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1. Alcohol

What is Alcohol?

Alcohol is considered a drug and it’s classified as a depressant, which means it slows down vital functions resulting in slurred speech, unsteady movement, disturbed perceptions and an inability to react quickly. Although classified as a depressant, the amount of alcohol consumed determines the type of effect. Most people drink for the stimulant effect, such as a beer or glass of wine taken to “loosen up.” But if a person consumes more than the body can handle, they then experience alcohol’s depressant effect. They start to feel “stupid” or lose coordination and control. [1]

Alcohol in You

Alcohol enters the stomach and small intestine, where small blood vessels carry it to the bloodstream. Approximately 20% of alcohol is absorbed through the stomach and most of the remaining 80% is absorbed through the small intestine.

 

Alcohol is metabolized by the liver, where enzymes break down the alcohol. In general, the liver can process one ounce of liquor (or one standard drink) in one hour. If you consume more than this, your system becomes saturated, and the additional alcohol will accumulate in the blood and body tissues until it can be metabolized. This is why having a lot of shots or playing drinking games can result in high blood alcohol concentrations that last for several hours. [2]

Blood Alcohol Content

 

Blood Alcohol Content is a measure of the amount of alcohol that is present in the blood, based on the volume of alcohol consumed over a given period of time. The factors that affect your BAC include the following: [3]

Age – As you age, the intoxicating effects of alcohol become increasingly pronounced.

Gender – Alcohol is highly water soluble. Because women generally have a lower water content in their bodies than men, they usually reach a higher BAC if they consume alcohol at a similar rate to their male counterparts, even if they are the same age and weight. Women also have a lower quantity of an enzyme in their stomachs that breaks down alcohol than men.

Rate of Consumption – The faster you consume alcohol, the faster your BAC will rise.  It takes around 20 to 40 minutes after a drink has been consumed for all the alcohol to be absorbed by the body.

Drink Strength – The higher the percentage of alcohol a drink contains, the more will end up in your bloodstream. 

Body Type – The more you weigh, the more water you tend to have in your body, which has a diluting effect on the alcohol you consume. That’s why larger people usually require more drinks to “keep pace” with their smaller companions.

Fat/Muscle Content – Fatty tissue is low in water content and cannot absorb alcohol, and the alcohol must remain in the bloodstream until the liver can break it down. However, tissues that are higher in water content, such as muscle, do absorb alcohol. Hence BAC will usually be higher in the person with more body fat.

Metabolism – “Metabolic tolerance” varies from person to person and describes the rate at which alcohol is processed by the body.

Emotional State – Stress can cause your body to divert blood from your stomach and small intestines to your muscles, and slow down the rate of absorption of alcohol into your bloodstream. When you calm down and your blood flows normally again, you may experience a surge in your BAC.

Medications – Many medications react negatively to alcohol, including cold or allergy pills and prescription drugs. They can intensify the effects of alcohol and even endanger your health. If you are taking meds, check the product labels for alcohol warnings, or consult your doctor or pharmacist before you drink.

Food – If you drink alcohol on an empty stomach, your BAC will be higher than a person who has eaten before drinking. Food slows the absorption in your bloodstream by keeping the alcohol you consume in your stomach and for a longer period of time.

Carbonation – Carbonated drinks such as sparkling wine or champagne, or mixed drinks with sodas may increase the rate at which alcohol passes through your stomach and result in a higher BAC.

Diabetes – Alcohol can affect the glucose levels of people who have diabetes and cause hypoglycemia. Diabetics should consult their doctors about drinking alcohol and avoid drinking on an empty stomach.

Alcohol Intolerance – Alcohol may cause adverse reactions in some, including flushing of the skin, nasal congestion, elevated heart rate, and reduced blood pressure. 

How Alcohol Affects the Brain

The brain’s structure is complex. It includes multiple systems that interact to support all of your body’s functions—from thinking to breathing and moving.

These multiple brain systems communicate with each other through about a trillion tiny nerve cells called neurons. Neurons in the brain translate information into electrical and chemical signals the brain can understand. They also send messages from the brain to the rest of the body.

Chemicals called neurotransmitters carry messages between the neurons. Depending on the type and the amount of neurotransmitter, these chemicals can either intensify or minimize your body’s responses, your feelings, and your mood. The brain works to balance the neurotransmitters that speed things up with the ones that slow things down to keep your body operating at the right pace.

Alcohol can slow the pace of communication between neurotransmitters in the brain.

Heavy alcohol consumption can throw the delicate balance of neurotransmitters off course. Alcohol can cause your neurotransmitters to relay information too slowly, so you feel extremely drowsy. Alcohol-related disruptions to the neurotransmitter balance also can trigger mood and behavioral changes, including depression, agitation, memory loss, and even seizures.

Long-term, heavy drinking causes alterations in the neurons, such as reductions in the size of brain cells. As a result, brain mass shrinks and the brain’s inner cavity grows bigger. These changes may affect a wide range of abilities, including motor coordination; temperature regulation; sleep; mood; and various cognitive functions, including learning and memory.

One neurotransmitter particularly susceptible to even small amounts of alcohol is called glutamate. Among other things, glutamate affects memory. Alcohol will interfere with glutamate action, and this is what causes some people to “blackout,” or forget what happened during a night of heavy drinking.

Alcohol also causes an increased release of serotonin, another neurotransmitter, which helps regulate emotional expression, and endorphins, which are natural substances that may spark feelings of relaxation and euphoria as intoxication sets in. The brain is trying to compensate for these disruptions and the neurotransmitters adapt to create balance in the brain despite the presence of alcohol. But making these adaptations can have negative results, including building alcohol tolerance, developing alcohol dependence, and experiencing alcohol withdrawal symptoms. [4]

How Alcohol Impairs Driving?

 

Alcohol is a major risk in driving. You need to concentrate on keeping your eyes on the road, reacting to changing road conditions and controlling different aspects of your vehicle. By drinking alcohol and driving, you slow down your ability to control the steering wheel, the brakes, and gas pedal.

A short 5-minute video “Drinking & Driving – How Alcohol Affects Your Body?” will be played in this section:

Reaction Time and Physical Impacts

There has been an abundance of research that shows Alcohol affects the brain and how it reduces your reaction time. Studies have shown that reaction time increases from 1.5 seconds to 3 seconds when blood alcohol content (BAC) reaches 0.08. [5] If it normally takes you 1.5 seconds to react to something, you will be taking 3 seconds to react. If you’re driving 60mph, you will travel 130 feet in 1.5 seconds so that means if you drink and drive, you will be stopping 130 feet later than if you are sober. 

The brain is part of the Central Nervous System (CNS) and it’s made up of billions of neurons. The neurons form a network that carries information to the neck and arms, trunk, legs, skeletal muscles, and internal organs. Muscle coordination decreases while intoxicated and the driver is very likely to respond incorrectly to their environment. [6] This means if you see a change in signal, you may not respond properly by braking and instead accelerate instead. You may also not respond at all because you are not concentrated on the task at hand. This is extremely dangerous to both the driver, passenger and other drivers and pedestrians on the road.

A driver will have trouble doing basic tasks to drive a car safely if they are impaired by alcohol. A driver needs to multi-task by scanning the road, adjusting their speed and reacting to other vehicles and pedestrians. All of this will be affected by drinking. Research has shown that behaviors such as steering and braking will be affected by BAC starting at 0.05. Every day, 28 people in the US die from motor vehicle crashes that’s alcohol-related (1 death every 51 minutes. Here are what will be affected at different BAC levels. [7] If you’re under the age of 21, you cannot have blood alcohol or breath-alcohol level of 0.02 or higher. [8]

Effects at different BAC levels:

Blood Alcohol Concentration (BAC)*Typical EffectsPredictable Effects on Driving
.02% About 2 alcoholic drinks**
  • Some loss of judgement
  • Relaxation
  • Slight body warmth
  • Altered mood
  • Decline in visual functions (rapid tracking of a moving target)
  • Decline in ability to perform two tasks at the same time (divided attention)
.05% About 3 alcoholic drinks**
  • Exaggerated behavior
  • May have loss of small-muscle control (e.g., focusing your eyes)
  • Impaired judgment
  • Usually good feeling
  • Lowered alertness
  • Release of inhibition
  • Reduced coordination
  • Reduced ability to track moving objects
  • Difficulty steering
  • Reduced response to emergency driving situations
.08% About 4 alcoholic drinks**
  • Muscle coordination becomes poor (e.g., balance, speech, vision, reaction time, and hearing)
  • Harder to detect danger
  • Judgment, self-control, reasoning, and memory are impaired
  • Concentration
  • Short-term memory loss
  • Speed control
  • Reduced information processing capability (e.g., signal detection, visual search)
  • Impaired perception
.10% About 5 alcoholic drinks**
  • Clear deterioration of reaction time and control
  • Slurred speech, poor coordination, and slowed thinking
  • Reduced ability to maintain lane position and brake appropriately
.15% About 7 alcoholic drinks**
  • Far less muscle control than normal
  • Vomiting may occur (unless this level is reached slowly or a person has developed a tolerance
  • for alcohol)
  • Major loss of balance
  • Substantial impairment in vehicle control, attention to driving task, and in necessary visual and auditory information processing

Making Bad Decisions

The behaviors often associated with alcohol consumption (sociability, rowdiness, and poor judgment) are the result of alcohol’s slowing of brain activity. This is because alcohol slows the brain activity in the part of the brain that tends to keep in check, or in inhibit, self-judgment. As a result, individuals are left at a disadvantage when it comes to thinking through their actions. This makes the individual less nervous to engage another in conversation but also less likely to realize the consequences of engaging in risky behaviors, such as drunken driving. That’s why you are drunk; it is easy to think that you are driving normally when truly you are not.

In particular for teens, because the prefrontal cortex is not mature, alcohol can harm a teen’s ability to reason and make choices even more than adults. Teens may do something simply because it is fun or feels good and they can take risks they would not usually take. Because connections between the prefrontal cortex and the ventral striatum are still maturing, alcohol can affect those connections. As a result, teens may do impulsive things, such as drinking and driving or having unprotected sex. Both of these activities can have negative consequences. [6] This will be very dangerous because they may not even know they are impaired and will continue to drive thinking everything is fine.

When driving impaired, the driver would take reckless decisions they may not normally make such as driving too quickly or making frequent lane changes. As you can see in the table above, BAC of 0.02 can affect a person’s decision-making abilities. Don’t drink and drive!

When driving impaired, the driver would take reckless decisions they may not normally make such as driving too quickly or making frequent lane changes. As you can see in the table above, BAC of 0.02 can affect a person’s decision-making abilities. Don’t drink and drive!

Long Term Effects of Alcohol

Heavy or binge drinking can have long-lasting effects including brain damage, cancer, liver issues, weight gain, and sexual problems. [9]

Brain Damage

Binge drinking can cause blackouts, memory loss, and anxiety. Long-term drinking can result in permanent brain damage, serious mental health problems, and alcohol dependence or alcoholism. Teenager’s brains are more vulnerable because their brain is still developing during their teenage years. Alcohol can damage parts of the brain, affecting behavior and the ability to learn and remember.

Cancer

Drinking alcohol is the second biggest risk factor for cancers of the mouth and throat (smoking is the biggest). People who develop cirrhosis of the liver (often caused by too much alcohol) can develop liver cancer.

Heart and circulation

Alcohol can cause high blood pressure (hypertension), which increases the risk of:

  • having a heart attack or stroke
  • developing some types of dementia.

It also weakens heart muscles, which can affect the lungs, liver, brain and other body systems, and also cause heart failure. Binge drinking and drinking heavily over long periods can cause the heart to beat irregularly (arrhythmia) and has been linked to cases of sudden death.

Lungs

People who drink a lot of alcohol have more lung infections, are more likely to suffer collapsed lungs and can be more likely to get pneumonia. When a person vomits as a result of drinking alcohol, choking can occur if the vomit gets sucked back into their lungs.

Liver

Drinking too much alcohol initially causes fat deposits to develop in the liver. Continued excessive drinking will cause the liver to become inflamed, causing alcoholic hepatitis, which can result in liver failure and death. Excessive alcohol can permanently scar and damage the liver, resulting in liver cirrhosis and an increased risk of liver cancer.

Stomach

Drinking above recommended limits can lead to stomach ulcers, internal bleeding, and cancer. Alcohol can cause the stomach to become inflamed (gastritis), which can prevent food from being absorbed and increase the risk of cancer.

Pancreas

Heavy or prolonged use of alcohol can cause inflammation of the pancreas. This can be very painful causing vomiting, fever and weight loss which can be fatal.

Intestine

Heavy drinking may result in colon ulcers and colon cancer. It also affects your body’s ability to absorb nutrients and vitamins.

 

Kidneys

Heavy drinking can increase your risk of developing high blood pressure – a leading cause of chronic kidney disease.

 

Fertility

In men: Excessive drinking leads to impotence (lowered libido/sex drive) and infertility.

In women: Excessive drinking leads to infertility.

Drinking alcohol when pregnant can seriously damage the development of the unborn baby.

 

Bones

Alcohol interferes with the body’s ability to absorb calcium. As a result, your bones become weak and thin (osteoporosis).

 

Weight gain

Alcohol is high in calories and the alcohol in a drink contains almost as many calories as fat. The average bottle of wine contains 600 calories while four pints of average strength lager contains 640. The recommended daily calorie intake of an adult is 2000 calories.

Skin

Alcohol dehydrates your body and your skin. It also widens blood vessels, causing your skin to look red or blotchy. Yikes!

Sexual health

Binge drinking makes you lose your inhibitions and affects your judgment. This may make you less likely to use a condom, which will increase your risk of getting a sexually transmitted infection (STI) such as chlamydia, HIV or hepatitis. It can also lead to an unplanned pregnancy.

 

Mental health

People may think that alcohol helps them cope with difficult situations and emotions and that it reduces stress or relieves anxiety, but alcohol is in fact associated with a range of mental health problems including depression, anxiety, risk-taking behavior, personality disorders and schizophrenia.

Alcohol has also been linked to suicide. The Mental Health Foundation reports that:

  • 65% of suicides have been linked to excessive drinking;
  • 70% of men who take their own life drink alcohol before doing so;
  • almost one-third of suicides among young people take place while the person is intoxicated.

Excessive drinking can disrupt normal sleeping patterns, resulting in insomnia and a lack of restful sleep, which can contribute to stress and anxiety.

 

Other effects

Alcohol affects the parts of your brain that control judgment, concentration, coordination, behavior, and emotions. If you binge drink, you may be at greater risk of:

  • becoming a victim of crime, (rape, domestic violence, mugging or assault);
  • being involved in anti-social or criminal behavior, (fights, domestic violence, vandalism or theft);
  • having an accident, (road accident, fall, accident at work or accidental fire);
  • losing your job, (repeated absence or poor performance);
  • damaging relationships with family or friends.

 

Positive vs Negative Coping Skills

The act of coping is the combination of thoughts we have and the actions we take to deal with a threatening situation. Coping occurs in response to physical or psychological stress and many mental health issues begin with these stressors. Healthy coping includes [10]:

  • Meditation and relaxation – This can include deep breathing techniques, relaxation skills, and muscle relaxation meant to reduce stress
  • Alone time – Give yourself time alone to process the stress of life
  • Exercise – Cardio or strength exercise will help your body release natural endorphins that make you feel good.
  • Spirituality – Believing in a higher power or deeper spiritual connection and practicing that faith can be beneficial to your coping and mental health.
  • Humor – Acknowledging the humorous aspects of a problem, or “positive reframing” can help you deal with small setbacks of failures.
  • Sleeping – When the human body is stressed it needs to rest and reset. Sleep can give you the rest you need to perform another day.
  • Eating healthy – Eating foods that are good for you will improve your physical health and mental health. When your body receives the proper nutrients, it can function more efficiently.

Unhealthy coping mechanisms will prevent you from dealing with the stress and overwhelming situations. They are harmful to your mental and physical health [11]:

  • Drugs
  • Excessive alcohol use.
  • Self-mutilation.
  • Ignoring or bottling up strong feelings.
  • Excessive working.
  • Avoiding problems.
  • Self-blame or blaming others.
  • Other destructive or addictive behaviors like shopping, binge eating, or gambling.

Some negative coping is worse than others such as drug and excessive alcohol use. Drugs and excessive alcohol will only temporarily numb your brain so you don’t have to deal with the physical or psychological stress but they are not a long-term solution. Over time, you will build an addiction to drugs or alcohol and may cause you more problems such as brain damage.

What’s a Standard Drink

Many people are confused about what counts as a drink. It doesn’t matter how much is in your glass, what counts is the amount of alcohol in the drink. Understanding alcoholic drink equivalence is important. We know that having two beers before driving is no safer than having two glasses of wine or a few shots of whiskey or a few Martinis. Being aware of drink equivalence can help us avoid driving while impaired. That can prevent us from having trouble with the law. But much more important, it can prevent injuries and save lives.

In the US, a “standard” drink contains 14 grams of pure alcohol, which is equivalent to:

  • 12 ounces of regular beer at 5% alcohol
  • 5 ounces of wine at 12% alcohol
  • 5 ounces of distilled spirits at 40% alcohol

Even though they come in different sizes, the drinks below are each example of one standard drink:

The percentage of alcohol in the drink is the most important criteria to look for when measuring how much alcohol is in a drink. Some sugary drinks such as long island ice tea contain multiple shots of alcohol and may be very deceptive in their alcohol content. This is dangerous because you can be impaired with just 1 drink depending on the number of shots in the drink. Carbonated alcoholic beverages such as champagne hit the blood system and brain much more quickly than non-carbonated drinks. The drinker rarely knows the effects of the drink until it is too late. If you know you’ll be drinking, make sure you get a designated driver or call a Taxi or Uber. [12]

Stages of Alcohol Intoxication

The figure below is from the University of Oklahoma Department of Medicine and it demonstrates the different stages of intoxication based on blood alcohol content (BAC). [13]

STAGES OF ACUTE ALCOHOLIC INFLUENCE/INTOXICATION [14]

BLOOD- ALCOHOL CONCENTRATION

grams/100 mL

STAGE OF ALCOHOLIC INFLUENCE

 

CLINICAL SIGNS/SYMPTOMS

 

0.01-0.05

 

Subclinical

Influence/effects usually not apparent or obvious Behavior nearly normal by ordinary observation Impairment detectable by special tests

 

 

0.03-0.12

 

 

Euphoria

Mild euphoria, sociability, talkativeness Increased self-confidence; decreased inhibitions Diminished attention, judgment and control Some sensory-motor impairment

Slowed information processing

Loss of efficiency in critical performance tests

 

 

 

0.09-0.25

 

 

 

Excitement

Emotional instability; loss of critical judgment Impairment of perception, memory and

comprehension

Decreased sensory response; increased reaction time

Reduced visual acuity & peripheral vision; and slow glare recovery

Sensory-motor incoordination; impaired balance; slurred speech; vomiting; drowsiness

 

 

 

0.18-0.30

 

 

 

Confusion

Disorientation, mental confusion; vertigo; dysphoria Exaggerated emotional states (fear, rage, grief, etc.)

Disturbances of vision (diplopia, etc.) and of perception of color, form, motion, dimensions

Increased pain threshold

Increased muscular incoordination; staggering gait; ataxia

Apathy, lethargy

 

 

0.25-0.40

 

 

Stupor

General inertia; approaching loss of motor functions Markedly decreased response to stimuli

Marked muscular incoordination; inability to stand or walk

Vomiting; incontinence of urine and feces Impaired consciousness; sleep or stupor

 

 

0.35-0.50

 

 

Coma

Complete unconsciousness; coma; anesthesia Depressed or abolished reflexes

Subnormal temperature

Impairment of circulation and respiration Possible death

0.45+

Death

Death from respiratory arrest

Statistics

Alcohol causes a lot of traffic accidents and fatalities in Florida and in 2015, 16,400 crashes were related to alcohol and caused 828 fatalities. That is 828 deaths that could have been avoided. The leading cause of death among teenagers is traffic accidents. [15] If you are drinking and driving, you put your life and the lives of your passengers at risk. Teenagers usually have very little experience in driving and in combination with Alcohol that impairs judgment, the risk of a traffic accident and fatality increases significantly compared to other age groups. It’s just not worth the risk! 

Reference

[1]

Foundation for a Drug-Free World, “What is Alcohol,” [Online]. Available: http://www.drugfreeworld.org/drugfacts/alcohol.html.

[2]

Brown University, “Alcohol and Your Body,” [Online]. Available: https://www.brown.edu/campus-life/health/services/promotion/alcohol-other-drugs-alcohol/alcohol-and-your-body.

[3]

BacTrack, “Factors that Affect BAC,” [Online]. Available: https://www.bactrack.com/blogs/expert-center/35040709-factors-that-affect-bac.

[4]

National Institute on Alcohol Abuse and Alcoholism, “Beyond Hangovers,” September 2010. [Online]. Available: https://pubs.niaaa.nih.gov/publications/Hangovers/beyondHangovers.htm#chapter02.

[5]

H. Cefrey, Drinking and Driving, New york: The Rosen Publishing Group Inc, 2009.

[6]

AAAS Science NetLinks, “Alcohol and Your Brain,” [Online]. Available: http://sciencenetlinks.com/student-teacher-sheets/alcohol-and-your-brain/.

[7]

CDC, “Motor Vehicle Safety,” 16 06 2017. [Online]. Available: https://www.cdc.gov/motorvehiclesafety/impaired_driving/impaired-drv_factsheet.html.

[8]

The 2017 Florida Statutes, “322.2616,” [Online]. Available: http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0322/Sections/0322.2616.html.

[9]

Know Your Limits, “Know… the effects of alcohol,” 2013. [Online]. Available: http://www.knowyourlimits.info/know%E2%80%A6-effects-alcohol.

[10]

Crisis Centre, “Coping & Self-Care,” [Online]. Available: https://crisiscentre.bc.ca/coping-and-self-care/.

[11]

The Recovery Village, “Why you need healthy coping mechanisms in recovery,” [Online]. Available: https://www.therecoveryvillage.com/treatment-program/aftercare/healthy-coping-mechanisms/#gref.

[12]

National Institute on Alcohol Abuse and Alcoholism, “What is a standard drink,” [Online]. Available: https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/what-standard-drink.

[13]

Sunrise House, “What Are the Stages of Alcohol Intoxication,” [Online]. Available: http://sunrisehouse.com/stop-drinking-alcohol/stages-intoxication/.

[14]

P. D. D. KURT M. DUBOWSKI, “STAGES OF ACUTE ALCOHOLIC INFLUENCE/INTOXICATION,” p. 1, 2006.

[15]

Florida Department of Transportation, “Alcohol Related Share of Highway Crashes & Fatalities in Florida,” [Online]. Available: http://www.floridatransportationindicators.org/index.php?chart=15e&view=about.

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