Alcohol and the brain
A healthy brain relies on a delicate balance of chemicals and processes. Alcohol is a depressant, which means it disrupts that balance.
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Every time you drink alcohol, it affects your brain. As well as feeling less inhibited and being less able to make clear judgments, you are risking long-term effects for your brain and mental health.
The type of alcohol in alcoholic drinks is a chemical called ethanol. Ethanol is a very small molecule, so when you drink it reaches most parts of your body – including your brain.
Small amounts of alcohol can cause initial feelings of relaxation, but what’s actually happening is that alcohol is suppressing activity in parts of the brain associated with inhibition.1
Even after you’ve stopped drinking, your brain and central nervous system are still affected while they process the alcohol, which can lead to withdrawal symptoms. Severe withdrawal symptoms are life-threatening – find out more about what they are and how to get help here.
The way alcohol affects the brain is partly down to its effect on ‘neurotransmitters’ - the chemicals that help to transmit signals from one nerve (or neuron) in the brain to another. The more you drink in a session the higher the chance it will cause feelings of tension and anxiety, because of effects on these brain chemicals.2
Research has found that regular heavy alcohol consumption over a long period is associated with a decline in the number of brain cells (or ‘neurons’), and their quality.3
Regular heavy drinking can cause:
A good way to protect your brain health is to follow the UK Chief Medical Officers’ low risk drinking guidelines. To keep health risks from alcohol to a low level, it’s safest to drink no more than 14 units a week - spread over three or more days with several drink-free days every week, and no bingeing.
Drinking a lot of alcohol in a short space of time (which some people call binge drinking, or heavy session drinking) can be dangerous. It affects your brain function – making you more impulsive, slowing your reaction times and affecting your balance.6
You are more likely to vomit, have an accident or become involved in a fight, or even lose consciousness with the risk that breathing stops.7
Another possible consequence is ‘blackouts’ - gaps in your memory for events that occurred while you were intoxicated. These gaps happen if you drink enough alcohol to temporarily block the transfer of memories from short-term to long-term storage - known as memory consolidation.8
The developing brain can be harmed by alcohol.
When a pregnant woman drinks, alcohol goes through the placenta to the fetus via the bloodstream. This has a number of harmful effects on a developing fetus, including destroying brain cells12 and damaging developing organs,13 and can lead to one of several serious life-long conditions for the child, that are together called Fetal Alcohol Spectrum Disorder (FASD).
During childhood and teenage years, the brain and body are still developing. Alcohol – even small amounts - can affect memory function, reactions, learning ability and attention span.14
The risks associated with underage drinking are why England’s Chief Medical Officer recommends an alcohol-free childhood is the healthiest and best option.
The more alcohol you drink regularly, the greater the effect it has on your brain function including – potentially – your mental health.
Recent research has found that the risk of dementia was increased in people who regularly consumed more than 14 units of alcohol per week.17 Heavy drinking, or repeated binge drinking, can also cause alcohol-related brain damage – which can lead to alcohol-related dementia.
On a day-to-day basis, research has shown that alcohol makes stress harder to deal with.18,19
Alcohol is a depressant. Drinking heavily and regularly is linked with depression20 and anxiety; and withdrawal from alcohol can temporarily cause or worsen anxiety.21
The immediate effects of alcohol, like increased impulsiveness, and the long-term negative effects on physical and mental health mean there is a strong association between heavy drinking and suicidal thoughts or actions.22
If you are concerned that you or someone you care about has a problem with alcohol there is a lot of help available. Here you can find useful links and phone numbers to get the support you need.
 Liu, Y., Grasman, R. P. P. P., Wiers, R. W., Ridderinkhof, K. R., & van den Wildenberg, W. P. M. (2021). Moderate acute alcohol use impairs intentional inhibition rather than stimulus-driven inhibition. Psychological Research, 85(4), 1449–1461. https://doi.org/10.1007/s00426-020-01353-w
 Gimeno, C., Dorado, M. L., Roncero, C., Szerman, N., Vega, P., Balanzá-Martínez, V., & Alvarez, F. J. (2017). Treatment of Comorbid Alcohol Dependence and Anxiety Disorder: Review of the Scientific Evidence and Recommendations for Treatment. Frontiers in Psychiatry, 8, 173. https://doi.org/10.3389/fpsyt.2017.00173
 Daviet, R., Aydogan, G., Jagannathan, K., Spilka, N., Koellinger, P. D., Kranzler, H. R., Nave, G., & Wetherill, R. R. (2022). Associations between alcohol consumption and gray and white matter volumes in the UK Biobank. Nature communications, 13(1), 1175. https://doi.org/10.1038/s41467-022-28735-5
 Alzheimer’s society website. Alcohol-related brain damage (ARBD): what is it and who gets it? [Accessed 16 November 2022]. Available at: https://www.alzheimers.org.uk/about-dementia/types-dementia/alcohol-related-brain-damage-arbd
 Waszkiewicz, N., Galińska-Skok, B., Nestsiarovich, A., Kułak-Bejda, A., Wilczyńska, K., Simonienko, K., Kwiatkowski, M., &Konarzewska, B. (2018). Neurobiological Effects of Binge Drinking Help in Its Detection and Differential Diagnosis from Alcohol Dependence. Disease Markers, 2018, 5623683. https://doi.org/10.1155/2018/5623683
 National institute on Alcohol Abuse and Alcoholism website. Interrupted memories: alcohol-induced blackouts. (Accessed 12 October 2022). Available at: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/interrupted-memories-alcohol-induced-blackouts
 Scottish Intercollegiate Guidelines Network (SIGN). SIGN156 – Children and young people exposed prenatally to alcohol – A national clinical guideline (January 2019) [Accessed 15 June 2022]. Available at: https://www.sign.ac.uk/our-guidelines/children-and-young-people-exposed-prenatally-to-alcohol/
 Bailey, B. A., & Sokol, R. J. (2011). Prenatal alcohol exposure and miscarriage, stillbirth, preterm delivery, and sudden infant death syndrome. Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism, 34(1), 86–91.
 Sundermann, A. C., Zhao, S., Young, C. L., Lam, L., Jones, S. H., Velez Edwards, D. R., & Hartmann, K. E. (2019). Alcohol Use in Pregnancy and Miscarriage: A Systematic Review and Meta-Analysis. Alcoholism, clinical and experimental research, 43(8), 1606–1616. https://doi.org/10.1111/acer.14124
 Wilhelm, C. J., & Guizzetti, M. (2016). Fetal Alcohol Spectrum Disorders: An Overview from the Glia Perspective. Frontiers in integrative neuroscience, 9, 65. https://doi.org/10.3389/fnint.2015.00065
 Sari, Y. (2017). Commentary: Targeting NMDA receptor and serotonin transporter for the treatment of comorbid alcohol dependence and depression. Alcoholism, Clinical and Experimental Research, 41(2), 275.
 Sabia, S., Fayosse, A., Dumurgier, J., Dugravot, A., Akbaraly, T., Britton, A., Kivimäki, M., & Singh-Manoux, A. (2018). Alcohol consumption and risk of dementia: 23 year follow-up of Whitehall II cohort study. BMJ (Clinical research ed.), 362, k2927. https://doi.org/10.1136/bmj.k2927
 Becker, H.C. (2017). Influence of stress associated with chronic alcohol exposure on drinking. Neuropharmacology, 122, 115-126.
 Windle, M. and Windle, R.C. (2015). A prospective study of stressful events, coping motives for drinking, and alcohol use among middle-aged adults. Journal of Studies on Alcohol and Drugs, 76(3),465-473.
 Abrahao, K. P., Salinas, A. G., & Lovinger, D. M. (2017). Alcohol and the Brain: Neuronal Molecular Targets, Synapses, and Circuits. Neuron, 96(6), 1223–1238. https://doi.org/10.1016/j.neuron.2017.10.032
 Edwards, A.C., Ohlsson, H., Sundquist, J., Sundquist, K. and Kendler, K.S. (2020). Alcohol use disorder and risk of suicide in a Swedish population-based cohort. American Journal of Psychiatry
Last Reviewed: 7th March 2023
Next Review due: 7th March 2026