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alcohol FAQs



What is Alcohol?

Ethanol or ethyl alcohol is the primary ingredient found in beer, wine, and spirits that cause intoxication.  The formation of alcohol happens when yeast ferments with sugar in different foods. For example, beer is made from the sugar in malted barley, wine is made from the sugar in grapes, and vodka is made from the sugar in potatoes.  Alcohol is a central nervous system depressant and classed as a sedative-hypnotic. Large amounts of alcohol will depress the central nervous system, and small amounts of alcohol will act as a stimulant. People who use alcohol will feel euphoria, become talkative, and will eventually feel drowsy and sleepy.  Large amounts of alcohol have the potential to lead to respiratory depression, coma, and even death.

Alcohol has an effect on every organ within the body, and the effects depend on blood alcohol concentration over time.  Alcohol is a drug that can affect the body in many ways, and once it is swallowed the alcohol is rapidly absorbed into the bloodstream and moves throughout the body.  The liver breaks down most of the alcohol at an average rate of one standard drink per hour. Small amounts of alcohol leave the body through the skin, breath, and urine.  The amount of alcohol that is in the blood at any time varies depending on the amount being consumed. Other factors, such as the strength of the alcohol and the speed at which it is consumed, along with age, gender, and body weight, determine blood alcohol content.      

Roughly 20% of the alcohol passes through the stomach into the blood.  An empty stomach means that alcohol passes through the stomach faster and into the intestines.  Food in the stomach slows down the rate at which alcohol is absorbed through the stomach lining.  Certain enzymes in the stomach have the ability to break down alcohol before all of it is passed into the intestines.  The remaining 75% to 85% of alcohol is absorbed through the small intestines. The alcohol moves throughout your entire body affecting every organ, the central nervous system, and every bodily function.  Alcohol is very quickly moved around the body in the bloodstream and stays circulating in the blood until the liver can break it down.  

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How long does it take your liver to start to recover once you have stopped drinking alcohol?

The liver is filtering the blood that is filled with alcohol and will break down around 80 to 90% of the alcohol with the help of certain enzymes produced within the liver.  The alcohol is broken down into water, carbon dioxide, and products the body can use for energy, which is not much. However, the liver can only break down alcohol at an average of one standard drink per hour.  The kidneys during all of this balance the amount of fluid in the body, and alcohol makes the kidneys work harder. The kidneys produce more urine when someone is drinking, and only 10% of alcohol leaves the body in the urine.  The liver can only produce so many of the enzymes at one time to break down the alcohol. While new enzymes are being produced, the remaining alcohol stays in the body, waiting to be filtered out through the liver.  

Alcohol does not work the same on everyone, but many health experts say it takes around 6 to 12 months after drinking to know if the liver can repair itself.  Clinical research suggests that the liver is the only organ in the body able to regenerate and replace damaged tissue. However, factors such as how long the person has been drinking, how much, and other drugs contribute to the length of time needed for the liver to repair itself.  Each individual is entirely different, it could 5 to 10 years or 20 to 30 years, but the development of scar tissue within the liver makes the healing process difficult to impossible. Once the scar tissue has developed from alcohol passing through the liver, it is tough to reverse the process.  

Roughly 90% of the metabolism of alcohol is happening within the liver, and the liver can only break down a certain amount of alcohol per hour.  The extra alcohol can destroy or change your liver cells, and fat can collect in your liver, there is inflammation, and permanent scarring. Anyone who drinks alcohol regularly or heavily can damage their liver.  The damage can be mild or severe; for example, fatty liver can be reversed if a person stops drinking alcohol. When there is no alcohol in your blood for several months, the liver cells can return to normal. Severe liver damage such as hepatitis or cirrhosis, can not necessarily be reversed.  Once the severe liver disease starts, it can continue to cause liver damage.  

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Does alcohol affect the fertility of men and women?

Heavy drinking among women can make it more challenging to get pregnant and does affect the developing baby’s health.  Heavy alcohol consumption among men does reduce a man’s sex drive and affect the quality of sperm along with causing impotence.  Heavy drinking and alcohol abuse do reduce both men’s and women’s fertility. Heavy drinking also increases the time it takes to get pregnant and reduces the chances of having a healthy baby.  For women who are pregnant or who are choosing to become pregnant, not drinking is the safest approach to take. Binge drinking, for example, will cause miscarriage, stillbirth, premature birth, small birth weight, and Fetal Alcohol Spectrum Disorder.  Alcohol is a poison and affects your brain, central nervous system, and every organ and system throughout your entire body.  

Men who drink heavily can have erectile dysfunction, reduced sex drive, and the quality of sperm is affected.  Excessive drinking among men also causes weight gain, heart problems, liver problems, and respiratory issues. Many medical experts do not know how alcohol affects women’s fertility, but even light drinking has been reported to make it difficult for some women to become pregnant.  Women who drink large amounts of alcohol are more likely to have irregular periods and even fertility problems. If a woman is considering becoming pregnant and is a heavy drinker, they should consider stopping drinking. Doing this will increase the chances of becoming pregnant and also producing a healthy baby.   

Binge drinking and heavy alcohol use are problematic in the United States, and many studies have shown that heavy binge drinking does have adverse effects on a man’s sperm.  For example, more than 14 alcoholic drinks in a week can lower testosterone levels affecting the sperm count. Heavy drinking among men will lower testosterone, cause impotence or infertility, and change the shape, size, and movement of healthy sperm.  There are endless health problems connected with binge drinking, heavy drinking or just weekly casual drinking. If you are planning to have children and want to increase your chances of having a healthy baby, experts recommend that you stop drinking alcohol.    

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How does alcohol affect the brain?

Alcohol can have long-lasting effects on the brain and affects the way the brain works and controls the rest of the body.  For example, alcohol will block chemical signals between brain cells, which leads to the common immediate symptoms of intoxication.  Alcohol causes a person to engage in impulsive behavior, have slurred speech, poor memory, and slowed reflexes. When the heavy drinking continues, the brain adapts to the blocked signals.  When someone stops drinking, the brain continues over activating neurotransmitters, which creates dangerous withdrawal symptoms. The damage done to the brain from binge drinking is much worse.  Neurotoxicity occurs in the brain when neurons overreact to neurotransmitters for too long. Eventually, this causes neurons to burn out which leads to slowed reactions within the body. Alcohol dependency causes brain shrinkage, which is the reduced volume of both gray matter and white matter within the brain.  The loss of brain matter increases with age and the amount of alcohol being consumed.

There are many visible effects someone will notice when alcohol has damaged the brain.  For example, there can be different cognitive impairments as a result of heavy drinking.  The impairments include verbal fluency, verbal learning, processing speed, working memory, attention, problem solving, spatial processing, and impulsivity.  The higher functions within the brain are more susceptible to the damage done by alcohol. Adolescents are especially at risk for this damage because the brain is still developing, and the damage can be long-lasting or permanent.  Cognitive impairment grows worse with alcohol use and can result in alcohol-related dementia, which represents around 10% of all dementia cases. Malnutrition because of alcohol abuse, also contributes to brain damage. However, the brain can repair itself and with the proper treatment, and if started in time, abstinence from alcohol can reverse much of the physical damage caused by heavy drinking.    

During treatment, the brain can heal itself; however, it does require being abstinent from alcohol. Brain tissue that has been repaired leads to improved cognitive performance.  Along with this, improvement comes as a result of the brain adapting to the damage and creating a new pathway to complete basic tasks. Typically, after one year not drinking alcohol, the improved cognitive function starts to show itself, and more extended periods of abstinence does result in more enhanced cognitive functions.  For example, things such as attention and working memory were significantly improved in patients who had remained alcohol-free. Alcohol is a devastating drug and does significant damage to the brain. However, despite the damage that is done the brain is resilient and can heal and adapt to most injury and damage.     

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How does alcohol cause liver disease?

The liver is an essential organ within the body as it filters the blood toxins, breaks down proteins, and creates bile to help the body absorb fats.  Heavy alcohol use, especially over many years, result in healthy liver tissue being replaced with scarred liver tissue. This is referred to as alcoholic liver cirrhosis, and as the disease progresses, the healthy liver tissue is replaced with scarred tissue.  The American Liver Foundation reports that between 10 and 20% of heavy drinkers will develop cirrhosis. Cirrhosis is the most advanced form of liver disease that is related to consuming alcohol. The condition may start with a fatty liver and then progress to alcoholic hepatitis, and alcoholic cirrhosis.  The damage is done by repeated and excessive alcohol abuse. Healthy liver tissue starts to scar because of the excessive alcohol being processed by the liver. The body cannot produce enough proteins to filter toxins out of the blood as it should. 

The symptoms of liver cirrhosis will start to develop when an adult is between the ages of 30 and 40.  The body does compensate for the liver’s limited functions; however, as the disease progresses, the symptoms become more noticeable.  Some of the symptoms include jaundice, portal hypertension, and itchy skin. Alcohol abuse is the most significant cause of liver disease, and typically the person has drunk alcohol heavily for at least eight years.  Heavy drinking is defined as drinking five or more drinks in one day on at least five out of 30 days, per the National Institute on Alcohol Abuse and Alcoholism. Cirrhosis of the liver causes a variety of complications, such as a buildup of fluid in the stomach.  Other problems result in mental confusion, internal bleeding, and jaundice, which makes the skin and eyes have a yellow tint.

Liver disease can be treated, and doctors can help you reverse some of the progression of the disease.  However, alcoholic liver cirrhosis usually cannot be reversed. The first step in treatment is, of course, getting the person to stop drinking.  Typically, people with alcoholic liver cirrhosis are dependent on alcohol and require detox and treatment. Some treatment options include medications, nutritional counseling, extra protein, and a liver transplant.  A liver transplant requires the person to be sober for at least six months to even be considered as a candidate.         

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What is considered a standard drink in America?

The National Institute on Alcohol Abuse and Alcoholism defines a standard drink contains around 14 grams or 0.6 ounces of pure alcohol.  Generally, this amount of alcohol is found in 5 ounces of wine with 12% alcohol content. This same amount of alcohol is also found in 8 ounces of malt liquor with 7% alcohol content, 12 ounces of beer with 5% alcohol content, and 1.5 ounces or a shot of 80 proof with 40% alcohol content.  Most people are surprised to learn what is considered a standard drink in American. The amount of liquid that is in your glass, can, or bottle does not match to how much alcohol is in your drink. According to the Dietary Guidelines for Americans 2015 – 2020, moderate drinking is up to one drink per day for women and up to 2 drinks per day for men.  Binge drinking is defined as a pattern of drinking that brings the blood alcohol content to 0.08 g/dL. When this happens, it is usually after four standard drinks for women and five standard drinks for men within two hours.  

The Substance Abuse and Mental Health Services Administration defines binge drinking as five or more alcoholic drinks for males and four or more alcoholic drinks for females on the same occasion.  Heavy alcohol use is defined as binge drinking five or more days in the past month. Low-risk drinking for women is defined as no more than three drinks on any single day and more than seven drinks per week.  Low-risk drinking for men is defined as no more than four drinks on any single day and no more than 14 drinks per week. Certain people should avoid drinking altogether, and these include people who plan to operate a vehicle.  Anyone who is taking medication such as pain medication should not be drinking alcohol. If you have a medical condition that alcohol can aggravate or are pregnant, you should not be drinking.  

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What is alcohol abuse?

A standard drink contains around 14 grams or 0.6 ounces of pure alcohol, which is 5 ounces of wine, 8 ounces of malt liquor, 12 ounces of beer, and 1.5 ounces of 80-proof.  Alcohol abuse can be defined as isolated incidents of alcohol misuse, such as binge drinking. The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of alcohol consumption that brings the BAC to 0.08% or more.  This type of drinking corresponds to five or more drinks on a single occasion for men or four or more drinks on a single occasion for women within two hours. Binge drinking is essentially alcohol abuse, and heavy drinking is also considered alcohol abuse.  Heavy drinking for men is defined as consuming 15 drinks or more per week. Heavy drinking for women is defined as consuming eight more drinks per week.   

However, according to the Centers for Disease Control, around 90% of people who drink excessively or abuse alcohol would not be expected to meet the clinical diagnostic criteria for having an alcohol use disorder.  Alcoholism or alcohol addiction is different from alcohol abuse and is an inability to limit drinking, or continuing to drink despite personal or professional problems. Alcoholics need to drink more to get the same effect and want to drink to a point where it is all they think about.  Alcohol abuse can still point to problematic patterns that do place the person in a position to become an alcoholic. The constant abuse of alcohol is often associated with problems at home, school, work, or other areas of someone’s life.     

Most alcohol abuse problems do lead to alcoholism if the underlying issues are not treated.  Alcohol abuse should not be confused with safe levels of drinking, as defined by The Dietary Guidelines for Americans.  A safe level of drinking alcohol for men is no more than two alcoholic drinks per day, and for women, it is no more than one alcoholic drink per day.  Alcohol abuse leads to countless problems, such as drinking and driving. When someone is mildly impaired their speech is affected, and memory, balance, coordination, and attention are also mildly affected.  The blood alcohol content with mild intoxication is 0.05 g/dL. Being intoxicated is having a blood alcohol content of 0.06 to 0.15 g/dL, and everything is impaired, such as speech, motor control, coordination, attention, memory, and balance.  Operating a motor vehicle at any level of impairment is dangerous and will result in deadly consequences.    

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What is alcoholism or an alcohol use disorder?

When someone can no longer control their alcohol consumption and compulsively abuses alcohol despite the negative ramifications, they are suffering from alcoholism.  Alcoholics who experience emotional distress when they are not drinking may suffer from an alcohol use disorder. Alcohol use disorder is a chronic relapsing problem, which means that despite every attempt to stop on their own, they continuously relapse.  Someone who is struggling with alcoholism will use alcohol in higher amounts for a longer time than initially intended. An alcoholic will be unable to cut down on alcohol use despite a desire to do so, along with spending a lot of time obtaining, using, and recovering from the effects of alcohol.  Alcoholics will have severe cravings and a strong desire to use alcohol.  

When you struggle with alcoholism, you are continuing to use alcohol despite adverse interpersonal or social problems because of alcohol use.  Alcoholics will give up previously enjoyed social, occupational, or recreational activities because of alcohol use. When you become addicted to alcohol, you putting yourself in physically dangerous situations such as driving a vehicle.  Alcohol abuse continues despite the presence of developing psychological or physical problems. Alcoholics develop a tolerance, which means they need to drink more substantial or more frequent amounts of alcohol increasingly to achieve the desired effect.  Someone who is struggling with alcoholism is developing symptoms of withdrawal when efforts are made to stop using alcohol.

The National Institute on Alcohol Abuse and Alcoholism defines women who have no more than three drinks on a given day and no more than seven drinks per week as low-risk for alcohol addiction.  For men, this low-risk range is defined as no more than four drinks on a given day and no more than 14 drinks per week. Having a drinking problem starts when your drinking causes trouble in your relationships, in school, social activities, and affects how you think and feel.  If you are concerned about your alcohol use and if you feel you have a drinking problem, it is crucial to reach out for help.    

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Can an alcoholic be functional?

Some people react differently to alcohol than others, and the functioning alcoholic manages to appear normal and sober and in some cases, leads to maintain routine and structure in his or her life.  For example, it is not uncommon for a functioning alcoholic to hold down a job, keep their family lives, and other responsibilities in their lives. It is usually an un-expected alcohol-related event such as a DUI charge or liver disease that shows the person as being addicted to alcohol.  A functioning alcoholic is bound by denial and tolerance, and even a social drinker builds up tolerance to alcohol. So long as a drinker does not develop a dependency on alcohol there is no harm caused by increased tolerance and the people around them are none the wiser.    

However, functioning alcoholics will develop alcohol dependency because the frequency of drinking does tend to increase with time.  The overconsumption starts to occur regularly, and eventually, they will no longer be feeling a hangover. Typically, what happens is the alcoholic will be in denial and will be unable to realize they are consuming too much alcohol.  Every alcoholic develops a physical tolerance to the effects of large amounts of alcohol. Even with a dependency on alcohol and increased tolerance, a functioning alcoholic can still seem to live a normal life. Family and friends notice that they are drinking more consistently throughout each day, yet are making it to work, holding down the job, and other responsibilities.  

Trying to help a functioning alcoholic is difficult because it often always results in a professional intervention.  The alcoholic has not lost anything, and they are in complete denial about their drinking and do not consider it to be a problem.  Someone who has never had to face the consequences because of their alcohol use is difficult to convince to get help. A professional alcohol intervention is the only way to help them understand their drinking is problematic. 

What are the symptoms of alcohol withdrawal?

Alcohol withdrawal can range from mild to physically dangerous and includes a variety of different symptoms.  Alcohol detox is the first step that any alcoholic takes before they start counseling or therapy. When alcoholics are left unmanaged, the heavy alcohol users may experience uncomfortable and potentially severe alcohol withdrawal symptoms when they attempt to stop drinking.  Withdrawal symptoms include irritability, anxiety, agitation, increased heart rate, high blood pressure, seizures, and in rare cases, delirium tremens. Medical detox or a hospital inpatient program is the only successful way to help an alcoholic overcome his or her addiction.  A medically supervised detox helps an alcoholic avoid unnecessary discomfort or life-threatening withdrawal complications. 

Alcohol withdrawal is caused in a particular way because alcohol interacts with unique receptor complexes in the brain.  Alcohol modifies the responsiveness of these receptor proteins and enhances the signaling power. Essentially alcohol replaces the naturally occurring receptors, and the brain becomes accustomed to this newly enhanced reaction.  However, there is no ceiling effect, which means the brain develops a tolerance to the effects of alcohol and requires more to meet the demand. A person eventually grows dependent on alcohol, and when they stop using it or drink less than what they need, it starts a chain reaction.  When an alcohol user stops, or slows down their drinking, the brain becomes overly excited in a negative way. It no longer has the enhanced receptors and starts to have a meltdown becoming excessively enthusiastic and flooding the brain with natural receptors, causing withdrawal symptoms.  

Alcohol withdrawal symptoms are experienced as soon as eight hours after the last time alcohol was consumed.  Depending on the severity of the dependency, the withdrawal symptoms can continue to arise beyond the 24-hour mark.  The more severe withdrawal symptoms start to emerge within the two to the four-day range after drinking has stopped. Mild withdrawal symptoms include anxiety, headaches, insomnia, tremors, palpitations, and gastrointestinal disturbances.  Moderate withdrawal symptoms may consist of hyperthermia, excessive sweating, increased blood pressure, shallow breathing, and confusion. Severe withdrawal symptoms include delirium tremens or DTs, and the symptoms progress in severity. The alcoholic may begin to become disorientated and experience impaired attention, visual and or auditory hallucinations, and seizures.  Medical detox is the only successful treatment option for an alcoholic who is going through severe withdrawal.

What are the health problems associated with alcohol addiction?

Alcohol addiction and excessive drinking do cause significant problems for your health.  For example, chronic diseases such as liver cirrhosis, pancreatitis, various cancers, such as liver, mouth, and throat cancer, and high blood pressure can occur from excessive drinking.  Along with the many different physical problems, an alcoholic can develop severe psychological issues such as anxiety, depression, and alcohol-related psychosis. Someone who is drinking excessively will suffer from unintentional injuries such as motor vehicle traffic crashes, falls, drawing, or even firearm injuries.  Problems with violence, child maltreatment, homicide, and suicide are also common for people who drink excessively. There are many short-term and long-term health effects connected to alcohol abuse and addiction.  

If someone is not abusing alcohol regularly, they can still experience short-term health problems that affect their mind and body.  The effects of alcohol can range from mild to severe, but this is determined by how much is being used and for how long. Someone who is drinking will have lowered inhibitions leading to poor social judgment.  Heavy drinkers have trouble concentrating, and experience a loss of coordination and loss of critical judgment. Other short-term effects involve a dulled perception, mood swings, reduced core body temperature, raised blood pressure, passing out, and vomiting.  The continual use of alcohol leads to the damage of the liver, and some of the physical injuries can have lasting effects on your health.  

When you drink too much alcohol over time, it can cause chronic physical and mental health issues.  Heavy drinking or alcoholism contributes to liver damage, cardiovascular disease, and many types of cancer.  The long-term effects of alcohol use include diminished gray and white matter in the brain, memory loss, loss of attention span, and trouble learning.  Alcoholism can also create alcoholic hepatitis, liver fibrosis, fatty liver, high blood pressure, strokes, and irregular heartbeat. Binge drinking leads to alcohol poisoning, which can become fatal.  Signs of alcohol poisoning include confusion, nausea, vomiting, slowed or irregular breathing, pale skin, low body temperature, and seizures.

What is the scope of alcohol addiction in the United States?

n the 2017 National Survey on Drug Use and Health, over 86% of Americans ages 18 or older reported that they drank alcohol at some point in their lifetime.  Over 70% reported that they drank in the past year, and over 55% reported they drank alcohol in the past month. Binge drinking is problematic throughout the United States, and in 2017 over 26% of people, ages 18 or older, reported that they engaged in binge drinking in the past month.  There were an estimated 88,000 people who died from alcohol-related causes annually. Alcohol-related deaths are the third leading preventable cause of death in the United States. For example, in 2014, the alcohol-impaired driving fatalities accounted for close to 10,000 deaths, which was over 30% of all driving fatalities.  

The problems of alcohol abuse and addiction affect adult and adolescent men and women differently throughout the nation.  In 2017 over 14 million adults ages 18 and over had an alcohol use disorder, which is over 9 million men, and over 5 million women.  Roughly 7% of adults who had an alcohol use disorder in the past year received treatment, which is a small percentage when considering the millions of Americans addicted to alcohol.  According to the same survey, an estimated 443,000 adolescents ages 12 to 17 had an alcohol use disorder in 2017. Roughly 5% of youth who had an alcohol use disorder in the past year received treatment.  The economic burden in the United States is billions of dollars each year, and three-quarters of the total cost of alcohol misuse is related to binge drinking.  

More than 10% of children in the United States are living with a parent with alcohol problems.  Roughly 30% of children 15 years old reported they had used alcohol at least once in their lives.  Over 7 million people, ages 12 to 20 in the nation, reported drinking alcohol in the past month. Over 4.5 million people ages 12 to 20 reported binge drinking and underage drinking drastically interferes with brain development and increases the risk of developing alcohol addiction.  In 2015, there were close to 80,000 liver disease deaths among individuals aged 12 and older, and 47% involved alcohol. Each year over 1800 college students in the nation die from alcohol-related unintentional injuries. Close to 700,000 college students are assaulted by another student who has been drinking.  Over 95,000 college students between 18 and 24 years old report experiencing alcohol-related sexual assault or date rape.  

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