Research consistently shows that heavy drinking harms brain health, but emerging evidence suggests that even light to moderate drinking can be detrimental. A 2022 study found that just one alcoholic drink a day is linked to reduced brain volume, a trend that strengthens with increased alcohol intake.

While you probably have heard about the benefits of red wine for heart health and potentially lowering the risk of Alzheimer’s disease, the supporting evidence in human studies is still inconclusive. Cleveland Clinic hepatologist, Shreya Sengupta, MD, points out the bitter truth in the institution’s Health Essentials blog: “Alcohol causes more health troubles than it could ever help.” This is especially true regarding its impact on the brain.

Ahead, read about the short-term and long-term consequences of alcohol on cognitive health and whether there really is a safe drinking threshold.

Does drinking alcohol kill brain cells?

The brain is made up of cells known as neurons, which are essential for transmitting signals throughout the body and facilitating all brain functions. “What people don’t know is that alcohol is neurotoxic. It damages your brain cells,” explains Akhil Anand, MD, an addiction psychiatrist at the Cleveland Clinic.

What does alcohol do to your brain? In the short term, alcohol affects the brain by promoting feelings of sociability and relaxation. However, even a slight increase in the amount consumed can overwhelm the body’s ability to break down alcohol, leading to rapidly rising blood alcohol levels, which results in impaired coordination, slurred speech, memory lapses, and severe reactions like blackouts, coma, or death due to alcohol poisoning. Over the long term, regular alcohol use can lead to persistent memory problems and increase the risk of developing dementia.

The effects of alcohol on the brain also depend on the type of drink and its concentration. “Drinks with higher alcohol content will cause a stronger and faster response than drinks with low alcohol content,” notes Samuel Mathis, MD, a board-certified family medicine doctor and assistant professor of family medicine at the University of Texas Medical Branch. Therefore, a small quantity of a high-alcohol drink can have the same impact as a larger amount of a weaker drink. Eating food alongside alcohol can also slow its absorption into the bloodstream, helping to moderate these effects.

Examples of drinks with higher alcohol content:

  • Spirits like vodka, rum, whiskey
  • Liqueurs
  • Fortified wines

Examples of drinks with lower alcohol content:

  • Light beer
  • Table wines
  • Ciders

Your brain on alcohol

Your brain when you’re drinking

Alcohol is a brain relaxant. Dr. Mathis describes its effects, saying, “While drinking alcohol, there is an elevation in the brain’s neurotransmitters—GABA, dopamine, serotonin, and glutamate. These neurotransmitters induce relaxation and a sense of euphoria, contributing to the ‘buzz’ drinkers often feel.”

Alcohol also interferes with the ability of brain cells to communicate with the rest of the body, which leads to the typical drinking symptoms you know about, such as impaired judgment, poor coordination, changes in vision, and memory disturbances.

Your brain the day after drinking

The day after enjoying your favorite alcoholic beverages is often marred by a hangover. Dr. Mathis explains that one of the primary effects of alcohol on the body is dehydration, which “largely contributes to the hangover symptoms—headache, nausea, fatigue, and difficulty concentrating—that people experience the next day.” These symptoms are caused not only by dehydration but also because the liver is busy metabolizing the alcohol. Additionally, alcohol triggers inflammation, disrupts glucose levels, and affects the ability to achieve deep, restful sleep. “All of these factors collectively influence how we feel the following day,” shares Dr. Mathis.

Your brain the week after drinking

While the most immediate effects of alcohol usually subside within a week, some symptoms like sleep disturbances and mood changes can persist. Dr. Mathis explains, “This happens because the brain downregulates the neurotransmitters and their receptors.” Essentially, during heavy drinking episodes, the brain is overwhelmed with high levels of dopamine and serotonin. In response, it compensates by reducing its own production of these chemicals. Once alcohol consumption ceases, this change results in a deficiency of neurotransmitters and takes a toll on your mental health. Alcohol affects your mental health by prolonging symptoms like irritability and disrupted sleep, and exacerbating symptoms of anxiety and depression.

Long-term effects of drinking on the brain

Heavy drinking can severely impact brain health in the long term, leading to an increased risk of developing dementia and other memory-related issues, such as Korsakoff syndrome or Wernicke’s encephalopathy. Symptoms of Wernicke’s encephalopathy include confusion, memory issues, problems with gait and eye movements, and mood fluctuations. Dr. Anand emphasizes, “If you stop drinking, improve your nutrition, and replace your thiamine, these effects can be reversible.”

Dr. Mathis points out another long-term consequence: “Heavy drinking also creates a system of dependence and can lead to withdrawal symptoms when people stop drinking alcohol.” These symptoms can include anxiety, tremors, headaches, insomnia, and more.

And it’s not just heavy drinking that impacts brain health; if you drink alcohol daily or gradually increase your intake from one to two units or two to three units per day, it also leads to reductions in both gray and white matter, which are essential for processing information in the brain.

For context, the Centers for Disease Control and Prevention (CDC) provide the following guidelines:

  • Heavy Drinking (Binge drinking):
    • Five or more drinks per occasion for men
    • Four or more drinks per occasion for women
    • Any alcohol use by minors or pregnant individuals
    • 15 or more drinks per week for men
    • Eight or more drinks per week for women
  • Moderate Drinking:
    • Up to one drink per day for women
    • Up to two drinks per day for men

How much alcohol is too much for your brain

The CDC defines safe drinking limits as up to one drink per day for women and two drinks per day for men, but recent research by the World Health Organization (WHO) suggests that no level of alcohol consumption is completely safe.

And if you’re concerned about whether the brain can recover after years of alcohol use? Dr. Mathis explains, “The brain is a beautiful organ that has a significant capacity to heal minor damage.” However, the extent of recovery can vary greatly among individuals, and some damage may be irreversible.

It’s essential to consult with your healthcare provider about strategies for protecting and healing the brain after prolonged alcohol use.

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