With no gag reflex, a person who drinks to the point of passing out is in danger of choking on their vomit and dying from a lack of oxygen (i.e., asphyxiation). Even if the person survives, an alcohol overdose like this can lead to long-lasting brain damage. Underage drinking is a serious public health problem in the United States. Alcohol is the most widely used substance among America’s youth and can cause them enormous health and safety risks.
Alcohol Effects
BAC is largely determined by how much and how quickly a person drinks alcohol as well as by the body’s rates of alcohol absorption, distribution, and metabolism. Binge drinking is defined as reaching a BAC of 0.08% (0.08 grams of alcohol per deciliter of blood) or higher. A typical adult reaches this BAC after consuming 4 or more drinks (women) or 5 or more drinks (men), in about 2 hours. In the NIAAA guide to drinking levels, for women, heavy alcohol use is defined as consuming 4 or more drinks on any day and more than 8 drinks per week.
Get the Facts About Underage Drinking
ADH transforms ethanol, the type of alcohol in alcoholic beverages, into acetaldehyde, a toxic, carcinogenic compound. Generally, acetaldehyde is quickly broken down to a less toxic compound, acetate, by aldehyde dehydrogenase (ALDH). Acetate then is broken down, mainly in tissues other than the liver, into carbon dioxide and water, which are easily eliminated. To a lesser degree, other enzymes (CYP2E1 and catalase) also break down alcohol to acetaldehyde. Other Core articles will help you to screen for heavy drinking, identify possible medical complications of alcohol use, assess for signs of AUD, and conduct a brief intervention to guide patients in setting a plan to cut back or quit if needed. Excessive drinking is called at-risk drinking mainly because it significantly boosts your chances of developing diagnosable alcohol problems.
Director’s Report to the National Advisory Council
- Lasting changes in the brain caused by alcohol misuse perpetuate AUD and make individuals vulnerable to relapse.
- The figure fell to 62% in 2023 and to 58% in 2024, before reaching 54% today.
- Declines in alcohol consumption do not appear to be caused by people shifting to other mood-altering substances — in particular, recreational marijuana, which is now legal in about half of U.S. states.
- The more drinks on any day and the more alcohol misuse over time, the greater the risk.
The changes can endure long after a person stops consuming alcohol, and can contribute to relapse in drinking. As blood alcohol concentration (BAC) increases, so does the effect of alcohol—as well as the risk of harm. Even small increases in BAC can decrease motor coordination, make a person feel sick, and cloud judgment. This can increase an individual’s risk of being injured from falls or car crashes, experiencing acts of violence, and engaging in unprotected or unintended sex.
More information about alcohol’s effects on the brain is available on NIAAA’s topic page on Alcohol and The Brain. The Diagnostic and Statistical Manual of Mental Disorders (DSM) initially developed out of a need to collect statistical information about mental disorders in the United States. The first attempt to collect information on mental health began in the 1840 census. By the 1880 census, the Bureau of the Census had developed seven categories of mental illness. In 1917, the Bureau of the Census began collecting uniform statistics from mental hospitals across the country.
An alcohol overdose occurs when there is so much alcohol in the bloodstream that areas of the brain controlling basic life-support functions—such as breathing, heart rate, and temperature control—begin to shut down. Symptoms of alcohol overdose include mental confusion, difficulty remaining conscious, vomiting, seizures, trouble breathing, slow heart rate, clammy skin, dulled responses (such as no gag reflex, which prevents choking), and extremely low body temperature. If a person drinks enough, particularly if they do so quickly, alcohol can produce a blackout.
- Showing your patients a standard drink chart (printable here PDF – 184 KB) will help inform them about drink equivalents and may help your patients estimate their consumption more accurately.
- Here, we will provide basic information about drink sizes, drinking patterns, and alcohol metabolism to help answer the question “how much is too much?
- In the United States, a “standard drink” or “alcoholic drink equivalent” is any drink containing 14 grams, or about 0.6 fluid ounces, of “pure” ethanol.
- Know the danger signals, and if you suspect that someone has an alcohol overdose, call 911 for help immediately.
- Examples of these medications include sleep aids, such as zolpidem and eszopiclone, and benzodiazepines, such as diazepam and alprazolam.
The U.S. Dietary Guidelines for American adults recommends that if alcohol is consumed, it should only be consumed in moderation — up to 1 drink per day for women and 2 drinks per day for men. This is not intended as an average over several days, but rather the amount consumed in any single day. Alcohol use and taking opioids or sedative hypnotics, such as sleep and anti-anxiety medications, can increase your risk of an overdose. Examples of these medications include sleep aids, such as zolpidem and eszopiclone, and benzodiazepines, such as diazepam and alprazolam. Even drinking alcohol while taking over-the-counter antihistamines can be dangerous.
Recovery Community Centers
In a presentation to the NIAAA Advisory Council in early 2022, Council Member H. Westley Clark, M.D., J.D., Dean’s Executive Professor at Santa Clara University in Santa Clara, California, provided an overview of contingency management (CM). CM is a behavioral treatment based on the systematic delivery of positive reinforcement, such as incentives, for desired behaviors. Subsequent discussion addressed the possibility that CM could be part of an overall harm reduction treatment strategy. Alcohol can affect behaviors that increase the likelihood of acquiring or transmitting HIV to others. Alcohol may also speed HIV progression in people living with the disease, influence their engagement and retention in HIV treatment, and increase their susceptibility to organ damage and coinfections. Through regular conversations about alcohol and by parents being a positive role model with their own drinking, parents can shape kids’ attitudes about alcohol and set them up to make healthy choices.
Alcohol misuse—which includes binge drinking and heavy alcohol use—over time increases the risk of alcohol use disorder (AUD). In clinical trials for AUD, abstinence and no heavy-drinking days are currently the only endpoints approved by the U.S. However, many individuals who do not achieve these endpoints may still reduce their drinking to less harmful levels during treatment. Dr. Witkiewitz and other investigators have examined associations between reductions in drinking risk levels established by the World Health Organization (WHO) and improvements in physical health and quality of life. In addition to its effects on the brain, alcohol also affects the peripheral nervous system, which comprises the nerves outside the brain and spinal cord. For example, alcohol misuse is linked to peripheral neuropathy, a condition that commonly occurs in people with severe alcohol use disorder (AUD) and can cause numbness in the arms and legs and painful burning in the feet.
For more information about how alcohol affects the brain, please visit Alcohol and the Brain, and for more information about available evidence-based treatments for AUD, please visit the NIAAA Alcohol Treatment Navigator. Celebrating at parties, cheering a favorite sports team, and enjoying get-togethers after work are common ways to relax or be with friends. For some people, these occasions may also include drinking—even binge or high-intensity drinking. Parents and teachers can play a meaningful role in shaping youth’s attitudes toward drinking.
Do not wait for the person to have all the symptoms, and be aware that a person who has passed out can die. Don’t play doctor—cold showers, hot coffee, and walking do not reverse the effects of alcohol overdose and could actually make things worse. What tips the balance from drinking levels defined national institute on alcohol abuse and alcoholism niaaa drinking that produces impairment to drinking that puts one’s life in jeopardy varies among individuals. Age, sensitivity to alcohol (tolerance), sex, speed of drinking, medications you are taking, and amount of food eaten can all be factors.
If you drink heavily just once a month, your long-term risks for these problems rise from a mere 2% to 20%. If you drink heavily at least twice per seven days, your chances of developing alcoholism or serious, non-addicted alcohol abuse at some point in your life reach fully 50%. There are certain cases in which it is recommended that American adults avoid alcohol completely. It is strictly advised that under no circumstances should individuals under the legal drinking age of 21 years old consume alcohol in any amount.
Guide: 11 Indicators of Quality Addiction Treatment
The dietary guidelines are generally concerned also with other aspects of harms caused by alcohol, including toxicity, which is known to cause cancer. Each beverage portrayed above represents one standard drink, defined in the United States as any beverage containing 0.6 fl oz or 14 grams of pure alcohol. The percentage of pure alcohol, expressed here as alcohol by volume (alc/vol), varies within and across beverage types.
