Is Alcohol Bad For My Brain?

The relationship between alcohol and our health has been extensively studied. While you probably know about the damaging effects it has on the liver, research also reveals concerning links between drinking and the brain that warrant a closer look.

As awareness grows around alcohol’s health risks, public attitudes are shifting as well. Recent Gallup polls show that alcohol consumption among Americans is the lowest it’s been in 90 years, with only 54% of Americans saying they currently drink alcohol. The polls also show that 53% of Americans believe drinking one or two drinks a day is bad for their health, while only 25% of Americans held the same view between 2001 and 2011.

Still, even as perceptions shift, alcohol becomes much harder to avoid during the holiday season with added social pressure and an uptick in stress. But a few drinks won’t hurt, right?

“I don’t generally discourage people who enjoy [alcohol] from light drinking in these settings, provided they don’t overconsume it,” said Kelly Rogers, MD, a neurologist at Remo Health, a virtual dementia care provider. “The key is moderation, and while we can’t say that light drinking is beneficial, we know that the biggest risks come from heavy drinking.”

With the holidays upon us, it’s the perfect moment to pause and ask: How does drinking really affect the brain—and do the short-term rewards outweigh the long-term costs?

Once consumed, alcohol is absorbed through the stomach and small intestine, enters the bloodstream, and can reach the brain in as little as five to 10 minutes. From there, it begins altering neurotransmitters and neural communication almost immediately.

Let’s start by exploring what happens to the brain in the short term.

Short-Term Effects

Alcohol begins to affect the brain by interfering with the neural pathways, explained Simon Faynboym, MD, lead psychiatrist and medical director at the California-based mental health clinic Neuro Wellness Spa.

“It disrupts the way neurons communicate with each other, slowing reaction time, memory, focus and mood regulation,” he said.

During the first stage of intoxication, your blood alcohol content (BAC)—the amount of alcohol in your blood—typically falls between 0.01% and 0.05%. At this point, you begin to feel relaxed and uninhibited with a slowed reaction time and a lower level of alertness. This level of intoxication usually occurs after about one drink.

Next comes the euphoric stage, where your brain begins to release more dopamine, one of the “feel good” hormones responsible for increasing happiness and pleasure. Your blood alcohol level may be anywhere between 0.05% and 0.12%, and side effects include reduced muscle coordination, slurred speech and slowed mental processing.

Alcohol disrupts the brain as a whole, but it notably impairs the frontal, temporal and occipital lobes, which are involved in judgment, memory and vision.

As your blood alcohol content increases, so do the intoxication symptoms. With BAC levels of 0.15% and above, you’ll begin to experience blurred vision, mood swings, confusion, nausea, eventual alcohol poisoning and potentially death.

Long-Term Effects

If drinking becomes chronic, the effect on the brain can be lasting and irreversible. Perhaps most alarming, regular alcohol use has been shown to shrink the size of the brain, leading to other cognitive disruptions.

Long-term drinking also makes the GABA receptors in your brain less responsive, which can lead to depression and anxiety. But because alcohol produces a euphoric effect, for some, drinking becomes a coping mechanism to deal with the effects of depression and anxiety, creating a vicious cycle of dependency and addiction.

After consistent use, alcohol also negatively affects the prefrontal cortical areas of the brain, which are responsible for impulse control, decision-making and emotional regulation. When these areas are impaired, it becomes harder to manage urges around drinking, which can fuel the addiction cycle.

One of the more serious side effects of long-term alcohol abuse is how it contributes to cognitive decline and an increased risk of neurodegenerative disease.

“Excessive alcohol use can increase the risk of developing the two most common causes of dementia: Alzheimer’s disease and vascular dementia,” Rogers said. “In addition, heavy, long-term alcohol use can cause deficiency of the vitamin thiamine (vitamin B1), which in turn can cause a severe type of memory loss called Korsakoff syndrome.”

Korsakoff syndrome is a form of dementia that results in difficulty absorbing new information, short-term memory lapses and gaps in long-term memory. People with Korsakoff syndrome may also fabricate stories to fill in memory gaps without intending to lie. While there’s no cure, symptoms can be improved with thiamine supplements, alcohol abstinence, and improved diet and nutrition.

While alcohol doesn’t directly cause Alzheimer’s, prolonged drinking can lead to its development. Chronic alcohol use shrinks the brain’s white matter (which facilitates communication between different parts of the brain) and causes impaired functioning. Oxidative stress and vascular damage to the brain are additional factors that may contribute to early-onset Alzheimer’s in heavy drinkers.

How Much Alcohol Is Too Much?

Most of the previous symptoms come from drinking heavily over a long period of time. But, can casual drinking also contribute to brain damage?

“Some studies have shown that people who engage in light or moderate drinking have better cognitive outcomes than those who either don’t drink or engage in heavy drinking,” Rogers said.

“However, there are other differences between these groups that might account for those findings. For example, people who have medical conditions or who have memory changes might stop drinking, while people with good health might engage in more activities that involve some drinking,” she said. “It’s likely those differences between the groups, rather than the amount of alcohol consumed, are causing these findings.”

To play it safe, experts recommend taking a lighter approach to alcohol. “Health guidelines often define ‘moderate’ as up to one standard drink a day for women and up to two for men, but the general rule of thumb is less is safer,” Faynboym said.

As those recommendations illustrate, biology plays an important role in how we metabolize alcohol and how it affects our brains. In general, women are more vulnerable to the effects of alcohol than men and should moderate their intake.

Tips to Help Curb Drinking

Drinking can be an engaging social activity that helps us foster connection, but if you’re trying to curb your alcohol consumption—whether during the holidays or in general—there are plenty of ways to do that.

“Decide on your goal, and change your routine with substitutes,” Faynboym recommended. There are many non-alcoholic beers, wines, and mocktails that rival even the best alcoholic options.

“Tell a friend for accountability, avoid high-risk settings at first, and use apps, campus counseling, or support groups if you need extra backup,” Faynboym said.