Different concentrations of alcohol in the human body have different effects on the subject. The following lists the effects of alcohol on the body, depending on the blood alcohol concentration or BAC.
Please note: the BAC percentages provided below are just estimates and used for illustrative purposes only. They are not meant to be an exhaustive reference; please refer to a healthcare professional if more information is needed.
Euphoria (BAC = 0.03 to 0.12 %)
Subject may experience an overall improvement in mood and possible euphoria.
They may become more self-confident or daring.
Their attention span shortens. They may look flushed.
Their judgement is not as good — they may express the first thought that comes to mind, rather than an appropriate comment for the given situation.
They have trouble with fine movements, such as writing or signing their name.
Lethargy (BAC = 0.09 to 0.25 %)
Subject may become sleepy
They have trouble understanding or remembering things (even recent events). They do not react to situations as quickly (if they spill a drink they may just stare at it).
Their body movements are uncoordinated; they begin to lose their balance easily.
Their vision becomes blurry. They may have trouble sensing things (hearing, tasting, feeling, etc.).
Confusion (BAC = 0.18 to 0.30 %)
Profound confusion — uncertain where they are or what they are doing. Dizziness and staggering occur.
Heightened emotional state — aggressive, withdrawn, or overly affectionate. Vision, speech, and awareness are impaired.
Poor coordination and pain response. Nausea and vomiting often occur.
Stupor (BAC = 0.25 to 0.40 %)
Movement severely impaired; lapses in and out of consciousness.
Subjects can slip into a coma; will become completely unaware of surroundings, time passage, and actions.
Risk of death is very high due to alcohol poisoning and/or pulmonary aspiration of vomit while unconscious.
Coma (BAC = 0.35 to 0.50 %)
Unconsciousness sets in.
Reflexes are depressed (i.e., pupils do not respond appropriately to changes in light).
Breathing is slower and more shallow. Heart rate drops. Death usually occurs at levels in this range.
Death (BAC more than 0.50 %)
Alcohol causes Central Nervous System to fail, resulting in death.
Moderate doses
Although alcohol is typically thought of purely as a depressant, at low concentrations it can actually stimulate certain areas of the brain. Alcohol sensitises the N-methyl-D-aspartate (NMDA) system of the brain, making it more receptive to the neurotransmitter glutamate. Stimulated areas include the cortex, hippocampus and nucleus accumbens, which are responsible for thinking and pleasure seeking. Another one of alcohol's agreeable effects is body relaxation, possibly caused by heightened alpha brain waves surging across the brain. Alpha waves are observed (with the aid of EEGs) when the body is relaxed. Heightened pulses are thought to correspond to higher levels of enjoyment.
A well-known side effect of alcohol is lowering inhibitions. Areas of the brain responsible for planning and motor learning are dulled. A related effect, caused by even low levels of alcohol, is the tendency for people to become more animated in speech and movement. This is due to increased metabolism in areas of the brain associated with movement, such as the nigrostriatal pathway. This causes reward systems in the brain to become more active, and combined with reduced understanding of the consequences of their behavior, can induce people to behave in an uncharacteristically loud and cheerful manner.
Behavioural changes associated with drunkenness are, to some degree, contextual. A scientific study found that people drinking in a social setting significantly and dramatically altered their behaviour immediately after the first sip of alcohol, well before the chemical itself could have filtered through to the nervous system. Likewise, people consuming non-alcoholic drinks often exhibit drunk-like behaviour on a par with their alcohol-drinking companions even though their own drinks contained no alcohol whatsoever.
Excessive doses
The effect alcohol has on the NMDA receptors, earlier responsible for pleasurable stimulation, turns from a blessing to a curse if too much alcohol is consumed. NMDA receptors start to become unresponsive, slowing thought in the areas of the brain they are responsible for. Contributing to this effect is the activity which alcohol induces in the gamma-aminobutyric acid system (GABA). The GABA system is known to inhibit activity in the brain. GABA could also be responsible for the memory impairment that many people experience. It has been asserted that GABA signals interfere with the registration and consolidation stages of memory formation. As the GABA system is found in the hippocampus, (among other areas in the CNS), which is thought to play a large role in memory formation, this is thought to be possible.
Blurred vision is another common symptom of drunkenness. Alcohol seems to suppress the metabolism of glucose in the brain.
The occipital lobe, the part of the brain responsible for receiving visual inputs, has been found to become especially impaired, consuming 29 % less glucose than it should. With less glucose metabolism, it is thought that the cells aren't able to process images properly.
Often, after much alcohol has been consumed, it is possible to experience vertigo, the sense that the room is spinning (referred to in certain circles as 'The Spins'). This is associated with abnormal eye movements called nystagmus, specifically positional alcohol nystagmus. In this case, alcohol has affected the organs responsible for balance (vestibular system), present in the ears. Balance in the body is monitored principally by two systems: the semicircular canals, and the utricle and saccule pair. Inside both of these is a flexible blob called a cupula, which moves when the body moves. This brushes against hairs in the ear, creating nerve impulses that travel through the vestibulocochlear nerve (Cranial nerve VIII) in to the brain. However, when alcohol gets in to the bloodstream it distorts the shape of the cupola, causing it to keep pressing on to the hairs. The abnormal nerve impulses tell the brain that the body is rotating, causing disorientation and making the eyes spin round to compensate. When this wears off (usually taking until the following morning) the brain has adjusted to the spinning, and interprets not spinning as spinning in the opposite direction causing further disorientation. This is often a common symptom of the hangover.
Another classic finding of alcohol intoxication is ataxia, in its appendicular, gait, and truncal forms. Appendicular ataxia results in jerky, uncoordinated movements of the limbs, as though each muscle were working independently from the others.
Truncal ataxia results in postural instability; gait instability is manifested as a disorderly, wide-based gait with inconsistent foot positioning. Ataxia is responsible for the observation that drunk people are clumsy, sway back and forth, and often fall down. It is probably due to alcohol's effect on the cerebellum.
Extreme overdoses can lead to alcohol poisoning and death due to respiratory depression.
A rare complication of acute alcohol ingestion is Wernicke encephalopathy, a disorder of thiamine metabolism. If not treated with thiamine, Wernicke encephalopathy can progress to Korsakoff psychosis, which is irreversible.
Chronic alcohol ingestion over many years can produce atrophy of the vermis, which is the part of the cerebellum responsible for coordinating gait; vermian atrophy produces the classic gait findings of alcohol intoxication even when its victim is not inebriated.
Severe drunkenness and diabetic coma can be mistaken for each other on casual inspection, with potentially serious medical consequences for diabetics. The major physical finding they share is the sickly-sweet odour of ketosis on the breath; alcoholic ketosis and diabetic ketosis are both marked by the presence of acetone and other ketones in the bloodstream, although the ketones are produced by different metabolic pathways in each disorder. Measurement of the serum glucose and ethanol concentrations in comatose individuals is Ethanol routinely performed in the emergency department and easily distinguishes the two conditions.
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