How Does Alcohol Affect the Brain? Everything You Need to Know

How Does Alcohol Affect the Brain?

Once consumed, alcohol quickly moves through different systems in the body. It begins in the stomach before moving to the bloodstream and finally to the brain. There, it interacts with various chemicals called neurotransmitters involved in communicating signals throughout the body. With the disruption caused by alcohol, the brain cannot function as well or as efficiently as it normally would.¹

Alcohol is a drug that depresses, or slows down, the central nervous system (CNS). This depressed brain activity changes a person’s behavior, thinking, and memory. Along with changes in the brain, alcohol can also affect a range of organs that manage functions like blood pressure and respiration rate.²

The intensity and duration of alcohol’s effects will vary from person to person, but typically, the more the person drinks, the more severe the impact on the brain will be. Due to aspects of body composition and the way their body processes the drug, women tend to be more affected by similar amounts of alcohol.²

Some other factors that contribute to the specific effects someone experiences from alcohol include:²

• The speed in which the alcohol was consumed
• How much food was present in the stomach while drinking
• Age
• Race or ethnicity
• General physical and mental health
• Family history of alcohol use disorders or other addictions

Even though people may note a brief period of pleasant feelings caused by alcohol use, the overall effects tend to be overwhelmingly negative.

Short-Term Effects of Alcohol on the Brain

The main effects of alcohol on the brain are caused by neurotransmitter changes. Alcohol acts as a CNS depressant by shifting the balance of transmitters that excite and inhibit functioning. Alcohol will increase inhibitory chemicals like gamma-aminobutyric acid (GABA), glycine, and adenosine, and it will decrease excitatory transmitters like glutamate and aspartate.³

Every short-term effect of alcohol on the brain is a result of this imbalance of neurotransmitters. Short-term effects of alcohol on the brain include:

Sedation

Someone feeling sleepy before drinking will likely feel more tired after drinking alcohol. This effect is due to the action of GABA in the system as the chemical is linked to states of sedation and reduced anxiety. Medications, like benzodiazepines, also interact with GABA to produce sedative results.³ Although alcohol may induce tiredness, alcohol and sleep do not go together very well and the sleep may not be very restful.

Judgment

A person’s behavior, judgment, and impulsivity can all become influenced by alcohol in the short-term. With decreased self-control, a person will be more likely to engage in risky or reckless behaviors that jeopardize their safety or the safety of those around them. Paired with poor coordination, this worsening judgment can prove deadly, especially if someone decides to drive.²

Memory

One neurotransmitter affected by alcohol, glutamate, plays a vital role in the brain storing new memories. So, when a person is done drinking, they may have only a spotty recollection of the events that occurred when under the influence of alcohol. In some more extreme situations, the impact of glutamate could create complete gaps in memory, called blackouts.¹

Long-Term Effects of Alcohol on the Brain

The alcohol effects on the brain do not stop in the short-term, though. As alcohol use continues, the person will experience additional long-term risks in addition to the problems that occur with each use. Whereas many short-term effects are temporary or reversible, the long-term effects can be chronically irreversible throughout the body with the brain being a vulnerable target.

Long-term effects of alcohol on the brain include:

Shrinks Your Brain

Alcohol can actually shrink the overall brain size of people who consume it consistently in the long-term. Alcohol will reduce the size of brain cells called neurons. Then, as the neurons shrink and the inner cavity grows bigger, the total mass of the brain is lessened.¹

Increased Tolerance

With consistent alcohol use over time, increased tolerance is a certainty. As the brain becomes tolerant to alcohol, it decreases the expected neurotransmitter response to alcohol consumption. Because of this, the person will be driven to consume higher amounts of alcohol or more potent drinks in order to experience the wanted effects of the substance.³

Dependence

Like tolerance, physical dependence is an expected outcome of consistent alcohol use in the long-term. When dependence forms, the brain begins to rely on levels of alcohol in the system to maintain a balance of neurotransmitters. If the person reduces or stops their alcohol use, there will be imbalance in the system causing them to feel unwell and struggle to function normally.^{3, 4}

Cell Death & Brain Damage

Long-term alcohol misuse can kill brain cells. A host of disorders of the brain are linked to alcohol use. These conditions are often serious and frequently irreversible, even with treatment.

Some brain disorders linked to alcohol use include:⁵

• Cerebellar atrophy
• Frontal lobe dysfunction
• Hepatic encephalopathy
• Wernicke’s encephalopathy
• Korsakoff’s amnesic syndrome
• Peripheral neuropathy

Alcohol & Brain Development

Alcohol use seems to damage the brain, regardless of the age of the individual consuming it, but younger brains are particularly susceptible to the harms of alcohol. Teens who drink could experience higher risks than adults.⁶

Alcohol & Brain Development During Pregnancy

Prenatal alcohol exposure leads to a range of lasting brain issues. In some cases, a person does not even have to consume the alcohol directly. The brain development of a fetus can be drastically impacted by the mother’s alcohol use. On a developing fetus, alcohol contact is associated with behavioral, cognitive, and learning problems.⁶

Alcohol & Mental Health

The connection between alcohol and mental health issues seems to be bi-directional because those who drink alcohol are more likely to have problems like depression and anxiety. Likewise, people with depression and anxiety may be more interested in using alcohol. This increased use is frequently a form of self-medication with the person attempting to feel better, but the alcohol only makes symptoms worse.⁷

Signs of Alcohol Abuse

Alcohol abuse occurs any time someone consumes an unhealthy amount of alcohol or uses alcohol in problematic situations. With time, alcohol abuse may lead to alcohol addiction and alcohol use disorders. Alcohol use disorder is a diagnosable mental health condition that creates a powerfully negative impact on the individual and their loved ones.

Signs of alcohol abuse or an alcohol use disorder include:⁷

• Drinking more alcohol than intended in a sitting
• Drinking alcohol for a longer period of time than intended
• Spending a lot of time trying to get and use alcohol
• Needing a lot of time to recover from previous alcohol use
• Having a strong but unsuccessful desire to cut back or quit drinking
• Feeling strong cravings for alcohol when none is available
• Instances when alcohol use gets in the way of completing responsibilities at home, work, or school
• Experiencing problems with relationships due to alcohol use
• Drinking alcohol, even when it could harm the person’s physical or mental health
• Giving up other activities to focus on drinking
• Needing to drink more to feel the effects – tolerance
• Looking up ways to get over a hangover or how sober up fast
• Feeling unwell when no alcohol is available – alcohol withdrawal linked to dependence

Treatment Options For Alcohol Abuse

Therapy, medication, and lifestyle changes are all helpful treatment options for people with alcohol use disorders. Along with professional treatments, self-help programs and support groups can create wonderful changes as they establish a community network centered on recovery.

Some treatment options for alcohol abuse include:^{4, 7}

• Cognitive behavior therapy (CBT): The treatment works well for a multitude of mental and physical health conditions, so CBT for addiction is an effective tool. By finding the connection between thoughts, feelings, and behaviors, people can learn ways to manage their symptoms without alcohol.
• Motivational enhancement therapy/ motivational interviewing: Motivational interviewing for substance use treatment works towards the goal of increasing a person’s internal motivation for change.
• Contingency management: CM helps by offering real, tangible rewards for engaging in recovery-focused activities.
• Family therapy: By working with family members in addition to the individual, family therapy can improve relationships, communication, and conflict resolution.
• 12-step programs: Programs like Alcoholics Anonymous (AA) have a long record of creating lasting change and helping people sustain recovery.
• Other recovery programs: Options like SMART Recovery, LifeRing Secular Recovery, Secular Organizations for Sobriety, and Women for Sobriety may be more comfortable or beneficial options for people looking for lasting recovery.

Medication for alcoholism options are available as well.

Some medication used to help with alcohol abuse include:⁷

• Acamprosate (Campral)
• Disulfiram (Antabuse)
• Naltrexone (Revia, Vivitrol)
• Topiramate (Topamax)

When to Seek Professional Help

It is never too early or too late to seek professional treatment for alcohol use disorders. Getting help from a team of mental health and addiction experts can help an individual return to a higher level of function that is less negatively impacted by the dangers of substance use.

Talking to loved ones about the concern is always a great place to start while others may have success consulting with an online therapist directory or online therapy platform.

Some people will benefit from speaking to a medical prescriber, a psychiatrist or nurse practitioner, to receive medications that aid in the treatment of alcohol use disorders. Medications could directly address addiction concerns or they could address underlying mental health conditions that contribute to alcohol use. Anyone interested in medications should consider online psychiatrist options.