Did you know that alcohol-related incidents claimed 88,000 lives (62,000 men and 26,000 women) in 2015? Alcohol is the third leading preventable cause of death in the United States. In the U.S. alcohol misuse cost the country $249 billion, and three-quarters of those costs are attributed to binge drinking. In 2014 alone, alcohol-impaired driving fatalities accounted for 9,967 deaths.
Alcoholism is a problem that affects us on a global scale. In 2012, 3.3 million deaths were attributed to alcohol worldwide — and more than 10 percent of children in the U.S. live with a parent who has problems with alcohol. Easy access to alcohol has encouraged the problem of underage drinking with more than 7.7 million people aged 12 to 20 reported drinking in the past month.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 86.4 percent of people aged 18 or older reported that they drank alcohol at some point in their life. This should come as no surprise with the accessibility to alcohol, which is legal to buy. Another 70 percent reported that they drank in the past year. More startling statistics, however, about binge drinking show that 26.9 percent of those aged 18 or older said they engaged in the act in the past month.
Another 7 percent mentioned that they participated in heavy alcohol use in the past month. With that said, 15.1 million adults aged 18 or older have alcohol use disorder (AUD), but only 6.7 percent of them received treatment for it.
While alcohol consumption varies across gender, race/ethnicity, data show that men consume more alcohol than women, but women in developed countries drink more than those in developing countries. Given the trend, it is a clear understanding of the underlying social and cultural factors that contribute to these behaviors. Individuals with socioeconomic status (SES), education, income, and occupation are more likely to drink, but low SES groups tend to drink larger quantities of alcohol. While many factors contribute to drinking in the United States, one theory is the prevalence of drinking in nearly all parts of life.
One of the problems we must highlight is how ingrained alcohol is in American culture. For example, in college, having a high tolerance for alcohol is lauded. We have a growing number of social media influencers who glamorize the use of alcohol, and the advertising we consume about the product is that it’s safe and elegant.
Alcohol is none of the above, and there is a dark side of it that seldom is spoken about by the media. The only downfall that is spoken about in major news media is the high levels of drunk driving crashes, and the countless victims that have their lives cut too short by the hands of those who drive drunk. Alcohol can severely impact one’s memory, liver, and kidneys, and it can cause cancer. One of the most underreported problems related to alcohol is its impact on our memory.
Alcohol is the active ingredient in beer, wine, and liquor. The process known as fermentation produces alcohol. When yeast is fermented, sugar breaks down into carbon dioxide and alcohol. Carbon dioxide then exits the process through gas bubbles and leaves behind a combination of water and ethanol. The process is precise, and if any mistakes are made, it could result in tainted alcohol, which has been a cause for concern in many resorts lately in Mexico.
Alcohol is typically made from sugar and yeast, but different sources of sugar can produce different types of alcohol. The sugar made from the grape pulp is combined with yeast to create red or white wine, and for beer, the source of sugar is barley in most cases. Once the sugars are ready for use, yeast is added, and the fermentation process starts.
Alcohol is classified as a sedative-hypnotic drug, which means it acts to depress the central nervous system (CNS) at high doses. At lower doses, however, alcohol acts as a stimulant inducing feelings of euphoria, talkativeness, but drinking too much alcohol in one session can lead to drowsiness, respiratory depression, coma, or even death.
When a drink has been consumed and enters into the body, alcohol is rapidly absorbed into the blood (20 percent through the stomach and 80 percent through the small intestine), with effects felt within five to 10 minutes after ingestion. The effects typically peak in the blood after 30 to 90 minutes and are carried through all of the body’s organs.
The liver metabolizes most of the alcohol and turns it into carbon dioxide and water. The rest is excreted through the lungs, kidneys, and into the sweat. It is why breath tests can detect alcohol. The liver can break down only a certain amount of alcohol per hour, which is around one standard drink.
The blood-alcohol concentration (BAC) rises, and the feeling of drunkenness occurs, when alcohol is consumed faster than the liver can break it down. The BAC will not correlate precisely with symptoms, and different people have symptoms even after drinking similar amounts of alcohol.
Blood-alcohol levels vary by the person, which are influenced by:
It’s true that while alcohol can stimulate individuals and help them socialize at a party, alcohol, as we’ve mentioned, is still a central nervous system (CNS) depressant. The depressant effects of alcohol are apparent when those who drink have slurred speech or poor limb coordination that prevents them from walking normally. While these outward signs of intoxication can be easily observed, it isn’t clear how alcohol acts on a deeper level inside the body. So how does the substance work on a neurological level?
Alcohol affects brain chemistry by altering levels of neurotransmitters. Neurotransmitters are chemical messengers that transmit signals throughout the body that control thought processes, behavior, and emotion. Neurotransmitters are either considered excitatory or inhibitory.
Excitatory means they stimulate brain electrical activity, and inhibitory refers to a decrease in brain electrical activity. Alcohol increases the effects of the inhibitory neurotransmitter known as gamma-Aminobutyric acid (GABA).
GABA causes slow movements and slurred speech that is commonly attributed to alcohol consumption. On that same note, alcohol inhibits the excitatory neurotransmitter glutamate. Suppressing this stimulant results in a similar physiological slowdown, and increasing GABA and decreasing glutamate increases the amount of another chemical known as dopamine. Dopamine is referred to as the brain’s reward center, and it creates the feeling of pleasure that occurs when someone consumes an alcoholic beverage.
Alcohol affects different regions in the brain in different ways:
Occasional drinkers can experience one or more short-term effects after one or more drinks. Memory impairment can begin after a few drinks, and it can become significantly worse as the consumption increases. When consumed in high volumes on an empty stomach, the result can be a blackout. Occasional drinkers can recover from blackouts without long-term mental issues, but there are many dangers associated with acute alcohol intoxication. Those with lower inhibitions that drink less frequently can be involved in alcohol-related incidents such as a car accident, unprotected sex, or vandalism.
The U.S. Centers for Disease Control and Prevention (CDC) considers moderate drinkers as individuals who consume up to one drink per day for women, and up to two drinks per day for men. As mentioned earlier, the media portray alcohol positively. News outlets consistently speak about the health benefits of alcohol when consumed in moderation.
The guideline listed above mentions, however, that it is not a reason to start consuming alcoholic beverages. Moderate alcohol consumption is attributed to increased risk of breast cancer and causing violence, falls, drownings, and car accidents. Moderate drinking does not protect a person from the cognitive impairment associated with alcohol, and dangerous consequences can still occur as a result.
Unlike their occasional or moderate drinking counterparts, an individual who drinks heavily over an extended period may develop deficits in brain functioning that could persist despite achieving sobriety. Cognitive problems no longer occur from drinking alcohol but from brain damage that prior drinking has caused. Long-term alcohol abuse can adversely affect the brain’s natural wiring to the point that stopping may not be enough to reverse the cognitive problems.
The NIAAA found that most heavy long-term alcohol users will experience mild-to-moderate impairment of intellectual functioning as well as diminished brain size. The most common of these impairments will relate to the ability of abstract thinking as well as the ability to perceive and remember the location of objections in two and three-dimensional space.
There are many brain disorders attributed to chronic alcohol abuse. Researchers estimate that up to 80 percent of chronic alcohol users have a thiamine deficiency, and some in this category will eventually develop a severe brain disorder known as Wernicke-Korsakoff syndrome (WKS). The symptoms are intense and can include paralysis of eye nerves, confusion, impaired muscle coordination, and persistent problems with memory and learning ability.
There is a silver lining for those who do abstain from their alcohol use, and that is that some cognitive important can be reversed. Studies indicate that those who have recently undergone medical detox exhibit mild but significant improvement in problem-solving, and short-term memory. Continued abstinence from alcohol over several months to one year will improve these functions to an even greater extent. Brain volume can also increase with time if the individual is consistent with their goal.
There are two types of memory, retrospective (long-term) memory and perspective or working (short-term) memory. Retrospective memory is the ability to remember all events and episodes that have happened throughout our life. Perspective memory is day-to-day memory function.
Alcohol affects prospective, day-to-day memory most often. It’s common to forget things from time to time, but those who consume substantial amounts of alcohol tend to make more memory mistakes than those who do not drink or drink less frequently.
A study published by Alcoholism: Clinical and Experimental Research highlight the findings of researchers who looked at the amount of alcohol consumed and its effect on daily memory function. It showed that a heavy drinker reported more than 30 percent more memory-related issues than someone who reportedly did not drink, and almost 25 percent more problems than those who said they drank only small amounts of alcohol.
Study participants who reported higher levels of alcohol consumption were more likely to miss appointments, forget birthdays, or pay bills on time. Even in those who stayed within a health drinking limit found a significant impact on memory loss issues.
Alcohol significantly inhibits the ability of the brain to transfer information from short-term to long-term storage. An example of this phenomena is a delivery truck on a route that gets sidetracked and does not make it to its final destination. The delivery never occurs. On that same note, a person just cannot remember what they need. The effects are more noticeable when someone is intoxicated.
Heavy drinkers can damage their hippocampus, which is vital to memory and learning. Heavy drinking can cause the hippocampus to shrink over time and change neurons. One brain chemical that is susceptible to small amounts of alcohol is glutamate. Glutamate also affects memory and causes some people to black out temporarily. Blacking out is when someone will forget much of what occurred after a heavy night of alcohol consumption.”
For most, binge-drinking significant amounts of alcohol cause them to black out. Studies agree that heavy drinking alone doesn’t cause blackouts. A person must consume large quantities of alcohol in a short period. The leading cause of a blackout is a rapid rise in blood alcohol, which can be propelled by drinking on an empty stomach or while dehydrated. Blackouts are caused by an inability to transfer information from short-term to long-term memory when blood-alcohol levels were rising.
Alcohol affects everyone differently, but research indicates that some brains are more apt to blacking out than others. The reverse in this scenario also rings true — some minds may be more resistant to blacking out. In a study of 100 alcoholics, 36 admitted to never blacking out despite heavy alcohol use. Research also included that someone who experienced a blackout is more likely to blackout in the future. The long-term effects are unknown, but they may cause the brain to be more susceptible to memory loss in the future.
A similar number of men and women report blacking out, but men drink significantly more than women. The conclusion is that women are at higher risk for blacking out than men because of the difference in ways men and women metabolize alcohol. Women are more likely to experience the effects of alcohol, such as liver cirrhosis, heart damage, nerve damage, and other diseases caused by alcohol.
More research is being done to find new ways to help those who have experienced memory loss to recover their brain function. Future event simulation (FES) is a memory technique involving strategies such as making linked and indexed lists.
Studies showed that FES helped those struggling with alcohol-induced memory loss remember event-based tasks. Other reports have indicated that abstaining from alcohol over several months to a year allows for structural brain changes to correct themselves partially.
Abstaining from alcohol will also help to reverse some adverse effects on thinking skills that include problem-solving, memory, and attention.
When asked how alcohol problems are treated, some may assume 12-step programs and 28-day residential treatment, but various methods benefit people who need treatment. Over the past 60 years, there have been significant advances in addiction studies, and treatment has become much more attainable and successful. There is not a one-size-fits-all model when it comes to treatment; what works for one person is not always going to work for another, but understanding the different options available is a significant first step.
The first portion of treatment, however, should be medical detoxification. As we’ve mentioned throughout this article, alcohol withdrawals can be fatal if not treated under the care of professionals. It is a process that can take between three and seven days, depending on the severity of the addiction. The process will allow you to be under the supervision of medical professionals that can provide support, and treat you for any unforeseen circumstances that can arise from alcohol withdrawal.
Clinicians will determine the next step of treatment after a thorough assessment. If they decide your addiction is severe, or you have a history of relapse, they will suggest residential treatment for continued intensive care. If you have access to a sober living environment and have no history of relapse, they can recommend outpatient treatment that allows you to go home once your therapy sessions conclude. Not all cases are the same and will be treated individually.
Wernicke-Korsakoff Syndrome Information Page. (n.d.). from https://www.ninds.nih.gov/Disorders/All-Disorders/Wernicke-Korsakoff-Syndrome-Information-Page
Cognitive Impairment and Recovery From Alcoholism Alert No: 53-2001. (n.d.). from https://pubs.niaaa.nih.gov/publications/aa53.htm
CDC – Frequently Asked Questions – Alcohol. (n.d.). from https://www.cdc.gov/alcohol/faqs.htm
Watson, S. (2018, June 28). How Alcoholism Works. from https://science.howstuffworks.com/life/inside-the-mind/human-brain/alcoholism4.htm
What happens when you drink alcohol? (n.d.). from https://www.alcohol.org.nz/alcohol-its-effects/about-alcohol/what-happens-when-you-drink-alcohol
CBS News. (2018, November 29). Mexican resort served "poisonous" alcohol to woman who died, family says. from https://www.cbsnews.com/news/abbey-conner-family-sues-mexican-resort-daughter-died-drinking-possibly-tainted-alcohol-iberostar-hotel/
Sudhinaraset, M., Wigglesworth, C., & Takeuchi, D. T. (2016). Social and Cultural Contexts of Alcohol Use: Influences in a Social-Ecological Framework. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4872611/
Alcohol Facts and Statistics. (n.d.). from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics