How Does Alcohol Affect the Brain?
By The Recovery Village
Medical Reviewer Benjamin Caleb Williams, RN | Editor Jonathan Strum
Last Updated: May 16, 2023
Editorial Policy | Research Policy
Alcohol can affect the brain in many different ways, and some effects can be permanent in certain situations. Fortunately, many effects are reversible.
When used in moderation, alcohol primarily has a temporary effect1 on the brain. When used heavily over a prolonged period of time, however, alcohol can have a more lasting effect on the brain.
Alcohol abuse can lead to cognitive issues that eventually become permanent in some situations. Alcohol can also lead to mental health concerns, including conditions like depression and anxiety. If you or someone you love struggles with drinking, it’s important to understand the many ways alcohol can impact your brain and overall health.
What Parts of the Brain Does Alcohol Affect?
Alcohol creates its effects by influencing gamma-aminobutyric acid (GABA) receptors in the brain. GABA receptors play an important role in calming the brain — when stimulated, they slow and inhibit brain function. By influencing GABA receptors, alcohol also affects different parts of the brain.
Some of the parts of the brain most influenced by GABA receptors include:
- Hippocampus: Influences memory and learning
- Amygdala: The center for emotion and social interaction
- Cerebral cortex: Controls high-level cognitive processes like reasoning
- Cerebellum: Center for motor movement and coordination
- Hypothalamus: Processes and controls biological processes like temperature, pain and appetite
Short-Term Effects of Alcohol on the Brain
On a short-term basis, alcohol interacts with GABA receptors2 until it is metabolized. This interaction suppresses brain activity in many different ways, leading the brain to experience:
- Decreased ability to reason
- Impaired judgment
- Difficulty processing sight and visual focus
- Impaired coordination
- Decreased social inhibition
- Impaired ability to remember and learn
- Changes in sensation of pain, temperature and appetite
These short-term effects typically only last while alcohol is still present in the bloodstream and will go away once alcohol is metabolized.
Long-Term Effects of Alcohol on the Brain
The long-term effects of alcohol on the brain can be more serious, and they occur due to repeated use of alcohol over a prolonged period of time. Over time, alcohol use can actually cause your brain to shrink in size. It can also change the chemical balance of the brain, leading to emotional changes, brain damage and addiction. Alcohol also affects chemicals in other parts of your body that will affect your brain health.
The long-term effects of alcohol can vary based on the amount and frequency of a person’s alcohol use. Some of the long-term effects of alcohol3 use can include:
- Problems forming new memories
- Learning problems
- Developing gaps in memory
- Losing sensation in nerves in the feet or hands
- Decreased coordination
Some of the long-term effects of alcohol abuse are reversible, but others may become permanent, even if alcohol use is stopped.
Brain Shrinkage From Alcohol
Using heavy amounts of alcohol for a prolonged period of time can lead the brain to shrink4 in size. Light to moderate alcohol use does not often cause this effect.
Shrinkage of the brain is called brain atrophy5, and the reason for brain atrophy with alcohol use is not fully understood. Current research suggests that atrophy of the brain occurs due to a combination of chronic dehydration and damage caused to brain cells, but other factors may also be at play.
Decreased brain size is known to be associated with decreased cognitive ability and other neurological problems. This makes sense because the smaller the brain is, the fewer cells and connections between cells it will be able to hold.
Does Alcohol Kill Brain Cells?
There is conflicting information regarding whether alcohol actually kills brain cells6. Many sources will say that alcohol does not cause brain cells to die but does damage them. Others say that alcohol can directly lead to the death of brain cells. While the effects of alcohol on brain cells is still a topic of ongoing research, all the evidence points to the fact that alcohol does damage brain cells.
Brain cells form thousands of connections7 with other brain cells. Even if a brain cell is only damaged, the connections they form can be altered. A damaged brain cell that loses connections may affect important memories or the ability to use your brain. Ultimately, brain cells do not have to die for alcohol to cause irreversible damage to them.
Alcohol-Related Brain Damage (ARBD)
Alcohol-related brain damage8 (ARBD) is a term that can include a number of different types of brain damage caused by alcohol. Some of these forms of brain damage can be reversed when alcohol use is stopped; however, some are permanent.
ARBD can be created by alcohol’s direct effects on the brain, but it can also be caused by effects on other areas of the body that impact the brain. ARBD can also be something that affects an unborn baby when their mother drinks alcohol. This form of brain damage is permanent and will affect the child for their entire life.
Symptoms of Alcohol-Related Brain Damage
The symptoms of alcohol-related brain damage will depend on the type of ARBD and how severe the damage is. Some of the symptoms of ARBD include:
- Emotional changes
- Learning problems
- Inappropriate interactions with others
Wernicke-Korsakoff syndrome9 describes two different conditions that are both part of the same thing. One complication of long-term alcohol use is that it depletes the body of vitamin B1, also called thiamine. Thiamine is essential to brain function, and depletion of thiamine causes Wernicke-Korsakoff syndrome.
Wernicke encephalopathy is the first part of Wernicke-Korsakoff syndrome. This stage of Wernicke-Korsakoff syndrome causes inflammation in the brain that is reversible if thiamine is given. There are three main symptoms caused by Wernicke encephalopathy, including lack of coordination, confusion and eye movement abnormalities.
Korsakoff syndrome is the second half of Wernicke-Korsakoff syndrome, and it occurs when brain damage caused by a lack of thiamine becomes permanent. Korsakoff syndrome is a form of dementia that makes it difficult or impossible to form new memories and learn new things. People with Korsakoff syndrome will also have large gaps in their memory, and they may fill these gaps with memories that are made up by their subconscious, called confabulations. This may make them seem like they are lying about past events when they are just trying to fill in gaps in their memory.
Alcoholic neuropathy10 is damage to the nerves that occurs with prolonged, heavy alcohol use. This can lead to numbness in areas of the body, problems moving correctly, difficulty swallowing, gastric problems and pins-and-needles sensations in different areas of the body. Alcoholic neuropathy can be harmful, as you may not recognize when you are injured. This can cause you to develop more severe injuries because your body does not recognize the need to protect itself.
Alcohol-related dementia11 refers to either Korsakoff syndrome or general brain damage that accumulates over time due to alcohol use. Alcoholic dementia can impair someone’s ability to remember how to perform basic tasks like dressing and feeding themselves. It can also impair a person’s ability to keep themselves safe and may result in behaviors like wandering out into traffic.
Alcoholic Cerebellar Degeneration
Alcoholic cerebellar degeneration12 (ACD) is caused by heavy alcohol use, and it is a type of brain damage that affects the cerebellum. The cerebellum controls muscle movement and coordination, and damage to this brain structure affects movements. ACD primarily affects the ability to walk and to hold the core of your body steady. The arms are generally not affected by ACD. ACD may also lead to cognitive disturbances.
Treatment for Alcohol-Related Brain Damage
Alcohol-related brain damage may improve by itself if alcohol use is stopped, but this will not always be the case. Treatment for alcohol-related brain damage always involves stopping alcohol use to prevent further damage and allow the brain to heal. Because Wernicke-Korsakoff syndrome is a common type of alcohol-related brain damage, thiamine will often be given to improve brain function and potentially treat developing Wernicke-Korsakoff syndrome.
Alcohol and Mental Health
Alcohol has a negative effect on mental health13 and can cause underlying mental health problems to surface or cause new mental health problems to occur. Alcohol has a biological effect that impacts the chemistry of the brain. This can lead to imbalances that result in depression, anxiety or even psychotic episodes.
Alcohol can also cause mental health problems when people become psychologically dependent on it. An important part of mental health is the ability to cope with stress. Alcohol can easily become a coping mechanism that reduces feelings of stress but does not address the underlying problem. This can cause people to become increasingly reliant on alcohol for coping and keep them from addressing psychological stress correctly.
Alcohol and Depression
Alcohol can lead to depression13 by affecting chemicals related to mood. While alcohol can improve your mood, it can also bring your mood down once it wears off, making it worse than it was prior to drinking alcohol. Because alcohol does not actually teach you to improve your mood or help your brain’s chemistry to balance, it can ultimately worsen depression in a continual downward cycle.
Alcohol and Anxiety
Like depression, anxiety can result from chemical imbalances in the brain or from a decreased ability to cope. Alcohol can cause or worsen chemical imbalances. Alcohol can also become a coping mechanism that does not actually help improve the underlying problem. In this case, a person relies on alcohol instead of their own ability to cope and deal with stress.
Alcohol and Psychosis
Psychosis is a detachment from reality that can manifest as hallucinations or beliefs that are not based on reality. Alcohol does not routinely cause psychosis, but withdrawal from alcohol can. Psychosis tends to be temporary and resolves once withdrawal symptoms go away. Sometimes, people who have Korsakoff syndrome may develop hallucinations.
Alcohol Use and Suicide
Alcohol use is connected with suicide14. Alcohol use can create a situation that feeds into the underlying factors that make someone want to commit suicide, such as depression. Further, it can also decrease the inhibitions that most people have about ending their own lives. Alcohol use is also more likely in people who have conditions that create suicide-related risks, so it can be difficult to tell how involved alcohol is in a particular situation.
Effects of Drinking on the Teenage Brain
While drinking alcohol can have a negative effect on anyone’s brain, it is especially harmful for teenagers15. Teenagers are more able to go seek out alcohol than younger children; however, their brains are still in the process of developing. When alcohol is used, it can affect brain development and inhibit a teen’s ability to learn correctly during a period when most of their focus is on their education.
Additionally, those who start using alcohol as a teenager are more likely than others to abuse alcohol as an adult. The use of alcohol can begin to rewire the brain’s reward system to seek out substances as a means of pleasure or coping, making it more likely that addiction to alcohol or other substances will occur later.
What Happens to Your Brain When You Stop Drinking?
When you stop drinking, your brain can begin to heal some of the damage caused by alcohol. Studies show16 that brain shrinkage from alcohol may at least partially reverse itself. Conditions like Wernicke-Korsakoff syndrome may also begin to resolve with thiamine and alcohol cessation.
There are also other changes that occur within the brain. During the period immediately following the cessation of alcohol, withdrawal symptoms can occur if alcohol has been used heavily. Withdrawal occurs17 because receptors in the brain have decreased their sensitivity to signals, making them function incorrectly once alcohol is gone.
Typically, the brain only takes around one to two weeks to fully readjust to the absence of alcohol. Once this adjustment has occurred, any physical withdrawal symptoms will stop.
Brain Recovery From Alcohol Timeline
The exact timeline for the brain’s recovery from alcohol will vary based on the individual. Once alcohol use has been stopped, the first significant change in the brain involves readjusting the sensitivity of brain receptors. This will take roughly seven to 10 days, and physical withdrawal symptoms will occur during this time.
If Wernicke-Korsakoff syndrome is present, symptoms may begin to improve within a few weeks of stopping alcohol and taking thiamine. However, it may take four to nine weeks18 to see full improvement of the symptoms. If Wernicke-Korsakoff syndrome has advanced from Wernicke encephalopathy to Korsakoff syndrome, the symptoms will be permanent and will never go away.
Brain shrinkage from alcohol use may begin to resolve within six weeks16 of stopping alcohol. It may take several months for the brain to get as close to its normal size as it can, and it may or may not actually return to its original size.
Begin The Recovery Process in New Jersey
The Recovery Village Cherry Hill at Cooper is one of New Jersey’s leading alcohol recovery facilities. We’re here to guide you or your loved one through the process of detox, helping you to stay safe and healthy while optimizing your comfort. Following detox, we offer modern rehab programs in a relaxing environment where you can learn the best strategies for maintaining sobriety.
Our addiction care experts are committed to your success and can help you gain the tools necessary to achieve long-term sobriety. Contact us today to learn more about how we can help you begin your journey to a healthier, alcohol-free life in recovery.
Our Recovery Advocates are ready to answer your questions about addiction treatment and help you start your recovery.
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