Alcohol impacts everyone. The extent of its effects on the body are related to how much a person drinks, how often they drink, and personal health, biological, and additional factors.
Whether you drink a little or a lot, alcohol has an effect on you. It impacts your body, your brain, and your behavior in numerous ways you may not even realize, and it has widespread societal impacts too. So what is alcohol actually doing to you, how do you know when it’s having a negative impact, and how can you minimize any issues it’s causing? Let’s take an in-depth look.
When you drink alcohol it affects your body and your health in numerous ways, and unfortunately, the effects are largely negative, especially if you’re drinking excessive amounts. In fact, harmful use of alcohol can contribute to more than 200 disease and injury conditions. Alcohol can have many short- and long-term side effects, impacting almost every system in the body.
Alcohol can affect everyone a little differently in varying amounts. The degree that alcohol is affecting you at any given moment is based on how much alcohol is in your bloodstream. It’s referred to as your blood alcohol content or BAC. For context, law enforcement in most areas will consider you to be legally intoxicated when your BAC is .08 or higher. The number of drinks that it takes to raise your BAC to that level will depend on factors like:
Age
Gender
Weight and body muscle mass
Tolerance to alcohol
Physical and mental health
Use with medications or other drugs
Food consumption
Metabolism
All of these factors will affect how intoxicated you feel and how the alcohol is impacting you in the short term.
While each person might feel the effects of alcohol a bit differently, here are the typical effects associated with rising BAC levels:
| BAC Level | Effects |
|---|---|
| BAC up to 0.04 | Feelings of relaxation and pleasure |
| BAC of 0.06 to 0.08 | Lowered inhibitionsImpaired judgmentLack of coordination |
| BAC of 0.08 to 0.1 | Reduced reaction timeClear lack of control |
| BAC of 0.12 | Vomiting typically begins |
| BAC of 0.15 to 0.2 | Balance and movement significantly impairedBlackouts may occur |
| BAC of 0.3 to 0.4 | Loss of consciousnessDanger of alcohol poisoning rises |
| BAC of 0.45 | Fatal dose for most people |
An alcohol overdose can be fatal. If you think someone has overdosed, call 911 immediately. While waiting for assistance to arrive, help the person lean forward to prevent choking on vomit. If the person is unconscious, roll them onto one side with one ear toward the ground.
The short-term effects of alcohol are very temporary, but if you drink alcohol on a regular or frequent basis, especially if you’re getting intoxicated on a regular basis, it can have long term effects on your health too. Alcohol damages many of the body’s organs with repeated exposure, which can increase the risk for disease and organ failure.
These are some of the dangerous long-term effects of alcohol:
Elevated blood pressure and cholesterol levels, which can cause an increased risk for heart attack, heart damage, and stroke
Mental health issues, such as depression, anxiety, and an increased risk for suicide
Weight gain and a heightened risk for diabetes
Cirrhosis of the liver, alcoholic liver disease, and liver failure
Pancreatitis
Increased risk for cancers, including stomach cancer, mouth and throat cancer, bowel cancer, breast cancer, and liver cancer
Brain damage and a higher risk for dementia in the form of Wernicke-Korsakoff syndrome
Fertility issues, including lower testosterone and a reduced sperm count in men
Sexual performance issues, including impotence or premature ejaculation
Harmful effects on a fetus for pregnant women, including a higher rate of miscarriage, still birth, or babies born with birth defects, such as fetal alcohol syndrome
Weakened immune system
Decreased bone density, weakened bones, and a risk for developing osteoporosis
Social issues
Learning and memory problems
Risky sexual behaviors leading to potential contraction of an infectious disease, such as HIV or a sexually transmitted disease
Alcohol dependence, difficult withdrawal symptoms that can be potentially life-threatening, and addiction
Nearly 180,000 people die every year in the US from excessive alcohol use. Experts say most of these deaths are due to negative health effects associated with drinking too much alcohol over a long period. Alcohol can impact nearly every system and organ in your body, so let’s take a closer look at how it impacts specific organs and aspects of your body.
Alcohol works by changing the chemical makeup of the brain and interfering with its communication pathways. This impacts regions of the brain involved in mood regulation, memory, balance, speech, impulse control, and decision-making processes.
Drinking too much can impair judgment, which can then lead to risky behaviors and an increased rate of accidents, injuries, and violence. Too much alcohol at a time can cause blackouts, or gaps in memory.
Heavy drinking over time reduces the size of the neurons in your brain. Early use of alcohol (drinking before the brain is fully developed) can alter the brain’s structure and function as well.
Regular drinking for a long period of time can cause your brain to become significantly deficient in thiamine (vitamin B1), which can lead to the onset of Wernicke-Korsakoff syndrome (WKS), a degenerative brain disorder. Wernicke’s encephalopathy is the acute form of the syndrome that can be reversed with immediate intervention. Korsakoff syndrome is a permanent form of brain damage with symptoms similar to dementia. WKS has a high mortality rate and can require specialized care.
In the short term, research indicates that alcohol raises your blood pressure and cholesterol levels. Alcohol can cause an irregular heart rate. In time, this can lead to cardiac complications, such as an increased risk for heart disease and heart attack.
Prolonged alcohol abuse can also cause alcoholic cardiomyopathy, which weakens your heart muscle.
While there has been some research indicating that low to moderate consumption of alcohol can have protective effects on the heart and cardiovascular system, drinking too much can have far more negative consequences on the heart.
The liver is the organ that works to break down alcohol. It can become overwhelmed when too much alcohol is present that it cannot successfully process.
Drinking causes a buildup of fat cells in the liver, which can cause an enlarged liver and the first stage of liver disease called fatty liver. This is the most common liver problem alcohol causes.
Liver disease is progressive, and the more alcohol is consumed over time, the worse it gets. The second stage is called alcoholic hepatitis, which is acute inflammation of the liver. Liver cells die, and there can be permanent scarring.
When normal liver tissue is destroyed and replaced by scar tissue, this is the third stage of liver disease called alcoholic cirrhosis. Alcoholic liver disease increases the risk for developing liver cancer and kidney problems, gallstones, intestinal bleeding, and serious infections.
Alcohol, even in more moderate amounts, has a direct impact on the body’s immune response, weakening it and increasing one’s overall vulnerability to infections caused by viruses or bacteria. The weakened immune response caused by alcohol consumption can increase the rate of cancer development and progression.
Alcohol can disrupt the healing process and make it harder to recover from medical procedures or accidents. Alcohol can also impair the body’s ability to protect and repair itself from injury, infection, or disease.
Heavy drinkers of alcohol are more prone to contracting diseases like the flu and pneumonia. The body will have an impaired ability to ward off infections up to 24 hours after being intoxicated.
Alcohol is essentially a toxin that can trigger an inflammatory response. Typically, inflammation is a trigger from your immune system to help fight off a harmful outsider, but when alcohol is present consistently, the response becomes chronic and starts to damage healthy cells and tissues.
Alcohol triggers both acute inflammation, which is the immediate inflammatory response when alcohol enters the system, and chronic inflammation.
Inflammation related to alcohol can impact the brain, face, gut, liver, and joints. This can cause brain damage, an increased risk for infections, joint and muscle conditions, a higher rate of heart and liver disease, and a great deal of discomfort.
When you drink alcohol, the first part of your body that it touches is the gastrointestinal system. Research indicates that alcohol can change the integrity and structure of the GI tract, which can cause leakage of microbes and bacterial products.
Alcohol may also cause your stomach to produce more acid than normal. This can lead to heartburn and acid reflux as well as cause gastritis (inflammation of the stomach lining), which can also lead to the development of stomach ulcers.
In the short term, alcohol can cause stomach upset, leading to nausea, vomiting, and diarrhea. Long-term effects on the gastrointestinal system can include difficulties absorbing essential nutrients, which can cause the body to become deficient in these nutrients.
The empty calories provided by alcohol can lead to significant weight gain. Excessive and long-term alcohol consumption also increases the risk for developing mouth, pharyngeal, esophageal, stomach, and bowel cancers.
Regular use of alcohol leads to both physical and psychological dependence on alcohol. Drinking alcohol changes the chemical makeup of the brain, altering the levels of neurotransmitters that help to regulate moods.
Drinking alcohol can have a positive impact on mood, but when it wears off, the resulting “low” can cause a person to want to drink more. It can also become difficult to feel pleasure without alcohol once dependence has formed.
Withdrawal symptoms when alcohol processes out of the body can be difficult both emotionally and physically. A significant dependence on alcohol can even lead to potentially life-threatening withdrawal symptoms, known as delirium tremens. Symptoms include confusion, delirium, high fever, and seizures.
Alcohol is an addictive substance. According to the 2023 National Survey on Drug Use and Health, nearly 29 million people in the United States had an alcohol use disorder (AUD).
While alcohol can have a substantial impact on your physical health, it affects your mental health in a dramatic way too. It can influence mental health conditions you might have, like depression or PTSD, and it can impact your stress and anxiety too.
People with depression may turn to alcohol as a quick pick-me-up in the hope that it will provide momentary relief from their emotional struggles. This temporary “fix” can quickly spiral into a dangerous cycle of depressive episodes and alcohol abuse.
The interplay of alcohol and depression is complicated. Depression already contributes to an imbalance in the brain, and alcohol can worsen this imbalance. Even if the person feels better in the moment, the after-effects of alcohol often include worsened depression symptoms.
Alcohol is classified as a depressant, which means it slows down your body’s central nervous system, so the chemical imbalance that causes depression is worsened by the use of alcohol. This happens on a small scale with a single session of alcohol use. Over time, though, ongoing alcohol abuse disrupts the balance of neurotransmitters, making depression even more intense.
Alcohol interacts with key brain chemicals involved in regulating your mood. Those changes could make depression symptoms worse.
Researchers say alcohol works on two key receptors:
Serotonin
This neurotransmitter is known for promoting feelings of happiness and well-being. Low serotonin levels can contribute to depression.
Dopamine
This neurotransmitter is associated with pleasure, motivation, and reward. While alcohol may initially increase dopamine levels, it’s depleted later and makes depression worse.
In short, alcohol disrupts the brain’s natural reward system and mood regulation, leaving you feeling more low and sad in the long run.
Additionally, when alcohol takes control of the brain, inhibitions drop and judgment becomes fuzzy. This means that the feelings of sadness and hopelessness that come with depression can be amplified under alcohol’s influence. It’s a dangerous combination that can increase the risk of impulsive behavior, self-harm, and other choices that can worsen their relationships and life circumstances, contributing further to feelings of depression.
Stress and alcohol are closely related, and the connection begins deep inside the brain.
When we experience stress, a specific area of the brain called the hypothalamus gets activated, particularly its paraventricular nucleus (PVN). This activation leads to the release of two chemicals: corticotropin-releasing factor (CRF) and vasopressin. These act as messengers, traveling to the pituitary gland.
The pituitary gland receives these signals so it then secretes another hormone called adrenocorticotropic hormone (ACTH). ACTH, in turn, stimulates the adrenal glands located above our kidneys.
Finally, the adrenal glands release stress hormones, primarily cortisol, into the bloodstream. This surge of cortisol throughout the body ultimately amplifies our overall stress response.
Interestingly, this same process happens when we drink alcohol too, so your brain activity is very similar when you’re anxious and when you’re drinking.
It’s very common for people with depression or anxiety to self-medicate with alcohol, but unfortunately, alcohol can actually make these and other mental health conditions worse with repeated use, so it becomes an ongoing cycle. The cycle of alcohol use and depression is complex, but it often looks like this:
1. Symptoms begin
The person has feelings of sadness, hopelessness, anxiousness or dread.
2. Self-medication starts
The person drinks alcohol in an attempt to lift their mood. The drinks increase dopamine levels at first and lead to a temporary mood boost.
3. Consequences start
As the alcohol wears off, serotonin and dopamine levels are depleted and the depression and anxiety symptoms return. Symptoms might be worse than they were before because now they’re combined with the depressive effects of alcohol or with hangover symptoms like anxiety and fatigue. The person may also have regrets about things they did or said while they were drunk.
4. Problems deepen
Because the post-effects of the alcohol are now making the person feel worse than they did before, they drink alcohol again to try to lift their mood, but this continues to produce the worsening after-effects.
5. Consequences deepen
As the person repeatedly self-medicates with alcohol, they begin to feel ashamed of their habits, and they may become socially isolated.
6. The problems become entangled
The person may experience withdrawal symptoms if they try to stop drinking, making it even harder to break the cycle. Depression or anxiety and dependence worsen each other, creating a powerful and difficult situation to overcome.
This cycle doesn’t only happen when you’re self-medicating a mental health condition with alcohol. Significant stress can have a similar effect too.
According to a study, these serious and traumatic events may lead to increased possibility of drug addiction, including alcohol use disorder:
Death of a parent, family member, partner, or close friend
Divorce of parents
Being isolated or abandoned
Living apart from parents early in life
Death or loss of a child
Serious relationship problems, such as being cheated on
Losing your house
Being the target of or witness to a violent attack
Living through a natural disaster
Being physically or sexually abuse
Difficulty controlling behavior or emotions
If a person experiences one or more of these traumatic experiences, their approach toward drinking may change for the worse. Drinking behavior may not change immediately following a traumatic event, and trauma early in life can lead to unhealthy drinking habits later in life.
According to a 2012 study, adults who said they felt more stress in a given year were found to drink more than those who said they felt lower levels of stress in the same year. Another study found that stress does not lead people to drink more often, but it does lead people to drink more in instances when they do drink. This behavior may eventually lead to alcohol use disorder if it persists.
For those recovering from alcohol use disorder or experiencing withdrawal symptoms from alcohol use disorder, stress may lead to an increase in alcohol cravings. Consequently, high stress levels can lead to relapse.
Alcohol use disorder or AUD is one of the potential effects of alcohol, affecting your mind and body as well as most or all aspects of your life. The experience of addiction is different from anyone, but there are a few different ways that alcohol addiction can appear in your behavior.
A common symptom of addiction is trying to hide your drinking from others. People who do this are sometimes called “closet alcoholics.”
Closet drinking refers to someone keeping their alcohol misuse hidden or concealed from others’ view. For instance, they may drink in private at odd hours and in large quantities, hide alcohol around the house, or claim to be sober when they are intoxicated. These individuals may still maintain a job and keep up with family responsibilities despite their excessive alcohol use.
Maintaining this facade can place a significant emotional and psychological burden on the individual and drive a wedge between them and their loved ones. Meanwhile, their use of alcohol usually increases as their AUD deepens and becomes more overwhelming.
Recognizing a closet alcoholic can be challenging. They may go to great lengths to hide their drinking, yet there are often indicators that suggest they are abusing alcohol undercover. Signs that someone is a closet alcoholic include the following:
Drinking in secret
While some degree of alcohol consumption when alone may not be concerning, such as a glass of wine with dinner, excessive intake when alone is a red flag. The person may hide bottles of alcohol or drink late at night when others are not paying attention.
Frequent trips to the bathroom
Making repeated trips to the bathroom during social gatherings or events, during which the person could be sneaking alcohol, could indicate discreet alcohol use.
Strong odor of alcohol
They may often have a noticeable smell of alcohol on their breath or clothing at times when it would be inappropriate to be drinking.
Stockpiling alcohol
They may store extra bottles of alcohol in hidden places, such as closets, drawers, or in disguised containers in order to maintain a secret supply.
Drinking early in the day
They may start their day with a drink, such as by adding liquor to their coffee, often justifying it to themselves as normal or not a big deal.
Defensiveness or irritability
They may react defensively or become easily irritated when questioned about their drinking habits, even if asked casually.
Frequent excuses or lies
They may make excuses or lie to justify their whereabouts, actions, or reasons for being unavailable when they were actually drinking.
Neglecting responsibilities
Failing to meet obligations at work, school, or home due to the effects of alcohol consumption will become more frequent occurrences.
Financial strain
Financial difficulties may occur due to excessive spending on alcohol, possibly leading to debt or borrowing money.
Declining physical health
Physical health issues associated with alcohol abuse — such as weight gain, liver problems, or deteriorating appearance — will likely begin to crop up for a closet alcoholic.
Mood swings or emotional instability
Abrupt changes in mood, depression or anxiety, or emotional instability are common in those who are privately abusing alcohol.
There are many different subtypes of alcohol addiction based on how the person manages their drinking. People who are “closet alcoholics” are very often “functional alcoholics” too. A functional alcoholic is someone who is still able to keep up with their basic responsibilities like maintaining a job, paying their bills, and being present with family and friends despite having an alcohol addiction. As a result of this, their addiction is unknown to many of their loved ones, or it’s underestimated because people assume that if they’re still able to manage their life, the addiction must not be very severe.
While the medical community recognizes addiction as a disease, society tends to stigmatize it instead. Many people still look at addiction as a moral failure or a lack of discipline. As a result, someone with alcoholism may hide their drinking to avoid the judgment of others. Unfortunately, this secrecy can also make it take longer for a person to get treatment because their loved ones don’t know how bad their addiction is.
In short, someone in alcoholic denial is a person who has an alcohol addiction but denies their addiction, not only to others but to themselves as well.
Denial is a coping mechanism. If a person doesn’t acknowledge their problem with drinking, they don’t feel the need to change their habits or alter their lives. If there isn’t a problem, life can continue as is.
But unless you can break through denial, the problem won’t disappear. People with AUD need treatment before their drinking patterns become ingrained and harder to break.
People in alcoholic denial aren’t trying to harm others or avoid the consequences of their drinking. Instead, they’re dealing with a very real psychological aspect of addiction. Their brain is trying to protect them from the self-shame of acknowledging their addiction by preventing them from realizing they have an addiction.
Alcoholic denial works as a shield, allowing the person to reject unpleasant truths. Deep down, they may know that their drinking isn’t healthy. In time, they can develop cognitive dissonance, or a sense that they’re trying to hold two conflicting beliefs at the same time.
While the denial is helpful in the short term, it can hinder long-term recovery. It prevents people from addressing and acknowledging the root of the problem.
People with alcoholic denial tend to share the following characteristics:
Lying
Deception is a core part of alcohol use disorder. Alcohol denial can involve lying about how much they drink, when they drink, and how those habits make them feel. Those lies can also obscure drinking consequences, such as drunk driving offenses, hospital visits, and job losses.
Blaming
People with AUD keep drinking despite the consequences. Instead of recognizing that these consequences are caused by their drinking, someone in denial may put the blame on a different person, place, or thing. They might blame coworkers or friends for drinking in front of them. They might blame restaurants for offering cocktails. Anyone is to blame but the person who takes the drink.
Comparing
More than 79% of people ages 12 and older drink alcohol. For someone in denial, all of these people are proof that drinking is harmless, accepted, and tolerated. They may count others’ drinks and compare them to theirs, or look for examples of people drinking more than they do as a way to feel that their own drinking isn’t a serious problem.
Rationalizing
A person in denial looks for reasons that would normalize their habits. This tactic helps them make sense of their out-of-control drinking. For example, they could claim that the day was particularly stressful, so alcohol is a deserved reward. They could cite a holiday, celebration, or the upcoming weekend as good reasons to start drinking.
Dismissing
Denial can prompt people to overlook the consequences of their drinking. They may claim that others are overreacting, and they can change their ways at any point. They may also suggest that their family and friends just don’t understand them.
While denial might be a tactic for someone to protect themselves psychologically, the problem is that it can delay addiction treatment. While a person is in denial, they don’t recognize that they have a problem so they don’t seek out treatment. If the person in denial is also hiding their drinking from others, they may not have pressure from others to enter treatment either.
The problem with this is that not only does alcohol addiction tend to escalate over time but many of the health issues and other consequences build up over time, so the longer a person continues to drink heavily, the more negative consequences it can have for their health and their life.
Most people think that alcoholism is purely defined by drinking too much, but there are other behaviors and thought patterns that are involved too. For someone to truly recover from addiction, they don’t just need to stop drinking but they need to correct those patterns associated with addiction. Someone who doesn’t do this is sometimes called a “dry drunk.”
A dry drunk is a term that refers to someone who has stopped drinking but continues to display behaviors and traits associated with heavy alcohol consumption. It often describes the emotional and psychological consequences associated with post-acute withdrawal syndrome (PAWS).
There are multiple problems with dry drunk syndrome. First, it leaves you more vulnerable to relapse. The reason addiction treatment focuses so much on therapy to change thought patterns is because your previous mindset made you vulnerable to addiction. So if those thought patterns remain the same, you’ll be at a higher risk for relapse.
The other issue is that alcohol addiction damages your life in many ways and not all of them are from the addiction – some consequences like poor relationships can come from the thoughts and behaviors associated with alcoholism. If you haven’t improved these thoughts and behaviors, you and your loved ones may continue to experience these problems.
Signs and Symptoms of Dry Drunk Syndrome
Someone who is a “dry drunk” might have some of these symptoms:
Anger, irritability, or frustration
Low mood or energy
Impatience, restlessness, or difficulty focusing
Anxiety or worry about your ability to maintain sobriety
Resentment directed toward yourself, people who can still drink, or people who want you to quit drinking
Negative or hopeless feelings about your ability to stop drinking
Distraction or boredom
In addition to these mood symptoms, specific behaviors and experiences often linked to this syndrome can include:
Aggressive or impulsive behavior
Trouble sleeping
A tendency to judge, blame, or criticize yourself harshly
Frustration with treatment, which may lead you to skip meetings or therapy sessions, or give up on them entirely
Frequent daydreaming or fantasizing, often about alcohol use
Dishonesty
Using other behaviors, like shopping or gambling, to cope with life while abstinent from alcohol
If you’ve stopped drinking but you believe you might have dry drunk syndrome, outpatient addiction counseling or therapy could help you move past this roadblock and reach a point of genuine, maintainable recovery.
How do you know when your drinking has become a problem and it’s time to get help? Here are some of the key warning signs to look for:
Struggling to or being unable to limit how much you drink or how often you drink
Experiencing withdrawal symptoms when you stop drinking, usually if it’s been 6 to 24 hours since you’ve had a drink
Being unable to stop drinking even when you want to
Thinking a lot about alcohol, including fixating on when and how you’ll get your next drink
Spending a lot of your time on drinking – either actively drinking, acquiring alcohol, being intoxicated, or recovering from a hangover
Continuing to drink even though you know that it’s causing problems in your life or your health
Skipping things you would normally enjoy so that you can drink instead
Developing a tolerance so that it takes more drinks to have the same effect
If these signs ring true for you, the good news is that you don’t have to figure out treatment on your own. All you have to do is contact a treatment facility or a local agency that helps with addiction. These facilities can conduct an assessment to understand your addiction and your needs, allowing them to recommend the treatment process that will be best for you.
Keep in mind that because alcohol and alcoholism affect you in both physical and psychological ways, treating alcohol addiction requires a combination of medical and mental health care too. You might, for example, start with medical detox to keep your health safe through withdrawal and keep you as comfortable as possible. This might be followed by therapy along with specialized medications that help you stay sober.
You might also find yourself in a situation where you’ve noticed that a loved one is struggling with alcohol and needs help but might be in denial. Here are some key dos and don’ts to keep in mind when you’re trying to help someone who is in denial about their alcohol addiction.
| Do… |
|---|
| Talk openly and honestly |
| Use “I” language, such as, “I feel sad when you come home drunk” |
| Research treatment options to help you talk openly with the person |
| Take care of yourself |
| Get counseling when you need it |
| Don’t… |
|---|
| Confront the person when they are drunk |
| Use “you” language, such as, “You always go to the bar after work” |
| Hold your conversation in a public place, like a restaurant or a bar |
| Focus only on the person’s drinking habits |
| Isolate yourself to care for the other person |
If you are struggling with problem drinking or alcoholism, Boca Recovery Center is here to help and can guide you through recovery from start to finish. Reach out to one of our luxury rehab centers in South Florida, Indiana, New Jersey, or Massachusetts for a free consultation and to learn about our programs. We know precisely how to help you recover from addiction and create the fulfilling and successful life you want.
Evidence Based
23 sources cited
