How Alcohol Affects the Brain and Behavior

Alcohol is an inseparable aspect of American society and, for many people, a significant part of their daily lives.  Alcoholic beverages are considered the main attraction at many social events and the primary profit-makers at a variety of recreational and entertainment venues. Although an extremely powerful, billion-dollar advertising industry relentlessly promotes the underlying message that alcohol consumption is normal, appealing, and even sexy, in reality, it is a neurotoxin and remains the world’s most widely abused substance. Once touted as a relatively harmless and potentially beneficial beverage if consumed in moderation, recent scientific findings have shattered this myth.  According to the Global Burden of Disease Studies that concluded in 2016, no amount of alcohol is deemed safe for human consumption.   

STATISTICS

To put the devastating scope of alcohol consumption into proper perspective, one must first consider evidence that contradicts previous claims of its potential benefits.   For example, the following statistics underscore alcohol’s total socioeconomic burden, threat to mortality, impact on mental health, and assault on quality of life:

• In 2015, The National Survey on Drug Use and Health (NSDUH) reported that approximately 90 percent of people ages 18 or older consumed alcohol at least once in their lifetime.
• Approximately 15 million adults over the age of 18 met the official diagnostic criteria for alcohol use disorder (AUD). Within that population, only 7 percent received treatment within the past year.
• Approximately 625,000 adolescents ages 12-17 suffered from AUD, with only five percent receiving treatment within the past year.
• Approximately three-quarters of the total costs associated with alcohol abuse are the result of binge drinking— defined as the consumption of at least five alcoholic beverages within a two-hour time span (for men) and at least four alcoholic beverages within the same period (for women).
• In 2018, approximately three million deaths were linked to excessive alcohol consumption, which equates to five percent of all global deaths.
• In 2014, the World Health Organization (WHO) reported that alcohol was responsible for either producing or contributing to over 200 diseases and medical conditions.
• Approximately 10 percent of children in the US live with a parent suffering from untreated alcohol abuse or an officially diagnosed AUD.
• The Centers for Disease Control and Prevention (CDC) reports that 38 million people binge drink at least four times per month, with approximately six dying daily from alcohol poisoning. The CDC further reports that, on average, 40 percent of college students admit to regular binge drinking.
• According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), approximately 17 million adults over the age of 18 met the diagnostic criteria for AUD.
• Approximately 30 to 50 percent of people struggling with AUDs simultaneously suffer from depression. According to the American Psychological Association (APA), alcohol abuse worsens pre-existing depression while creating new physical, cognitive and social deficits.
• The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in approximately 30 percent of U.S. suicides, blood alcohol levels (BALs) met or exceeded the legal limit.
• Alcohol-related car crashes, DUI arrests and insurance claims cost Americans billions of dollars annually (approximately $250 billion in 2010). The loss of productivity in the workplace and destructive effect on the family unit are so extreme that, in the opinion of many experts, exact figures are not quantifiable.

ALCOHOL’S EFFECT ON COGNITION

Alcohol’s effect on cognition is devastating.  Like other mind-altering substances, alcohol disturbs the delicate balance of brain chemicals and distorts perception. GABA and dopamine, for example, are two neurotransmitters located in the brain and throughout the central nervous system (CNS). Excessive alcohol consumption unleashes a surge of these naturally occurring chemicals that is initially perceived as highly pleasurable to users. However, in addition this fleeting high, alcohol simultaneously causes elevated blood pressure, shortness of breath, accelerated heart rate, delusions, hallucinations, depression and, in many people, aggression— all of which distort the clarity and reliability of cognition.

When used immoderately, alcohol leads to erratic behavior, dangerous impulsivity, and a generally muddy, distorted mindset that inevitably creates problems. Social difficulties, professional problems, chaotic and even violent family or personal relationships, criminal activity, and a loss of satisfaction and meaning in life are all hallmarks of alcoholism. The following blood alcohol content measurements provide a clear window of insight into the cognitive decline triggered by excessive alcohol consumption:   

• 04-.059 percent BAC results in lower inhibitions and slightly impaired judgment.
• 0.1–129 percent BAC results in significant loss of judgment, impaired coordination and hearing, and slurred speech.
• 0.13-0.159 percent BAC results in blurred vision, significant loss of balance and dysphoria.
• 2-0.249 percent BAC results in loss of motor skills, disorientation, inability to stand or walk, and vomiting.
• 0.25-0.399 percent BAC results in unconsciousness (black outs) and alcohol poisoning.
• 4 percent or higher BAC results in a coma or respiratory failure-induced death.

Over time, the effect of alcohol on brain tissue and function becomes debilitating. A 2008 study published in the Archives of Neurology revealed that excessive alcohol consumption eventually leads to brain atrophy. According to the findings, people who consumed more than 14 beverages per week over a 20-year period had smaller brains than those who did not by a margin of 1.6 percent. The study also revealed accelerated cognitive decline and premature memory loss— neither of which are reversible.

ALCOHOL AND DEPRESSION

There is a cyclical relationship between alcohol and depression.  Although alcohol may not be the original cause of a user’s depression, it almost always exacerbates it by depleting the body and mind of vital nutrients. For many people, alcohol represents a temporary escape from anxiety, trauma, relationship problems, major life stressors, and personal insecurities.  We’ve all heard the terms “he’s out to sea,” or “taking a trip to Margaritaville,” sayings which aptly characterize alcohol’s escapist charms. But in an all too common scenario, the same people who abuse alcohol to temporarily escape from life’s problems find themselves clinically depressed and unable to make it through a day or week without a drink—and more frequently—a binge drinking session.

Once someone becomes alcohol-dependent, that fact alone often drives them into the depths of depression. Assuming it doesn’t, the sheer chemical burden of the brain changes associated with their excessive drinking eventually results in the same outcome. As the overall poor mental health condition of contemporary society shows, drinking is not the answer to people’s problems, but rather a serious detriment to lasting health and happiness. Excessive alcohol consumption is associated with the following varieties of depression, all of which are considered clinically significant:

• Major Depressive Disorder (MDD) ­– a type of severe depression in which sufferers experience debilitating symptoms that interfere with their ability to function normally. It may appear as an isolated episode, but most of those with MDD have multiple episodes throughout their lives.
• Bipolar Disorder (BPD) – a serious disorder in which sufferers vacillate between episodes of depression and hypomania or mania, a state characterized by exaggerated moods and super-charged energy.
• Psychotic Depression – a type of depression in which sufferers experience severe symptoms accompanied by psychosis. Hallucinations may be of an audio or visual variety, or limited to having false beliefs and delusions.
• Persistent Depressive Disorder – a depressed mood lasting for two years or more. In certain cases, it is a lifelong condition.
• Seasonal Affective Disorder (SAD)—a type of depression that usually begins in the late fall and early winter months as sunlight decrease and the body produces less vitamin D. It can be alleviated by exposure to sunlight or even artificial light, but not when excessive drinking prevents the body from metabolizing necessary vitamins.

ALCOHOL-INDUCED DISEASES

Alcohol’s artificial manipulation of brain chemistry and assault on the body produces a multitude of diseases, many of which are chronic and relapsing (permanent), and all of which are serious. The presence of these conditions, in turn, leads to a far greater likelihood of corresponding mental health problems including anxiety, panic attacks, personality disorders, and a variety of other psychological issues. Many alcoholics have a prematurely aged complexion and obvious cognitive glitches that are the result of years of bodily abuse and a deteriorated mental condition.

Of all the anguishing diseases that result from alcoholism, perhaps none are more widely feared than Wernicke-Korsakoff syndrome (WKS)—a debilitating neurological condition common in late-stage alcoholics. “Wet brain,” as it is commonly known, is the result of progressively damaged neural pathways and deteriorated brain structure. Although the effects of wet brain can be managed when caught early and treated aggressively, once the disease progresses, it is generally considered irreversible and impacts every level of behavioral and physical functioning.

PROGNOSIS

Although alcoholism is an extremely difficult disorder to treat once fully developed, recovery is entirely possible, and there are more treatment options than ever before.  Despite the barrage of abuse that psychological and physiological processes suffer as a result of alcoholism, the body demonstrates a remarkable capacity for self-regeneration and healing. Even in cases where treatment is delayed, significant benefits can be expected from following a strict treatment program in the context of a medically managed setting.

If you or someone you love are suffering from alcoholism and in need of help, call a substance abuse professional today.  The sooner you take action, the greater your chances are of making a full recovery and living a happy, healthy lifestyle.

For more about alcoholism and recovery, check out these related articles:

1. “Alcohol Abuse: How to Get Help”
2. “Can You Reverse Alcohol’s Effects on the Brain and Liver?”
3. “Prenatal Effects of Drug and Alcohol Abuse”
4. “Dangers of Alcohol Detox at Home and Stopping Cold Turkey”

Sources:

1. Alcohol Research Current Reviews (ARCR). Alcohol’s Effects on Brain and Behavior. Jan, 2010.
2. Neuropsychology Review. Alcohol: Effect on Neurobehavioral Functions and the Brain. September, 2017.
3. American Journal of Public Health.  Key Findings on Alcohol Consumption and a Variety of Health Outcomes from the Nurses’ Health Study. September, 2016.
4. The BMJ. Alcohol in the body. Jan, 2005.