Effects of Alcoholism & Alcohol Abuse: Physical Impacts on the Brain and Body

Alcohol is a central nervous system depressant that affects mood, coordination, thinking and decision-making abilities. When abused regularly, alcohol can create a dependency that is both physical and psychological in nature. Around 17 million American adults suffered from an alcohol use disorder in 2014, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

Alcohol addiction is characterized by an inability to control one’s drinking that negatively disrupts relationships, job performance, school grades, family life, and personal mental and physical health. When someone battles an addiction to alcohol, the person may continue to drink in spite of any and all consequences that may occur as a result and may end up in potentially hazardous situations, increasing the odds of being in an accident or suffering an injury as a result.

Alcohol impairs motor skills, reflexes, reaction time, short-term memory, and the ability to think clearly or rationally. Inhibitions are lowered, increasing the risks for engaging in potentially dangerous sexual interactions or possibly falling victim to crime or violence. In the United States, 30 people are killed every day in a motor vehicle crash involving a driver impaired by alcohol, which equals one person every 51 minutes, the Centers for Disease Control and Prevention (CDC) publishes.

Too much alcohol consumed at once can cause a fatal overdose as the toxins overwhelm the body. The CDC reports that over 2,200 people die annually in America as the result of alcohol poisoning. In addition to the short-term negative health risks of excessive alcohol abuse and addiction, there are also multiple long-term physical consequences.

How Alcoholism Harms the Liver

Almost a quarter of the American adult population (18 and older) reported at least one episode of heavy drinking in 2014, the CDC publishes. Heavy drinking days are defined by five or more drinks for a man in a single day, or four drinks for a woman. Alcohol was a contributing factor in almost 30,000 deaths in 2014, the CDC further publishes, which doesn’t even account for homicides or accidents involving alcohol. A major factor in alcohol-related deaths is alcoholic liver disease, which was the cause of death in close to two-thirds of total alcohol-induced fatalities. Liver disease can have many complications from liver and kidney failure to liver cancer, increased fluid in the abdomen, bleeding in the stomach, an enlarged spleen, a buildup of toxins in the brain, and death.

Alcohol cannot be stored in the body, and the gastrointestinal system works hard to filter ethanol, the active chemical in alcohol, out. The liver is one of the body’s organs responsible for helping to filter out toxins like ethanol, and consuming alcohol in large amounts regularly can cause problems including a buildup of fatty tissue, inflammation, and scarring, or cirrhosis. It could potentially lead to alcoholic liver disease.

There are three main types of alcoholic liver disease: fatty liver or steatosis, alcoholic hepatitis, and cirrhosis, which can even progress into hepatocellular carcinoma. Progression through the forms of alcoholic liver disease, as the condition of the liver worsens with continued alcohol abuse, is common, and there is regularly overlap between them. The Merck Manual estimates that fatty liver occurs in around 90 percent of alcohol abusers, making it the most common form of alcoholic liver disease. Alcoholic hepatitis affects 10-35 percent, and 10-20 percent suffer from cirrhosis. Women are more prone to alcoholic liver disease than men. Generally speaking, the risk for developing it increases with age and prolonged addiction to alcohol (specifically drinking heavily for a period of eight years or more. Genetics, metabolism, obesity, and the malnutrition that typically accompanies alcohol addiction are also thought to play roles in the onset of alcoholic liver disease.

• Fatty liver disease: The earliest stage of alcoholic liver disease, fatty liver disease develops as fat builds up in the liver with the introduction of large quantities of alcohol. Fatty liver disease generally doesn’t have many, if any, symptoms and may be entirely reversed with abstinence from alcohol. If symptoms do present, they may include fatigue, pain in the upper right quadrant of the abdomen, weakness, and elevated liver enzymes.
• Alcoholic hepatitis: As fat continues to deposit in the liver as a result of alcohol consumption, inflammation and mild scarring can occur, resulting in hepatitis. This is basically an inflammation of the liver that can be mild, moderate, or severe. Mild hepatitis may be reversible with the cessation of alcohol consumption; however, severe hepatitis may be irreversible, and up to 30-40 percent of individuals suffering from severe alcoholic hepatitis die within a month, per Mayo Clinic. One of the most common symptoms of alcoholic hepatitis is yellowing of the skin and eyes, called jaundice. Other symptoms include loss of appetite, weight loss, pain in the stomach, nausea and/or vomiting, fatigue, fever, and mental confusion or behavioral changes as a result of toxins building up in the blood.
• Cirrhosis: Healthy liver tissue is damaged by alcohol consumption, resulting in scar tissue building up in its place, called liver cirrhosis. This is a serious condition that the National Health Service (NHS) reports can be fatal within five years in about half of the cases of severe cirrhosis where the person doesn’t stop drinking alcohol. Alcohol-induced liver cirrhosis is the most advanced type of alcoholic liver disease. While it may not be entirely reversible if a person stops drinking alcohol, further damage can be prevented and symptoms may be improved if drinking stops. Symptoms of cirrhosis are similar to those of severe hepatitis.

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Other Bodily Systems Negatively Affected by Alcohol Abuse

Studies have been published about the potential health benefits of alcohol, which may seen counterintuitive. Harvard Health published information that seems to link moderate drinking (no more than one drink a day for a woman, or two for a man) with a reduction in heart- and cardiovascular-related issues. The key word here is moderate. Someone battling alcohol addiction likely drinks more than one or two standard drinks in a day (A standard drink is defined by the National Institute on Alcohol Abuse and Alcoholism, or NIAAA, as one 12-ounce beer, 1.5 ounces of spirits, one 5-ounce glass of wine, or one 8- or 9-ounce glass of malt liquor). Chronic bouts of heavy drinking that go along with prolonged, or untreated, alcohol addiction can cause a variety of health problems in addition to the damage it may be doing to the liver.

 Alcohol is essentially a toxin that produces mind-altering effects. Its continued presence in the bloodstream can bring many health risks, such as:

• Increased risk for cancers of the mouth, esophagus, throat, breast, and liver
• Pancreatitis (inflammation of the pancreas leading to trouble with digestion)
• Hyperglycemia (imbalance in the body’s blood sugar levels, potentially contributing to, or worsening, diabetes)
• High blood pressure
• Malnutrition and dehydration, which can cause a multitude of health problems as a result
• Stroke
• Risks to unborn baby (Alcohol passes through the placenta and can cause a variety of health problems in an unborn baby, such as fetal alcohol syndrome, birth defects, sudden infant death syndrome (SIDS), or miscarriage)
• Bleeding in the stomach and creation of ulcers
• Irregular heart rate or arrhythmia
• Cardiomyopathy (stretching of the heart muscle)
• Heart failure or heart attack
• Weakened immune system, which may increase the risk for pneumonia and tuberculosis

Impact of Alcohol on the Brain

Alcohol also affects the brain and the way chemical messengers are produced and move around. Alcohol addiction actually causes parts of the brain that are involved in decision-making, impulse control, memory, motivation, pleasure, and reward processing to be rewired. Moods, behaviors, and even personality can be impacted.

Some of the damage caused to the brain as the result of alcohol abuse may be reversible; however, a serious brain disorder may develop, causing a permanent debilitating condition called Korsakoff ‘s psychosis. This is a type of memory disorder often preceded by the related disorder Wernicke encephalopathy. NIAAA estimates that close to 80 percent of people addicted to alcohol may suffer from a deficiency in thiamine (vitamin B-1), which is one of the body’s essential vitamins that alcohol may deplete. While Wernicke encephalopathy and Korsakoff syndrome are technically two separate disorders, they are often lumped together and called Wernicke-Korsakoff syndrome, which is considered a form of dementia. The Oxford Journal reported that out of a group of people affected by dementia, between 10 and 24 percent of the time it may have been caused, or its onset was contributed to, by alcohol.

Wernicke encephalopathy affects a person’s muscle coordination and ability to control eye movements, and it can lead to mental confusion. When treated, it may be reversible; however, NIAAA publishes that between 80 and 90 percent of those suffering from alcohol addiction and Wernicke encephalopathy will progress to Korsakoff’s psychosis. This is a serious memory disorder characterized by an inability to learn new information or remember recent events, as well as gaps in long-term memory that may cause the person to confabulate, or unintentionally make up events to fill these gaps. The Alzheimer’s Association reports that untreated Korsakoff syndrome is fatal about 20 percent of the time, while a quarter of those affected will recover, and half will improve with treatment and prolonged abstinence from alcohol.

Alcohol Withdrawal Risk Factors

Another potentially serious side effect of alcohol addiction is alcohol withdrawal, which occurs when an individual stops drinking, making it seem desirable to keep drinking. Alcohol withdrawal occurs when a person is dependent on alcohol and can range in severity. The New York Times estimates that about 95 percent of individuals dependent on alcohol will suffer from mild to moderate withdrawal symptoms while about 5 percent may suffer from delirium tremens (DTs), a severe and potentially life-threatening form of acute alcohol withdrawal syndrome. DTs is indicated by fever, significant confusion, nausea and vomiting, seizures, hallucinations, and agitation that may not manifest for up to a few days after stopping drinking. It requires immediate medical attention.

Mild to moderate alcohol withdrawal includes a range of both physical and psychological symptoms, including nausea and gastrointestinal upset, headaches, pallor, sweating, dilated pupils, mental “fogginess,” depression, insomnia, fatigue, suppressed appetite, anxiety, irritability, tremors, nightmares, high blood pressure, and rapid heart rate. These symptoms may start eight hours to two days of the last drink and generally peak in a few days.

Alcohol withdrawal is the result of an effort by some of the brain’s messengers, like dopamine and gamma-aminobutyric acid (GABA), to rebalance themselves after a long period of chemical interference. Dopamine is partially responsible for why a person feels happy, and it is one of the neurotransmitters involved in reward processing and pleasure. Alcohol floods the brain with dopamine, which is why it makes people feel good when they drink.

As the brain becomes accustomed to alcohol’s interactions with the dopamine levels on a regular basis, however, it may stop making it at normal levels without alcohol telling it to, resulting in a dip in these levels when alcohol is removed or not present. It may then be hard for a person to feel happy without alcohol at this point.

GABA is one of the body’s natural sedatives that suppresses the stress reaction. Alcohol stimulates GABA production, which enhances relaxation and slows nerve firings in the brain. When alcohol is suddenly removed, GABA levels may rebound, causing functions like blood pressure, body temperature, and heart rate to spike, resulting in increased stress levels and potential seizures or cardiovascular concerns.