This Is Your Body on Alcohol

Whether it’s relaxing into a glass of red wine at the day’s end, imbibing fancy cocktails with friends on the weekend (for you classy ones) or even just grabbing beers at the corner bar during the game — consuming alcohol is so second nature to many of us that we’ve stopped thinking about its effects on us.

“Alcohol in our culture is so much associated with positive things — pleasure, relaxation, socializing and food,” says Dr. Nathan Sackett, an addiction psychiatrist who runs UW Medicine’s Center for Novel Therapeutics in Addiction Psychiatry (NTAP). “It’s paired with all these things that make it hard to avoid.”

And not to be a bummer — but boy, does alcohol affect the body. Are you ready for some real talk about what actually happens when a person drinks alcohol? Get ready to never look at your refreshing rosé quite the same way. 

What happens when you take that first sip? 

When a person first consumes alcohol, it’s mostly absorbed in the small intestine. From there it travels through the bloodstream to the liver, and once it’s metabolized there, it acts on various organ systems.

One thing it most definitely acts on? The brain.

Alcohol has several effects on the brain, according to Dr. Sarah Leyde, a physician at Harborview Medical Center who specializes in addiction medicine.

“Alcohol has several effects on the brain including releasing dopamine, a feel-good neurotransmitter, and slowing brain responses by stimulating GABA receptors,” Leyde says.

And as for those very apparent impairments in coordination and balance that people also tend to experience? She explains that those are caused by alcohol’s effects on a part of the brain called the cerebellum.

Shots, shots ... shots? 

If you’re wondering how the amount of alcohol you drink will affect your body — that basically comes down to the rate of metabolism. Since alcohol is a toxic substance, our bodies immediately try to clear it out of the system once it’s consumed. This means that the one glass of wine you sip slowly over dinner won’t cause much havoc on your body, since you’ll be able to metabolize out the alcohol quickly.

On the other hand, if you’re drinking heavily and quickly (shots, anyone?), then your body has less of a chance to clear things out, which can result in some of the recognizable signs of a person being very drunk: slurred speech, altered behavior, impairment of motor skills and judgment, and maybe even loss of consciousness.  

Oh, the hangover

And let’s not forget about the hangover.

You know — the headache, nausea, anxiety and irritability, upset stomach. Though the symptoms can vary from person to person, the misery of a hangover is universally recognized.

Hangovers are caused by a number of things that alcohol does to your body, but it’s mostly because of mild dehydration, disrupted sleep, stomach issues and inflammation in your body.

Though you can never be sure of when you might get a hangover, it’s a pretty solid bet that drinking more is going to increase your chances of feeling terrible the next morning. And though there are plenty of “remedies” you can find online, you’ll probably just have to endure around 24 hours of pain, until your body is done clearing your system and you can start feeling normal again (and electrolyte-packed drinks can’t hurt).

Long-term consequences

And as for that belief that a glass of wine a day is good for you, a recent study found no health benefits of moderate drinking, while imbibing more carries significant health risks, particularly cardiovascular disease. Some of the other health issues caused by alcohol include cancers (especially head and neck, esophageal, breast, colorectal and liver), depression and anxiety, physical dependence, liver disease, dementia, sleep issues and, of course, injuries and accidents.

Another long-term consequence of drinking alcohol? How the body develops tolerance over time. Suppose you were to drink a lot of alcohol a lot of the time. In that case, your brain will start to adjust its excitatory neurotransmitters (which help regulate bodily functions by transmitting signals) to release more than usual to compensate for the sedative effects of the alcohol.

As Sackett explains it, “If your body is used to having a certain degree of sedatives, or half a bottle of wine every single day, the brain is going to compensate by upregulating excitatory neurotransmitters so you can function. Then over time, if you abruptly stop drinking that wine, there’s a balance shift. That’s why people have seizures, shakes and anxiety — because the balance in the brain is now tipped in a different way.”

So, if you have multiple drinks every night, he doesn’t suggest stopping abruptly, since you’ll likely have some unpleasant withdrawal symptoms. A Better option? Taper down your number of drinks gradually. If that proves difficult or you’re experiencing issues, consult a physician who may be able to prescribe medications to ease the transition. 

Identifying a problem

Alcohol use disorder (formerly called alcoholism) is increasingly common in our society. So, what are the signs that there may be a problem? Here are a few:

• When there are negative impacts on your relationships and work life
• When you have difficulty controlling your alcohol use
• When you make dangerous decisions like drunk driving
• When you feel dependent on alcohol for fun or to “feel normal”
• When you have physical signs like tolerance or withdrawal symptoms

It’s important to remember that it’s really up to the individual and how they see their use.

"You can come to me and say you’re drinking a bottle of wine and you’re not having any negative effects, and your family’s not concerned. And then I could have another person who is having a single glass of wine every day and they’re having significant physical, emotional and functional problems,” says Sackett.

Tips for the “casual” drinker

So, does this mean it’s time to kiss that time-honored happy hour with close friends goodbye? Not quite. Maybe it’s just time to rethink the way that we drink.

If guidelines are your thing, the Dietary Guidelines for Americans 2020-2025 encourage men to stick to two servings of alcohol a day and women to have one serving.

But if that seems unrealistic to you, Leyde has some additional tips for drinking responsibly and keeping yourself accountable:

• Track how much you drink — with an app or a journal.
• Slow down: Aim for no more than one drink per hour.
• Make sure you eat food and stay hydrated. Try alternating alcohol-containing beverages with nonalcoholic drinks.
• Figure out your ride — designate a safe driver or use a rideshare app.
• Talk to your healthcare team if you have concerns about your alcohol use. They are here to help and there are medications that can help you curb cravings without needing to stop drinking completely.

And all of this doesn’t mean you need to completely cut alcohol out of your life. It’s just helpful to understand how it affects your body, and when it might be time to turn down that next cocktail.