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This website says that Alcohol’s effect on the brain can be felt after just one drink for some, while others will have to drink more in order to feel drunk. Regardless of how many drinks it takes to actually feel the effects, alcohol begins influencing the brain as soon as it enters the body. If abused, the brain may sustain serious and lifelong injuries.

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Most people have experienced the side effects of excessive alcohol usage at least once in their life. Staggering, slurred speech, blurry vision and loss of motor skills are just a few of the most common indicators that someone has had too much to drink. These behaviors occur when drinking because of the way that alcohol affects the brain.

These symptoms will last for a couple of hours depending on how much alcohol has been consumed. Eventually, the toxic substance will leave the body and these side effects will resolve on their own- leaving just a painful hangover in their place.

However, when someone starts to consume alcohol heavily and on a regular basis, some of these more serious cognitive side effects can linger long after the drinking ends. Over an extended period of time, excessive drinking can lead to severe brain damage including irreversible memory loss and wet brain.

How Does Alcohol Affect The Brain?

Alcohol acts as a central nervous system depressant, causing thoughts, speech and movement to slow down when drinking. This happens when consuming alcohol because the substance directly affects the brain's chemistry by altering the levels of neurotransmitters- which are responsible for moving signals around the body that control processes such as thoughts, behaviors and emotions.

Most notably, consuming alcohol suppresses the neurotransmitter that controls excitement while increasing other neurotransmitters that inhibit the brain's activity. This combination is responsible for producing the sedative side effects of alcohol usage including symptoms like slurred speech and stumbling.

The more a person drinks, the slower the body and brain are to react. If too much alcohol is consumed in a short amount of time, it can lead to a period of memory loss known as a blackout.

Consuming alcohol also increases the levels of the "feel-good" chemical, dopamine, in the brain. The release of dopamine tricks the brain into thinking that consuming alcohol makes it feel great, when in reality, drinking alters the brain's chemistry in a way that enhances feelings of depression in the long run.

While the severity of the side effects of alcohol usage varies from person to person, several factors have been shown to directly influence how alcohol affects brain function:

How often someone drinks

How much someone drinks in one sitting

The age a person begins drinking

The number of years a person has been drinking

A person's gender, age and genetic factors

A family history of alcoholism

The person's general health

Alcohol's effect on the brain can be felt after just one drink for some, while others will have to drink more in order to feel drunk. Regardless of how many drinks it takes to actually feel the effects, alcohol begins influencing the brain as soon as it enters the body. If abused, the brain may sustain serious and lifelong injuries.

Alcohol-Related Brain Impairment (ARBI)

Repeated alcohol abuse over long periods of time will affect the brain in toxic ways. Depending on what part of the brain has been damaged, symptoms can include depression, reckless behavior, impaired judgment, poor memory recall, lack of coordination and a range of other side effects.

This group of problems is collectively known as alcohol-related brain impairment (ARBI). While frequent heavy drinkers are more likely to experience ARBI, binge drinkers are also at risk for developing any of these impairments.

The National Institute on Alcohol Abuse and Alcoholism explains that long-term, heavy drinking can actually shrink the size of the brain and cause the brain's inner cavity to grow larger. This change in the brain's mass is believed to be the cause of the variety of debilitating side effects listed above.

However, many of these symptoms are reversible. The National Institute on Alcohol Abuse and Alcoholism goes on to explain that abstaining from alcohol for several months or a year can allow time for structural brain changes to correct themselves. Abstaining from alcohol after a long period of heavy drinking may also help improve attention, memory and problem-solving skills.

Wet Brain

Wet brain, also known as Wernicke-Korsakoff syndrome, is a form of brain damage that develops from repeat and heavy exposure to alcohol. This condition stems from a deficiency of a thiamine, or vitamin B1.

Those who regularly abuse alcohol typically have a poor diet and as a result, do not get the recommended daily amount of thiamine. Additionally, alcohol hinders the body's ability to absorb thiamine. Instead, the body lives off of the thiamine that has been stored in the liver until the supply has been completely depleted.

Wet brain occurs in two stages:

Wernicke's encephalopathy:The first stage of Wernicke-Korsakoff syndrome is caused by biochemical lesions of the nervous system. The lesions can cause impaired muscle coordination, a confused mental state and paralysis of the nerves used to control eye movement. If treated immediately with thiamine injections, these symptoms can improve.

Korsakoff's psychosis: The second stage of this Wernicke-Korsakoff syndrome results from permanent damage to the part of the brain responsible for memory. People suffering from Korsakoff's psychosis may have severe memory loss, difficulties making new memories, and experience visual or auditory hallucinations. Unfortunately, around 80 perfect of Wernicke-Korsakoff patients who abuse alcohol will eventually develop the Korsakoff's psychosis, the more severe second stage of this condition.

While some symptoms of wet brain can be treated in order to reverse the negative side effects of alcohol abuse, total recovery is unlikely.

Hepatic Encephalopathy

Hepatic encephalopathy is damage to the brain as a result of liver failure.

The liver is one of the most essential organs in the body. It screens toxins out of the bloodstream in order to keep the body healthy. When someone is struggling with alcohol abuse, the liver can become severely overworked and damaged as it tries to rid the blood of the toxic alcohol.

When the liver fails, toxic chemicals are able to make their way to the brain and can cause slurred speech, disorientation, sudden mood changes, lethargy and in severe cases, coma.

Brain Damage From Alcohol Abuse

The brain can sustain serious damage from alcohol abuse. While some of the conditions cause lifelong brain impairments, many side effects are reversible after a period of abstinence from alcohol and the right treatment methods.

If you or a loved are experiencing symptoms of brain damage due to repeated and heavy alcohol use, call a treatment specialist today at 888-512-3326.

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Does Alcohol Abuse Cause Brain Damage? - Addiction Campuses

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Most people have experienced the side effects of excessive alcohol usage at least once in their life. Staggering, slurred speech, blurry vision and loss of motor skills are just a few of the most common indicators that someone has had too much to drink.

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This website says that. Alcohol affects brain chemistry by altering levels of neurotransmitters.
Neurotransmitters are chemical messengers that transmit the signals throughout the body that control thought processes, behavior and emotion. Neurotransmitters are either excitatory, meaning that they stimulate brain electrical activity, or inhibitory, meaning that they decrease brain electrical activity.

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Most of us have witnessed the outward signs of heavy drinking: the stumbling walk, slurred words and memory lapses. People who have been drinking have trouble with their balance, judgment and coordination. They react slowly to stimuli, which is why drinking before driving is so dangerous. All of these physical signs occur because of the way alcohol affects the brain and central nervous system.

Alcohol affects brain chemistry by altering levels of neurotransmitters. Neurotransmitters are chemical messengers that transmit the signals throughout the body that control thought processes, behavior and emotion. Neurotransmitters are either excitatory, meaning that they stimulate brain electrical activity, or inhibitory, meaning that they decrease brain electrical activity. Alcohol increases the effects of the inhibitory neurotransmitter GABA in the brain. GABA causes the sluggish movements and slurred speech that often occur in alcoholics. At the same time, alcohol inhibits the excitatory neurotransmitter glutamate. Suppressing this stimulant results in a similar type of physiological slowdown. In addition to increasing the GABA and decreasing the glutamate in the brain, alcohol increases the amount of the chemical dopamine in the brain's reward center, which creates the feeling of pleasure that occurs when someone takes a drink.

Summary of alcohol's effects on the brain - Move your cursor over the colored bar in the lower left-hand corner to see which areas of the brain are affected by increasing BAC.

Alcohol affects the different regions of the brain in different ways:

Cerebral cortex: In this region, where thought processing and consciousness are centered, alcohol depresses the behavioral inhibitory centers, making the person less inhibited; it slows down the processing of information from the eyes, ears, mouth and other senses; and it inhibits the thought processes, making it difficult to think clearly.

Cerebellum: Alcohol affects this center of movement and balance, resulting in the staggering, off-balance swagger we associate with the so-called "falling-down drunk."

Hypothalamus and pituitary: The hypothalamus and pituitary coordinate automatic brain functions and hormone release. Alcohol depresses nerve centers in the hypothalamus that control sexual arousal and performance. Although sexual urge may increase, sexual performance decreases.

Medulla: This area of the brain handles such automatic functions as breathing, consciousness and body temperature. By acting on the medulla, alcohol induces sleepiness. It can also slow breathing and lower body temperature, which can be life threatening.

In the short term, alcohol can cause blackouts -- short-term memory lapses in which people forget what occurred over entire stretches of time. The long-term effects on the brain can be even more damaging.

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Most of us have witnessed the outward signs of heavy drinking: the stumbling walk, slurred words and memory lapses. People who have been drinking have trouble with their balance, judgment and coordination. They react slowly to stimuli, which is why drinking before driving is so dangerous.

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This website says that Alcohol lowers inhibitions and clouds judgment, as well, which could lead a person to engage in risky behaviors like driving a car while drunk. And if a person has an underlying mental health disorder, like depression or bipolar disorder, it can exacerbate symptoms and increase mood swings.

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Here's What Really Happens to Your Brain When You Drink Too Much Alcohol

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The effects of alcohol on the brain are more serious than memory loss and blurred vision. Long-term effects of alcohol on the brain can be fatal.

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This website says that alcohol affects a large portion of the brain, many different kinds of cognitive impairment can occur as a result of heavy drinking, including problems with verbal fluency and verbal learning, processing speed, working memory, attention, problem solving, spatial processing, and impulsivity.

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Download the Cognitive Improvement and Alcohol Recovery Research Update.

Most people with alcohol dependence have experienced the memory problems and slowed thinking that come with alcohol use. While drinking, they may have difficulty recalling memories or remembering new information, such as a person's name. Afterward, they may experience a blackout: an inability to remember entire conversations or events that occurred while they were drinking. It is less commonly known why these side effects occur and how heavy drinking can eventually cause serious long-term damage to the brain. But what happens to alcoholics in recovery? Can damage caused by heavy drinking ever be reversed?

How Does Alcohol Affect the Brain?

Alcohol has a profound effect on the complex structures of the brain. It blocks chemical signals between brain cells (called neurons), leading to the common immediate symptoms of intoxication, including impulsive behavior, slurred speech, poor memory, and slowed reflexes.1,2 If heavy drinking continues over a long period of time, the brain adapts to the blocked signals by responding more dramatically to certain brain chemicals (called neurotransmitters). After alcohol leaves the system, the brain continues over activating the neurotransmitters, causing painful and potentially dangerous withdrawal symptoms that can damage brain cells. 1,2,3 This damage is made worse by drinking binges and sudden withdrawal. 1,4 Alcohol's damage to the brain can take several forms. The first is neurotoxicity, which occurs when neurons over react to neurotransmitters for too long. Too much exposure to a neurotransmitter can cause neurons to eventually "burn out." ¹ Since neurons make up the pathways between different parts of the brain, when they begin burning out, it can cause noticeable slowing in the reactions of these pathways. In addition to pathway damage, brain matter itself is also damaged by heavy alcohol use. People with alcohol dependence often experience "brain shrinkage," which is reduced volume of both gray matter (cell bodies) and white matter (cell pathways) over time.1,2,5 There are some subtle differences in how brain damage occurs in men and women, but regardless of gender, loss of brain matter increases with age and amount of alcohol consumed. 2,6,7

What are the observable effects of this damage? Since alcohol affects a large portion of the brain, many different kinds of cognitive impairment can occur as a result of heavy drinking, including problems with verbal fluency and verbal learning, processing speed, working memory, attention, problem solving, spatial processing, and impulsivity. 8,9,10 Parts of the brain relating to memory and "higher functions" (e.g., problem solving and impulse control) are more susceptible to damage than other parts of the brain, so problems in these areas tend to be worse than others. 5,11,12 Adolescents are especially at risk for long-lasting or permanent damage and performance deficits, since their most-impacted areas of the brain are still in development. 10,11,13,14 Without treatment, cognitive impairment grows worse, eventually developing into a lasting syndrome known as alcohol-related dementia-which represents about 10% of all dementia cases ¹ (additionally, alcohol is estimated to contribute to roughly 29% of all other dementia cases ⁸). Cognitive deficits are made worse by malnutrition, especially a deficiency of vitamin B (a common deficiency in alcohol dependent individuals). Malnutrition and heavy alcohol use can cause serious impairments in memory and language over time and can potentially result in a permanent cognitive disorder called Wernicke-Korsakoff syndrome, which causes amnesia and can lead to coma if left untreated. 1,2,6,7

What Happens in Recovery?

For most people, the brain can heal. If started in time, abstinence from alcohol can reverse much of the physical damage caused by heavy drinking. 8,9,10 Magnetic resonance imaging (MRI) studies are used to view and measure both the damage and improvement to tissue in all areas of the brain. These MRI studies have shown that lost gray matter volume due to chronic alcohol abuse begins to regenerate in as little as two weeks of abstinence. ¹⁵ Increased brain tissue was also found in a study that scanned alcoholics after three months of abstinence, but there were no significant increases for patients who relapsed in the first three months, which suggests that relapsing into heavy alcohol use reverses the rapid regeneration that occurs soon after abstinence. ¹⁶ A study of alcoholics after six months of continued abstinence or moderate resumption of alcohol use showed continued growth of brain tissue that was present among patients who had consumed small amounts of alcohol, suggesting that tissue damage is primarily the result of heavy or chronic alcohol use. ¹⁷

Just as brain damage leads to cognitive impairment, healed brain tissue leads to improved cognitive performance. In addition to improvements resulting from healed brain tissue, some cognitive improvement comes as a result of the brain adapting to the damage and creating new pathways to complete tasks impacted by neuron pathways damaged by alcohol abuse. ¹⁸ Most noticeable improvement in cognitive function begins after one year of abstinence from alcohol, 8,19 although longer periods of abstinence result in greater improvements. ²⁰ A meta-analysis of 12 areas of cognitive function among alcoholics found that cognitive performance was significantly improved across all 12 areas after one year of continuous abstinence, with only small differences between alcohol dependent and control subjects. ⁸ Another study found that attention and working memory were significantly improved in patients who had remained abstinent from alcohol for at least one year, as compared to those who had been abstinent for less than one year. ¹⁹

Alcohol use can result in cognitive deficits, but several studies have shown that abstinence can reverse much of the physical and cognitive damage caused by heavy drinking if treatment begins in time. Therefore it is important that substance-dependent people seek help as soon as possible.

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Alcohol Effects on the Brain | Hazelden Betty Ford

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Chronic alcohol use has a profound impact on the brain's complex structures. Learn how alcoholism and alcoholism recovery affect different parts of the brain.

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This website says that ,the study states that heavy alcohol use, as well as other alcohol use disorders, are important risk factors for dementia which can shorten lives by up to 20 years, with dementia as the leading cause of death.

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Ever wonder, "What does alcohol do to your body?" Particularly, how does alcohol affect the brain? The truth is the damage goes far beyond a headache and brain fog you experience the morning after drinking too much. The effects of alcohol on the brain are profound, and heavy drinking can set you up for some of the most dreaded brain diseases. The long-term effects of alcohol can completely rewire your brain, too, increasing the risk of depression and other conditions.

The Link Between Alcohol & Dementia

How alcohol affects the brain is likely more complex than most people think. True, it's well known that the chronic use of excessive alcohol can have detrimental effects on the body. Still, a surprising 2018 French study from shows a strong link between early onset dementia, in which an individual begins shows symptoms of dementia before the age of 65, and alcohol addiction.

The study states that heavy alcohol use, as well as other alcohol use disorders, are important risk factors for dementia which can shorten lives by up to 20 years, with dementia as the leading cause of death.

So how exactly are dementia, which up until now was mainly synonymous with Alzheimer's disease, and alcohol-related? To understand the link between the two, it is first helpful to understand the effects that alcohol has on the brain as a whole. ( 1, 2)
Alcoholism
Heavy drinking is considered three drinks a day for women and four to five drinks per day for men. ( that determine how alcohol affects the brain: ( 3) There are several factors 4)

How much and how often drinking occurs

Age when drinking first began

Prenatal alcohol exposure

Age, gender, genetic background/family history

Level of education

General health status

Symptoms of alcoholism are:

Physical

Poor coordination

Slurred speech

Slowed reaction times

Psychological

Impaired thinking

Memory loss

Behavioral

Engaging in risky behaviors

Addictive behavior

Depression

Withdrawal or abstinence of drinking results in sweating, nausea, shakiness, anxiety, and delirium tremens; which may include visual or auditory hallucinations. Immediate effects of alcohol are similar following a few drinks.

When you consume alcohol your liver breaks it down into nontoxic byproducts but with excessive consumption, your liver is unable to keep up with the demands required and the alcohol remains in the bloodstream. The effects of alcohol on the brain depends upon an individual's blood alcohol concentration (BAC) . ( 5)

How Does Alcohol Affect the Brain?

An increase in BAC interacts with the brain through the blood-brain barrier. Once in the central nervous system, alcohol causes alterations in behavior by acting upon specific regions in the brain susceptible to chemical modifications.

Regions of the Brain Affected by Alcohol

Mesolimbic pathway

Alcohol stimulates the mesolimbic pathway, or the reward pathway, within the brain and releases dopamine causing a feeling of pleasure.

This pathway is the major pathway involved with addiction in which constant stimulation of the pathway requires more of a substance to create the same level of pleasure. Studies have shown that a pathway that is repeatedly activated, in this case by drinking, becomes covered by a mesh-like glue that makes it difficult to form new synapses or break old ones. This explains why addiction is so tough to overcome, the pattern is ingrained and held together that way in the brain. ( 6, 7)
Frontal Lobe & Prefrontal Cortex
This region is involved in decision making, motivation, planning, goal setting, judgment problem solving, social conduct and impulse inhibition. Neuropathological studies have shown a large reduction in the number of neurons in the prefrontal cortex of alcoholics and overall reduced brain mass relative to controls (non-alcohol drinkers). ( 8, 9) Damage to the frontal lobe/prefrontal cortex results in emotional and personality changes.

Hippocampus

Hypothalamus

Also a part of the due to alcohol leads to memory deficits and amnesia can follow. (limbic system, the hypothalamus has connections to many systems and is involved in learning and memory, regulatory functions, eating/drinking, temperature control, hormone regulation and emotion. Long-term damage to the hypothalamus 14)

Cerebellum

Amygdala

Within the temporal lobe, the amygdala has connections to the prefrontal cortex, the hippocampus and the thalamus and mediates emotions (love, fear, rage, anxiety) and helps identify danger.

How Does Alcohol Affect the Brain: Alcohol & Neurotransmitters

Alcohol affects the brain chemistry by altering the levels of neurotransmitters within the above-mentioned regions.

Neurotransmitters are the chemical messengers within the brain that transmit signals within the central nervous system and extend out throughout the body. The alterations of neurotransmitters within the specific regions cause changes in an individual's behavior and motor functions.

Neurotransmitters are either excitatory and increase electrical activity in the brain or they are inhibitory or decrease electrical activity in the brain.

GABA and NMDA Receptors

Alcohol slows the brain down by binding to the inhibitory results in slurring of words, decreased memory and tiredness. (GABA and NMDA receptors. This slow down 17)

Dopamine

An excitatory neurotransmitter that is increased within the mesolimbic pathway, mediating the reward circuitry.

Norepinephrine

Glutamate

Glutamate is an excitatory neurotransmitter but is blocked from binding to its NMDA receptor by alcohol. The inability to bind to its receptor leads to overall depressant effects throughout the brain. ( 20)

Serotonin

Another excitatory neurotransmitter involved in the pleasure/reward effects of the mesolimbic pathway. Studies have shown a 50 percent reduction in serotonergic cells with chronic alcohol abuse, leading to alterations in mood, thinking, appetite, and sleep. ( 21)

Following the initial increase of the excitatory neurotransmitters, the stimulation wears off and there is a build-up of the inhibitory neurotransmitters; GABA and NMDA. This results in the depressed, subdued and tired "afterglow" of a night of binge drinking.
Alcohol-Related Syndromes
Following chronic excessive alcohol consumption studies have shown an overall decrease in neuronal density, regional blood flow volumes and glucose metabolism . ( 22, 23, 24)

The decrease in glucose metabolism as a result of alcohol consumption is due to a decrease in thiamine. Thiamine (also known as vitamin B1) is critical for all tissues in the body, especially the brain. The brain needs thiamine because of its critical role in glucose metabolism and neurotransmitters synthesis. ( 25)

A decrease in thiamine can occur in two ways due to alcohol consumption. One is a poor diet and the other is due to a decrease in thiamine absorption and activation. The body does have reserves of thiamine, but they become depleted during heavy drinking. If heavy drinking becomes chronic those reserves don't have to ability to recoup and an individual starts to have a thiamine deficiency. Of the people with a thiamine deficiency due to alcohol consumption, 80 percent will go on to develop:

Wernicke Encephalopathy

A person with Wernicke Encephalopathy will suffer from mental confusion, oculomotor disturbances (disturbances with muscles that move the eyes), and difficulty with muscle coordination. ( 26)

Korsakoffs Psychosis

Effects 80 to 90 percent of individuals with Wernicke encephalopathy. Individuals showing symptoms of Korsakoffs Psychosis have difficulty walking and severe problems with amnesia, particularly anterograde amnesia or forming new memories. ( 27)

Alcohol-Related Dementia

Research shows the risk of developing dementia is three times greater in heavy drinkers than other people. Dementia due to alcohol encompasses both Wernicke encephalopathy and Korsakoffs psychosis. ( 28)

Other syndromes due to alcohol consumption are:

Hepatic Encephalopathy: occurs following chronic excessive alcohol abuse leading to changes in sleep patterns and mood, in addition to shaking hands and shortened attention span. ( caused by alcohol results in an increase of ammonia in the blood which has a neurotoxic effect on the brain. (Liver dysfunction 29) The liver damage 30)

Cerebellar Syndrome with Anterior Superior Vermal Atrophy: Patient presents symptoms of a broad-based gait, difficulty with eye movements and dysarthria (slowed or slurred speech). (31)

Final Thoughts on How Does Alcohol Affect the Brain

Excessive use of alcohol causes a variety of chemical and molecular alterations within the brain that forms the basis of several behavioral and physical manifestations.

The neurotoxic effects of alcohol lead to thiamine deficiency and global cell death within, particularly vulnerable areas within the brain.

This cell death results in a decrease in overall brain volume, specifically within the frontal lobe/prefrontal cortex, cerebellum and hippocampus.

Due to neurogenesis, abstinence of alcohol over an extended period of time may see a restoration of cells within these areas.

Lastly, although the research illustrating a link between early onset dementia and alcohol is in its early stages, it is a strong warning of the ever-growing list of detrimental effects of excessive alcohol consumption.

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How Does Alcohol Affect the Brain? (It's Not Pretty) - Dr. Axe

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Ever wonder, "What does alcohol do to your body?" Particularly, how does alcohol affect the brain? The truth is the damage goes far beyond a headache and brain fog you experience the morning after drinking too much. The effects of alcohol on the brain are profound, and heavy drinking can set you up for some of the most dreaded brain diseases.

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This website says that our brains rely on a delicate balance of chemicals and processes. Alcohol is a depressant, which means it can disrupt that balance, affecting our thoughts, feelings and actions – and sometimes our long-term mental health.

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While alcohol can have a very temporary positive impact on our mood, in the long term it can cause big problems for our mental health. It's linked to a range of issues from depression and memory loss to suicide ¹.

Alcohol alters your brain chemistry

Our brains rely on a delicate balance of chemicals and processes. Alcohol is a depressant, which means it can disrupt that balance, affecting our thoughts, feelings and actions - and sometimes our long-term mental health. This is partly down to 'neurotransmitters', chemicals that help to transmit signals from one nerve (or neuron) in the brain to another.

The relaxed feeling you can get when you have that first drink is due to the chemical changes alcohol has caused in your brain. For many of us, a drink can help us feel more confident and less anxious. That's because it's starting to depress the part of the brain we associate with inhibition.

But, as you drink more, more of the brain starts to be affected. It doesn't matter what mood you're in to start with, when high levels of alcohol are involved, instead of pleasurable effects increasing, it's possible that a negative emotional response will take over. Alcohol can be linked to aggression you could become angry, aggressive, anxious or depressed.
How does alcohol impact our relationships? Find out more...
Alcohol can actually increase anxiety and stress rather than reduce it

Unfortunately reaching for a drink won't always have the effect you're after.
While a glass of wine after a hard day might help you relax, in the long run it can contribute to feelings of depression and anxiety and make stress harder to deal with. This is because regular, heavy drinking interferes with neurotransmitters in our brains that are needed for good mental health.

When we drink, we narrow our perception of a situation and don't always respond to all the cues around us. If we're prone to anxiety and notice something that could be interpreted as threatening in the environment, we'll hone in on that and miss the other less threatening or neutral information. For example, we might focus on our partner talking to someone we're jealous of, rather than notice all the other people they've been chatting to that evening.

Think you might be drinking too much? Use our Alcohol Self Assessment tool Find out more about how alcohol can contribute to feelings of anxiety
Alcohol depression = a vicious cycle

If you drink heavily and regularly you're likely to develop some symptoms of depression. It's that good old brain chemistry at work again. Regular drinking lowers the levels of serotonin in your brain - a chemical that helps to regulate your mood.

In Britain, people who experience anxiety or depression are twice as likely to be heavy or problem drinkers. For some people, the anxiety or depression came first and they've reached for alcohol to try to relieve it. For others, drinking came first, so it may be a root cause of their anxieties ².

Drinking heavily can also affect your relationships with your partner, family and friends. It can impact on your performance at work. These issues can also contribute to depression.

If you use drink to try and improve your mood or mask your depression, you may be starting a vicious cycle...
How does alcohol affect your sleep? Tips for a restful night
Warning signs that alcohol is affecting your mood include:

Four ways to help prevent alcohol affecting your mood
Find out how much you're really drinking with out Unit and Calorie Calculator

1. Use exercise and relaxation to tackle stress instead of alcohol.

2. Learn breathing techniques to try when you feel anxious.

3. Talk to someone about your worries. Don't try and mask them with alcohol.

4. Always be aware of why you're drinking. Don't assume it will make a bad feeling go away, it's more likely to exaggerate it.

Alcohol is linked to suicide, self-harm and psychosis

Alcohol can make people lose their inhibitions and behave impulsively, so it can lead to actions they might not otherwise have taken - including self-harm and suicide ³.
Learn more about the connection between alcohol and suicide here
According to the NHS in Scotland, more than half of people who ended up in hospital because they'd deliberately injured themselves said they've drunk alcohol immediately before or while doing it. 27% of men and 19% of women gave alcohol as the reason for self-harming ⁴.

Did you know?

Anxiety and depression are more common in heavy drinkers - heavy drinking is more common in those with anxiety and depression

Extreme levels of drinking (such as more than 30 units per day for several weeks) can occasionally cause 'psychosis'. It's a severe mental illness where hallucinations and delusions of persecution develop. Psychotic symptoms can also occur when very heavy drinkers suddenly stop drinking and develop a condition known as 'delirium tremens' - symptoms include body tremors and confusion.

Alcohol can damage your memory

Soon after drinking alcohol, your brain processes slow down and your memory can be impaired. After large quantities of alcohol, the brain can stop recording into the 'memory store'. That's why you can wake up the next day with a 'blank' about what you said or did and even where you were. This short-term memory failure or 'black out' doesn't mean that brain cells have been damaged, but frequent heavy sessions can damage the brain because of alcohol's effect on brain chemistry and processes.

Drinking heavily over a long period of time can also have long-term effects on memory. Even on days when you don't drink any alcohol, recalling what you did yesterday, or even where you have been earlier that day, become difficult.

Did you know?

Alcohol disrupts the balance of chemicals in your brain that affect your mood.

Staying in control

Drinking within the government's low risk alcohol unit guidelines will help keep your drinking in control. Here are three ways you can cut back:

Try alternative ways to deal with stress. Instead of reaching for a beer or glass of wine after a hard day, go for a run, swim or to a yoga class, or a talk to a friend about what's worrying you.

Keep track of what you're drinking. Your liver can't tell you if you're drinking too much, but the MyDrinkaware can. It can even help you cut down.

Give alcohol-free days a-go. If you drink regularly, your body starts to build up a tolerance to alcohol. This is why many medical experts recommend taking regular days off from drinking to ensure you don't become addicted to alcohol. Test out having a break for yourself and see what positive results you notice.

Further information

Your GP can help you figure out if you should make any changes in your drinking, and offer help and advice along the way.

If you're concerned about someone's drinking, or your own, Drinkline runs a free, confidential helpline. Call 0800 917 8282

Samaritans provides confidential non-judgemental emotional support, 24 hours a day for people who are experiencing feelings of distress or despair, including those which could lead to suicide.

You can ring them on 08457 90 90 90 or if you would prefer you can use their Samaritan email service. They answer around 600 emails a day and aim to get back to people within 12 to 24 hours. The email is jo@samaritans.org

Last reviewed: 2 March 2016

next review due: 2 March 2019

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If you would like to give us feedback about the information on this webpage, or any others on this website, please do so by emailing your comments to contact@drinkaware.co.uk

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While alcohol can have a very temporary positive impact on our mood, in the long term it can cause big problems for our mental health. It's linked to a range of issues from depression and memory loss to suicide 1. Our brains rely on a delicate balance of chemicals and processes.

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This website says that alcohol is is associated with a host of familiar cognitive changes , such as a loss of inhibitions, confused or abnormal thinking, and poor decision-making.

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How Does Alcohol Impacts Cognitive Ability?

Occasional and moderate drinkers:

Heavy and/or chronic drinkers:

Alcohol is an integral part of the American social scene. The failed experiment of Prohibition demonstrated the formidable demand Americans have for alcohol.
As advertisements caution, alcohol is meant to be enjoyed responsibly; however, alcohol consumption can cause individuals to lose their ability to think responsibly.

Alcohol is associated with a host of familiar cognitive changes, such as a loss of inhibitions, confused or abnormal thinking, and poor decision-making. Recreational alcohol users generally recover from its effects without any long-term problems. However, even short-term loss of control over normal mental functioning can result in legal and personal troubles that would likely not have occurred if alcohol were not involved. Alcohol consumption continues to maintain a foothold so strong in American culture that it is nearly impossible to imagine life without it.

What Is Alcohol?

As the National Institute on Drug Abuse explains, the active ingredient in beer, wine, and liquor is ethyl alcohol, or ethanol, which is known colloquially as alcohol. The chemical formula for ethanol is CH ₃CH ₂OH or C ₂H ₅OH. In terms of chemical accuracy, the proper name for alcohol is alkanol. There are different types of alcohol; the number carbon atoms present and the placement of the "OH bond in the formula determines the type of alcohol that will result. Ethanol is the most common type of alcohol.
The process known as fermentation produces alcohol. When yeast is fermented, sugar breaks down into carbon dioxide and alcohol. Carbon dioxide exits the process through gas bubbles and leaves behind a combination of water and ethanol. The process is so precise that if any air is present in the yeast, the result will be ethanoic acid, a chemical found in common vinegar.
Alcohol is basically made from sugar and yeast, but different sources of sugar can produce different types of alcohol. For instance, the sugar from grape pulp is combined with yeast to create either red or white wine. In the case of beer, the source of the sugar is usually barley, but it can also be other grains, such as wheat or rye. To release the sugars, the grains must be malted, mashed, and boiled. Once the sugars are ready for use, yeast is added and the fermentation process begins. Different liquors are made different ways. When it comes to vodka, for example, there is a popular belief that potato is usually the source of the sugar; however, the majority of vodka is made from fruit, barley, wheat, sorghum, or corn.

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Alcohol products, such as wine, beer, and liquor, are made in commercial distilleries, but the process of making DIY alcohol ( moonshine) still relies on the basics discussed above. In some parts of the world, such as Scandinavian Europe and Russia, moonshine is a popular and low-cost alternative to commercial alcohol in some locales. Moonshine is known for its potency, which can be dangerous. Moonshine can be 150-proof, which translates into it being 75 percent alcohol. An added hazard is that it is not created in a regulated setting; therefore, there are fewer, if any, quality and safety guarantees.Although there is not a pressing public concern about rampant sales of moonshine, there are reports of Americans making DIY alcohol and finding themselves in legal hot waters as a result. For instance, a 51-year-old man was arrested in Ohio after selling moonshine out of his camper at a fair. The man's ostensible motive was to make a profit. The Ohio court ordered the moonshine maker to pay an $800 penalty and required him to complete 50 hours of community service.
Making moonshine may sound antiquated to modern ears, but it demonstrates the relative ease with which alcohol can be illegally made. Although some Americans still have Prohibition sympathies, the ability to home-produce alcohol serves as a reminder that it would likely be impossible to entirely remove alcohol from the American landscape.

Alcohol Consumption in the US

The National Survey on Drug Use and Health is a key source of information about the patterns of alcohol and other drug use in America. The 2013 survey made the following estimated findings with respect to alcohol consumption:

About 52.2 percent of Americans aged 12 or older were current alcohol users.

Approximately 6.3 percent of the population aged 12 or older (16.5 million) were heavy alcohol users.

In the past 30 days, 22.9 percent of the population aged 12 or older (60.1 million) reported binge drinking behavior.

About 10.9 percent of Americans aged 12 or older reported that they had driven a car under the influence at least once in the past year.

Approximately 8.7 million Americans under the legal drinking age (12-20 years of age) were current alcohol users. This statistic includes 5.4 million binge drinkers and 1.4 million heavy drinkers.

Alcohol is the most commonly abused drug in the US, with marijuana occupying second place. Despite the known dangers of excessive alcohol consumption, these statistics clearly reflect that many alcohol users engage in heavy use and binge drinking. Further, despite the well-known fact that alcohol impairs brain functioning, an estimated one in 10 Americans aged 12 or older operated a vehicle under the influence. This statistic demonstrates that only a fraction of those who drive under the influence are actually detected.

It is well established in the mental health field that alcohol consumption can exacerbate an underlying mental health disorder.

In the field of substance abuse treatment, an individual who simultaneously has a substance use disorder and at least one other mental health disorder is considered to have a dual diagnosis. Whether alcohol causes or simply accompanies the underlying mental health disorder is not clearly understood. However, there is general consensus that individuals who abuse alcohol and have a mental health disorder diagnosis require treatment for both conditions.

Alcohol in the Brain

While it is true that alcohol can initially perk people up and even help them to socialize at a party, alcohol is a central nervous system depressant. The depressant effects of alcohol are witnessed when people who have been drinking have slurred speech and poor limb coordination that prevents them from being able to walk properly. Although these outward signs of intoxication can be easily observed, it isn't as clear how alcohol acts on a deeper level inside the body. So, how does alcohol act at the neurological level?
Alcohol acts on the receptor sites for the neurotransmitters (chemical messengers) known as GABA, glutamate, and dopamine. Alcohol's activity on the GAMA and glutamate sites result in the physiological effects associated with drinking, such as a slowing down of movement and speech. But individuals do not drink alcohol for the GABA and glutamate effects. Alcohol's activity on the dopamine site in the brain's reward center produces the pleasurable feelings that motivate many people to drink in the first place.
As a Psychology Today article on this topic discusses, the degree to which alcohol impacts a person's mood, behavior, and neurological functioning depends in part on whether the blood alcohol content (BAC) is elevating or decreasing. Alcohol acts as a stimulant, but as consumption tapers off, alcohol acts like a sedative. The fluctuation in BAC helps to account for why the same person can go from being the life of the party to needing help with basics, like walking.
In addition to whether BAC is rising or decreasing, the following factors have been shown to directly influence how alcohol affects a person's brain functions:

The volume a person drinks

How often a person drinks

The age at which drinking began

The number of years a person has been drinking

The person's sex, age, and genetic factors

Whether the person's family has a history of alcoholism

Whether the person was exposed to alcohol as a fetus

The person's general health condition

When considering the negative consequences of alcohol, people often think of what can happen in public, such as getting into a car accident or an alcohol-induced altercation. However, people play a game of roulette with themselves when they drink, especially when they drink heavily, because the effects of alcohol on the brain are uncertain both in the short-term and long-term. If other drugs are added to the alcohol consumption, the risks become more serious.

Occasional Drinkers

In occasional drinkers, alcohol can produce one or more short-term effects after one or more drinks. Memory impairment can begin after a few drinks, and it can become increasingly worse as the consumption increases. A high volume of alcohol consumption, especially on an empty stomach, can result in a blackout. Occasional drinkers will usually recover from a blackout without any lasting mental problems. However, there are numerous dangerous associated with acute alcohol intoxication, such as engaging in reckless activities like unprotected sex, vandalism, and driving. Further, an alcohol-involved incident, such as a car accident, can cause ongoing problems as court dates will need to be attended, fines must be paid, and educational or treatment requirements will have to be met.

Moderate Drinkers

As the Centers for Disease Control and Prevention discusses, the Dietary Guidelines for Americans considers a moderate drinker to be a person who consumes one drink (applies to women) or two drinks (applies to men) per day. Despite extensive news coverage of medical reports that moderate drinking has positive health benefits, the guidelines advise that this is not a reason to start drinking. Moderate alcohol consumption has negative associations, such as increasing the risk of breast cancer and causing violence, falls, drownings, and car accidents. Moderate drinking does not insulate a person from the cognitive impairment associated with drinking and the dangerous consequences that can result.

Heavy and Chronic Drinking

Unlike an occasional or moderate drinker, a person who drinks heavily over an extended period of time may develop deficits in brain functioning that continue even if sobriety is attained. In other words, cognitive problems no longer arise from drinking alcohol but from brain damage that prior drinking caused. In short, long-term alcohol abuse can negatively impact the brain's "hard wiring"such that even when drinking ends, the cognitive problems persist.

In some cases, heavy and/or chronic drinking directly leads to brain damage. In other cases, the brain damage results indirectly from an overall poor health condition (such as liver disease) due to the drinking.

According to the National Institute on Alcohol Abuse and Alcoholism, most heavy long-term alcohol users will experience a mild to moderate impairment of intellectual functioning as well as diminished brain size. The most common impairments relate to the ability to think abstractly as well as the ability to perceive and remember the location of objects in two- and three-dimensional space (visuospatial abilities).
In addition, there are numerous brain disorders associated with chronic alcohol abuse. For example, research supports that up to 80 percent of chronic alcohol users have a thiamine deficiency, and some in this group will progress to a serious brain disorder known as Wernicke"Korsakoff syndrome (WKS). Symptoms of WKS include confusion, paralysis of eye nerves, impaired muscle coordination, and persistent problems with memory and learning ability.
Fortunately, certain types of cognitive impairment can be reversed through abstinence from alcohol. Studies show that those who have recently undergone medical detox exhibit mild but significant improvement in certain cognitive abilities, especially those related to visuospatial tasks, problem-solving abilities, and short-term memory. Through ongoing abstinence, over a period of several months to one year, a recovering individual will continue to improve cognitive skills, such as visuospatial abilities, working memory, and attention span. In addition, research shows that brain volume can increase with abstinence.

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Alcoholism Addiction Treatment

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Short & Long-Term Effects of Alcohol On Brain Function & Cognitive Ability

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How Does Alcohol Impacts Cognitive Ability? Occasional and moderate drinkers: Heavy and/or chronic drinkers: Alcohol is an integral part of the American social scene. The failed experiment of Prohibition demonstrated the formidable demand Americans have for alcohol. As advertisements caution, alcohol is meant to be enjoyed responsibly; however, alcohol consumption can cause individuals to lose their ability to think responsibly.

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This website says that alcohol gives us difficulties with walking, blurred vision, slurred speech, slowed reaction times, impaired memory.

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Binge Drinking and Blackouts

* Drinkers who experience blackouts typically drink too much and too quickly, which causes their blood alcohol levels to rise very rapidly. College students may be at particular risk for experiencing a blackout, as an alarming number of college students engage in binge drinking. Binge drinking, for a typical adult, is defined as consuming five or more drinks in about 2 hours for men, or four or more drinks for women.

Equal numbers of men and women reported experiencing blackouts, despite the fact that the men drank significantly more often and more heavily than the women. This outcome suggests that regardless of the amount of alcohol consumption, females-a group infrequently studied in the literature on blackouts-are at greater risk than males for experiencing blackouts. A woman's tendency to black out more easily probably results from differences in how men and women metabolize alcohol. Females also may be more susceptible than males to milder forms of alcohol-induced memory impairments, even when men and women consume comparable amounts of alcohol (4).

ARE WOMEN MORE VULNERABLE TO ALCOHOL'S EFFECTS ON THE BRAIN?

Women are more vulnerable than men to many of the medical consequences of alcohol use. For example, alcoholic women develop cirrhosis (5), alcohol-induced damage of the heart muscle (i.e., cardiomyopathy) (6), and nerve damage (i.e., peripheral neuropathy) (7) after fewer years of heavy drinking than do alcoholic men. Studies comparing men and women's sensitivity to alcohol-induced brain damage, however, have not been as conclusive.

Using imaging with computerized tomography, two studies (8,9) compared brain shrinkage, a common indicator of brain damage, in alcoholic men and women and reported that male and female alcoholics both showed significantly greater brain shrinkage than control subjects. Studies also showed that both men and women have similar learning and memory problems as a result of heavy drinking (10). The difference is that alcoholic women reported that they had been drinking excessively for only about half as long as the alcoholic men in these studies. This indicates that women's brains, like their other organs, are more vulnerable to alcohol-induced damage than men's (11).

Yet other studies have not shown such definitive findings. In fact, two reports appearing side by side in the American Journal of Psychiatry contradicted each other on the question of gender-related vulnerability to brain shrinkage in alcoholism (12,13). Clearly, more research is needed on this topic, especially because alcoholic women have received less research attention than alcoholic men despite good evidence that women may be particularly vulnerable to alcohol's effects on many key organ systems.

BRAIN DAMAGE FROM OTHER CAUSES

People who have been drinking large amounts of alcohol for long periods of time run the risk of developing serious and persistent changes in the brain. Damage may be a result of the direct effects of alcohol on the brain or may result indirectly, from a poor general health status or from severe liver disease.

For example, thiamine deficiency is a common occurrence in people with alcoholism and results from poor overall nutrition. Thiamine, also known as vitamin B1, is an essential nutrient required by all tissues, including the brain. Thiamine is found in foods such as meat and poultry; whole grain cereals; nuts; and dried beans, peas, and soybeans. Many foods in the United States commonly are fortified with thiamine, including breads and cereals. As a result, most people consume sufficient amounts of thiamine in their diets. The typical intake for most Americans is 2 mg/day; the Recommended Daily Allowance is 1.2 mg/day for men and 1.1 mg/day for women (14).

Wernicke-Korsakoff Syndrome

Up to 80 percent of alcoholics, however, have a deficiency in thiamine (15), and some of these people will go on to develop serious brain disorders such as Wernicke-Korsakoff syndrome (WKS) (16). WKS is a disease that consists of two separate syndromes, a short-lived and severe condition called Wernicke's encephalopathy and a long-lasting and debilitating condition known as Korsakoff's psychosis.

The symptoms of Wernicke's encephalopathy include mental confusion, paralysis of the nerves that move the eyes (i.e., oculomotor disturbances), and difficulty with muscle coordination. For example, patients with Wernicke's encephalopathy may be too confused to find their way out of a room or may not even be able to walk. Many Wernicke's encephalopathy patients, however, do not exhibit all three of these signs and symptoms, and clinicians working with alcoholics must be aware that this disorder may be present even if the patient shows only one or two of them. In fact, studies performed after death indicate that many cases of thiamine deficiency-related encephalopathy may not be diagnosed in life because not all the "classic" signs and symptoms were present or recognized.

Human Brain

Schematic drawing of the human brain, showing regions vulnerable to alcoholism-related abnormalities.

Approximately 80 to 90 percent of alcoholics with Wernicke's encephalopathy also develop Korsakoff's psychosis, a chronic and debilitating syndrome characterized by persistent learning and memory problems. Patients with Korsakoff's psychosis are forgetful and quickly frustrated and have difficulty with walking and coordination (17). Although these patients have problems remembering old information (i.e., retrograde amnesia), it is their difficulty in "laying down" new information (i.e., anterograde amnesia) that is the most striking. For example, these patients can discuss in detail an event in their lives, but an hour later might not remember ever having the conversation.

Treatment

The cerebellum, an area of the brain responsible for coordinating movement and perhaps even some forms of learning, appears to be particularly sensitive to the effects of thiamine deficiency and is the region most frequently damaged in association with chronic alcohol consumption. Administering thiamine helps to improve brain function, especially in patients in the early stages of WKS. When damage to the brain is more severe, the course of care shifts from treatment to providing support to the patient and his or her family (18). Custodial care may be necessary for the 25 percent of patients who have permanent brain damage and significant loss of cognitive skills (19).

Scientists believe that a genetic variation could be one explanation for why only some alcoholics with thiamine deficiency go on to develop severe conditions such as WKS, but additional studies are necessary to clarify how genetic variants might cause some people to be more vulnerable to WKS than others.

LIVER DISEASE

Most people realize that heavy, long-term drinking can damage the liver, the organ chiefly responsible for breaking down alcohol into harmless byproducts and clearing it from the body. But people may not be aware that prolonged liver dysfunction, such as liver cirrhosis resulting from excessive alcohol consumption, can harm the brain, leading to a serious and potentially fatal brain disorder known as hepatic encephalopathy (20).

Hepatic encephalopathy can cause changes in sleep patterns, mood, and personality; psychiatric conditions such as anxiety and depression; severe cognitive effects such as shortened attention span; and problems with coordination such as a flapping or shaking of the hands (called asterixis). In the most serious cases, patients may slip into a coma (i.e., hepatic coma), which can be fatal.

New imaging techniques have enabled researchers to study specific brain regions in patients with alcoholic liver disease, giving them a better understanding of how hepatic encephalopathy develops. These studies have confirmed that at least two toxic substances, ammonia and manganese, have a role in the development of hepatic encephalopathy. Alcohol-damaged liver cells allow excess amounts of these harmful byproducts to enter the brain, thus harming brain cells.

Treatment

Physicians typically use the following strategies to prevent or treat the development of hepatic encephalopathy.

Treatment that lowers blood ammonia concentrations, such as administering L-ornithine L-aspartate.

Techniques such as liver-assist devices, or "artificial livers," that clear the patients' blood of harmful toxins. In initial studies, patients using these devices showed lower amounts of ammonia circulating in their blood, and their encephalopathy became less severe (21).

Liver transplantation, an approach that is widely used in alcoholic cirrhotic patients with severe (i.e., end-stage) chronic liver failure. In general, implantation of a new liver results in significant improvements in cognitive function in these patients (22) and lowers their levels of ammonia and manganese (23).

ALCOHOL AND THE DEVELOPING BRAIN

Drinking during pregnancy can lead to a range of physical, learning, and behavioral effects in the developing brain, the most serious of which is a collection of symptoms known as fetal alcohol syndrome (FAS). Children with FAS may have distinct facial features (see illustration). FAS infants also are markedly smaller than average. Their brains may have less volume (i.e., microencephaly). And they may have fewer numbers of brain cells (i.e., neurons) or fewer neurons that are able to function correctly, leading to long-term problems in learning and behavior.

Fetal Alcohol Syndrome

Children with fetal alcohol syndrome (FAS) may have distinct facial features.

Treatment

Scientists are investigating the use of complex motor training and medications to prevent or reverse the alcohol-related brain damage found in people prenatally exposed to alcohol (24). In a study using rats, Klintsova and colleagues (25) used an obstacle course to teach complex motor skills, and this skills training led to a re-organization in the adult rats' brains (i.e., cerebellum), enabling them to overcome the effects of the prenatal alcohol exposure. These findings have important therapeutic implications, suggesting that complex rehabilitative motor training can improve motor performance of children, or even adults, with FAS.

Scientists also are looking at the possibility of developing medications that can help alleviate or prevent brain damage, such as that associated with FAS. Studies using animals have yielded encouraging results for treatments using antioxidant therapy and vitamin E. Other preventive therapies showing promise in animal studies include 1-octanol, which ironically is an alcohol itself. Treatment with l-octanol significantly reduced the severity of alcohol's effects on developing mouse embryos (26). Two molecules associated with normal development (i.e., NAP and SAL) have been found to protect nerve cells against a variety of toxins in much the same way that octanol does (27). And a compound (MK-801) that blocks a key brain chemical associated with alcohol withdrawal (i.e., glutamate) also is being studied. MK-801 reversed a specific learning impairment that resulted from early postnatal alcohol exposure (28).

Though these compounds were effective in animals, the positive results cited here may or may not translate to humans. Not drinking during pregnancy is the best form of prevention; FAS remains the leading preventable birth defect in the United States today.

GROWING NEW BRAIN CELLS

For decades scientists believed that the number of nerve cells in the adult brain was fixed early in life. If brain damage occurred, then, the best way to treat it was by strengthening the existing neurons, as new ones could not be added. In the 1960s, however, researchers found that new neurons are indeed generated in adulthood-a process called neurogenesis (29). These new cells originate from stem cells, which are cells that can divide indefinitely, renew themselves, and give rise to a variety of cell types. The discovery of brain stem cells and adult neurogenesis provides a new way of approaching the problem of alcohol-related changes in the brain and may lead to a clearer understanding of how best to treat and cure alcoholism (30).

For example, studies with animals show that high doses of alcohol lead to a disruption in the growth of new brain cells; scientists believe it may be this lack of new growth that results in the long-term deficits found in key areas of the brain (such as hippocampal structure and function) (31,32). Understanding how alcohol interacts with brain stem cells and what happens to these cells in alcoholics is the first step in establishing whether the use of stem cell therapies is an option for treatment (33).

SUMMARY

Alcoholics are not all alike. They experience different degrees of impairment, and the disease has different origins for different people. Consequently, researchers have not found conclusive evidence that any one variable is solely responsible for the brain deficits found in alcoholics. Characterizing what makes some alcoholics vulnerable to brain damage whereas others are not remains the subject of active research (34).

The good news is that most alcoholics with cognitive impairment show at least some improvement in brain structure and functioning within a year of abstinence, though some people take much longer (35-37). Clinicians must consider a variety of treatment methods to help people stop drinking and to recover from alcohol-related brain impairments, and tailor these treatments to the individual patient.

Advanced technology will have an important role in developing these therapies. Clinicians can use brain-imaging techniques to monitor the course and success of treatment, because imaging can reveal structural, functional, and biochemical changes in living patients over time. Promising new medications also are in the early stages of development, as researchers strive to design therapies that can help prevent alcohol's harmful effects and promote the growth of new brain cells to take the place of those that have been damaged by alcohol.

References

Alcohol abuse and alcoholism. In: Nixon, S.J., ed. (1) Parsons, O.A. Neuropsychology for Clinical Practice. Washington, DC: American Psychological Press, 1996. pp. 175-201.(2) White, A.M. What happened? Alcohol, memory blackouts, and the brain. Alcohol Research & Health 27(2):186-196, 2003. (3) White, A.M.; Jamieson-Drake, D.W.; and Swartzwelder, H.S. Prevalence and correlates of alcohol-induced blackouts among college students: Results of an e-mail survey. Journal of American College Health 51:117-131, 2002. (4) Mumenthaler, M.S.; Taylor, J.L.; O'Hara, R.; et al. Gender differences in moderate drinking effects. Alcohol Research & Health 23:55-64, 1999.(5) Loft, S.; Olesen, K.L.; and Dossing, M. Increased susceptibility to liver disease in relation to alcohol consumption in women. Scandinavian Journal of Gastroenterology 22: 1251-1256, 1987. (6) Fernandez- Sola, J.; Estruch, R.; Nicolas, J.M.; et al. Comparison of alcoholic cardiomyopathy in women versus men. American Journal of Cardiology 80:481-485, 1997.(7) Ammendola, A.; Gemini, D.; Iannacone, S.; et al. Gender and peripheral neuropathy in chronic alcoholism: A clinical-electroneurographic study. Alcohol and Alcoholism 35:368-371, 2000. (8) Jacobson, R. The contributions of sex and drinking history to the CT brain scan changes in alcoholics. Psychological Medicine 16:547-559, 1986.(9) Mann, K.; Batra, A.; Gunther, A.; and Schroth, G. Do women develop alcoholic brain damage more readily than men? Alcoholism: Clinical and Experimental Research 16(6):1052-1056, 1992. (10) Nixon, S.; Tivis, R.; and Parsons, O. Behavioral dysfunction and cognitive efficiency in male and female alcoholics. Alcoholism: Clinical and Experimental Research 19(3):577-581, 1995.(11) Hommer, D.W. Male and female sensitivity to alcohol-induced brain damage. Alcohol Research & Health 27(2):181-185, 2003. (12) Hommer, D.W.; Momenan, R.; Kaiser, E.; and Rawlings, R.R. Evidence for a gender-related effect of alcoholism on brain volumes. American Journal of Psychiatry 158:198-204, 2001.(13) Pfefferbaum, A.; Rosenbloom, M.; Deshmukh, A.; and Sullivan, E. Sex differences in the effects of alcohol on brain structure. American Journal of Psychiatry 158:188-197, 2001. (14) National Academy of Sciences. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. 1999.(15) Morgan, M.Y. Alcohol and nutrition. British Medical Bulletins 38:21-29, 1982. (16) Martin, P.R.; Singleton, C.K.; and Hiller-Sturmhöfel, S.H. The role of thiamine in alcoholic brain disease. Alcohol Research & Health 27(2):134-142, 2003. (17) Victor, M.; Davis, R.D.; and Collins, G.H. The Wernicke-Korsakoff Syndrome and Related Neurologic Disorders Due to Alcoholism and Malnutrition. Philadelphia: F.A. Davis, 1989.(18) Martin, P. "Wernicke-Korsakoff syndrome: Alcohol-related dementia." Family Caregiver Alliance Fact Sheet, 1998. (19) Cook, C. "The Wernicke-Korsakoff syndrome can be treated." The Medical Council on Alcohol, vol. 19, 2000.(20) Butterworth, R.F. Hepatic encephalopathy-A serious complication of alcoholic liver disease. Alcohol Research & Health 27(2):143-145, 2003.(21) Mitzner, S.R., and Williams, R. Albumin dialysis MARS 2003. Liver International 23(Suppl. 3):1-72, 2003.(22) Arria, A.M.; Tarter, R.E.; Starzl, T.E.; and Van Thiel, D.H. Improvement in cognitive functioning of alcoholics following orthotopic liver transplantation. Alcoholism: Clinical and Experimental Research 15(6):956-962, 1991.(23) Pujol, A.; Pujol, J.; Graus, F.; et al. Hyperintense globus pallidus on T1-weighted MRI in cirrhotic patients is associated with severity of liver failure. Neurology 43:65-69, 1993. (24) Chen, W-J.A.; Maier, S.E.; Parnell, S.E.; and West, J.E. Alcohol and the developing brain: Neuroanatomical studies. Alcohol Research & Health 27(2):174-180, 2003. (25) Klintsova, A.Y.; Scamra, C.; Hoffman, M.; et al. Therapeutic effects of complex motor training on motor performance deficits induced by neonatal binge-like alcohol exposure in rats: II. A quantitative stereological study of synaptic plasticity in female rat cerebellum. Brain Research 937:83-93, 2002. (26) Chen, S.Y.; Wilkemeyer, M.F.; Sulik, K.K.; and Charness, M.E. Octanol antagonism of ethanol teratogenesis. FASEB Journal 15:1649-1651, 2001. (27) Spong, C.Y.; Abebe, D.T.; Gozes, I.; et al. Prevention of fetal demise and growth restriction in a mouse model of fetal alcohol syndrome. Journal of Pharmacology and Experimental Therapeutics 297:774-779, 2001. (28) Thomas, J.D.; Fleming, S.L.; and Riley, E.P. Administration of low doses of MK-801 during ethanol withdrawal in the developing rat pup attenuates alcohol's teratogenic effects. Alcoholism: Clinical and Experimental Research 26(8):1307-1313, 2002. (29) Altman, J., and Das, G.D. Autoradiographic and histological evidence of postnatal hippocampal neurogenesis in rats. Journal of Comparative Neurology 124(3):319-335, 1965.(30) Crews, F.T., and Nixon, K. Alcohol, neural stem cells, and adult neurogenesis. Alcohol Research & Health 27(2): 197-204, 2003.(31) Nixon, K., and Crews, F.T. Binge ethanol exposure decreases neurogenesis in adult rat hippocampus. Journal of Neurochemistry 83(5):1087-1093, 2002.(32) Herrera, D.G.; Yague, A.G.; Johnsen-Soriano, S.; et al. Selective impairment of hippocampal neurogenesis by chronic alcoholism: Protective effects of an antioxidant. Proceedings of the National Academy of Science of the U.S.A. 100(13):7919-7924, 2003.(33) Crews, F.T.; Miller, M.W.; Ma, W.; et al. Neural stem cells and alcohol. Alcoholism: Clinical and Experimental Research 27(2):324-335, 2003.(34) Oscar-Berman, M., and Marinkovic, K. Alcoholism and the brain: An overview. Alcohol Research & Health 27(2):125-133, 2003.(35) Bates, M.E.; Bowden, S.C.; and Barry, D. Neurocognitive impairment associated with alcohol use disorders: Implications for treatment. Experimental and Clinical Psychopharmacology 10(3):193-212, 2002.(36) Gansler, D.A.; Harris, G.J.; Oscar-Berman, M.; et al. Hypoperfusion of inferior frontal brain regions in abstinent alcoholics: A pilot SPECT study. Journal of Studies on Alcohol 61:32-37, 2000.(37) Sullivan, E.V.; Rosenbloom, M.J.; Lim, K.O.; and Pfefferbaum, A. Longitudinal changes in cognition, gait, and balance in abstinent and relapsed alcoholic men: Relationships to changes in brain structure. Neuropsychology 14:178-188, 2000.(38) Rosenbloom, M.; Sullivan, E.V.; and Pfefferbaum, A. Using magnetic resonance imaging and diffusion tensor imaging to assess brain damage in alcoholics. Alcohol Research & Health 27(2):146-152, 2003.(39) Kensinger, E.A.; Clarke, R.J.; and Corkin, S. What neural correlates underlie successful encoding and retrieval? A functional magnetic resonance imaging study using a divided attention paradigm. Journal of Neuroscience 23(6):2407-2415, 2003.(40) Wong, D.F.; Maini, A.; Rousset, O.G.; and Brasíc , J.R. Positron emission tomography-A tool for identifying the effects of alcohol dependence on the brain. Alcohol Research & Health 27(2):161-173, 2003.(41) Porjesz, B., and Begleiter, H. Alcoholism and human electrophysiology. Alcohol Research & Health 27(2):153-160, 2003.(42) Porjesz, B., and Begleiter, H. Human brain electrophysiology and alcoholism. In: Tarter, R., and Van Thiel, D., eds. Alcohol and the Brain. New York: Plenum, 1985. pp. 139-182.(43) Begleiter, H.; Porjesz, B.; Bihari, B.; and Kissin, B. Event-related potentials in boys at risk for alcoholism. Science 225:1493-1496, 1984.(44) Polich, J.; Pollock, V.E.; and Bloom, F.E. Meta-analysis of P300 amplitude from males at risk for alcoholism. Psychological Bulletin 115:55-73, 1994.

Resources

Back issues of

Source material for this Alcohol Alert originally appeared in the journal Alcohol Research & Health, "Alcoholic Brain Damage" (Vol. 27, No. 2, 2003).

Alcohol Research & Health is the quarterly, peer-reviewed journal published by the National Institute on Alcohol Abuse and Alcoholism. Each issue of AR&H provides in-depth focus on a single topic in the field of alcohol research.
Alcohol Research & Health and additional resources can be downloaded from NIAAA's Web site, www.niaaa.nih.gov. Subscriptions are available from the Superintendent of Documents for $25. Write to New Orders, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954; or fax 202/512-2250 .

All material contained in the Alcohol Alert is in the public domain and may be used or reproduced without permission from NIAAA. Citation of the source is appreciated.
Copies of the Alcohol Alert are available free of charge from the
National Institute on Alcohol Abuse and Alcoholism Publications Distribution Center
P.O. Box 10686, Rockville, MD 20849-0686.
Prepared: October 2004

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Binge Drinking and Blackouts * Drinkers who experience blackouts typically drink too much and too quickly, which causes their blood alcohol levels to rise very rapidly. College students may be at particular risk for experiencing a blackout, as an alarming number of college students engage in binge drinking.

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How does alcohol affect our brain?

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Brain damage from Alcohol.