's communication pathways by interacting with multiple neurotransmitter systems, disrupting the balance between inhibitory and excitatory neurotransmitters. Specifically, alcohol can act as a depressant by increasing inhibitory neurotransmission, decreasing excitatory neurotransmission, or through a combination of both. This depressant effect on neurons is associated with some of the behavioural manifestations of intoxication, including decreased attention, alterations in memory, mood changes, and drowsiness. Continued acute consumption may result in lethargy, confusion, amnesia, loss of sensation, difficulty breathing, and even death.
Short-term exposure to intoxicating concentrations of alcohol appears to inhibit both NMDA and non-NMDA receptor activity, potentially resulting in sedation. However, these excitatory receptors are relatively insensitive to intoxicating concentrations of alcohol under some experimental conditions, indicating the need for further research.
Long-term heavy drinking causes alterations in the neurons, such as reductions in their size. It makes it harder for brain areas controlling balance, memory, speech, and judgment to do their jobs, resulting in a higher likelihood of injuries and other negative outcomes.
Alcohol also affects the peripheral nervous system, which comprises the nerves outside the brain and spinal cord. Alcohol misuse is linked to peripheral neuropathy, commonly occurring in people with severe alcohol use disorder (AUD). This can cause numbness in the arms and legs and painful burning in the feet. Alcohol-related nerve damage may also lead to heart arrhythmias, postural hypotension, diarrhoea, and erectile dysfunction.
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Brain shrinkage
Alcohol has been proven to affect the brain in numerous ways, with excessive drinking linked to an increased risk of dementia. While moderate drinking has been deemed safe, a recent British study has indicated that even moderate drinking is associated with shrinkage in areas of the brain involved in cognition and learning.
Alcohol abuse can cause brain shrinkage, also known as atrophy, and increase the risk of severe and permanent brain damage. Brain shrinkage occurs because alcohol is toxic to nerve cells, causing brain cells to die and brain tissue to shrink. This results in a decrease in grey matter volume, which can compromise brain function.
Alcohol-related brain damage (ARBD)
ARBD is caused by regular binge drinking or drinking much more than the recommended limit. It can cause mild cognitive impairment, with small changes to thinking and memory. ARBD can be reversed if the person stops drinking and receives good support. However, if the person continues to drink excessively, they are at risk of developing more serious brain damage, such as Wernicke-Korsakoff syndrome, which causes problems with day-to-day tasks.
A study by Dr Kenneth J. Mukamal examined the alcohol consumption and MRI scans of 3,376 men and women. The study found that brain volume shrank in proportion to alcohol consumed, with atrophy greater even in light and moderate drinkers than in teetotalers. However, Dr Mukamal notes that the meaning of the MRI scans is still unclear, and the atrophy may be due to fluid shifts within the brain rather than brain cell death.
Heavy alcohol consumption has been associated with more severe brain structural changes, including neuronal loss and poorer white matter fiber integrity. A study of 424 men and 103 women found that those who had four or more drinks a day had almost six times the risk of hippocampal shrinkage, which is associated with memory and reasoning.
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Alcohol overdose
Alcohol is absorbed through the lining of the stomach into the bloodstream, where it spreads into tissues throughout the body, including the brain. Alcohol reaches the brain within five minutes and starts to affect the drinker within ten minutes. As the blood alcohol concentration (BAC) increases, so does the effect of the alcohol and the risk of harm. Even small increases in BAC can decrease motor coordination, induce nausea, and impair judgment.
At a BAC of 0.18 to 0.3, an individual may experience disorientation, and their cerebellum, which aids in coordination, is impacted. They may need assistance walking or standing, and they may experience blackouts or temporary memory loss due to the hippocampus—the region of the brain responsible for forming new memories—not functioning properly. A higher pain threshold may also increase the risk of injury.
At a BAC of 0.25, signs of alcohol poisoning become more severe, with all mental, physical, and sensory functions significantly impaired. The risk of passing out, suffocation, and injury is high. At this stage, the individual may experience mental confusion, difficulty remaining conscious, vomiting, seizures, trouble breathing, a slow heart rate, clammy skin, dulled responses, and an extremely low body temperature.
If the BAC reaches 0.35, the person is at risk of falling into a coma due to severely compromised respiration and circulation, motor responses, and reflexes.
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Prenatal alcohol exposure
Alcohol interferes with the brain's communication pathways and can affect the way the brain looks and works. It can also affect how the brain processes information. Alcohol makes it harder for the brain areas controlling balance, memory, speech, and judgment to do their jobs, resulting in a higher likelihood of injuries and other negative outcomes.
The term fetal alcohol spectrum disorders (FASD) refers to the wide range of physical, behavioral, and cognitive impairments that occur due to alcohol exposure before birth. FASD can be identified structurally or functionally. Structural evidence of FASD includes small brain size and alterations in specific brain regions, such as the hippocampus, frontal lobes, corpus callosum, and basal ganglia. Functional evidence of FASD includes cognitive and behavioral deficits, motor and coordination problems, and growth deficiencies.
Fetal alcohol exposure can lead to fetal alcohol syndrome (FAS), which is characterized by growth deficiencies, distinct facial features, and other physical factors in addition to central nervous system (CNS) involvement. Children with FAS are small for their age, exhibit characteristic facial anomalies, and demonstrate deficits in CNS development. The specific group of facial anomalies associated with FAS includes short palpebral fissures, a flattened nasal bridge, an absent or elongated philtrum, and a thin upper lip. These morphologic abnormalities occur when the midline of the face is formed during the first trimester.
The dangers of fetal alcohol exposure are entirely preventable if women abstain from drinking during pregnancy. The U.S. Surgeon General recommends that women who are pregnant, might be pregnant, or are trying to become pregnant should not drink alcohol at all.
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Frequently asked questions
Alcohol doesn't shut off a specific part of the brain but it does interfere with the brain's communication pathways and can affect the way the brain looks and works.
Areas of the brain that are especially vulnerable to damage from alcohol include the frontal lobes, the cerebellum, the hippocampus, the hypothalamus, the pituitary, the medulla, the cerebral cortex, and subcortical areas such as the limbic system, the thalamus, and the basal forebrain.
The frontal lobes are responsible for cognition, thought, memory, and judgment. Alcohol inhibits the effects of the frontal lobes, impairing nearly every one of these functions.
The cerebellum is the centre of movement and balance. Alcohol's impact on the cerebellum leads to loss of balance and uncoordinated movements.
The hippocampus forms and stores memory. Alcohol's impact on the hippocampus can lead to memory loss and temporary loss of consciousness or short-term memory (blackouts).
