Addictions to alcohol are common – perhaps because alcohol is one of the most widely legalised and available drugs on the market.
As well as being completely legal in many countries, the restrictions on purchasing and consuming alcohol are often very generalised, meaning that many individuals consume high quantities of alcohol without being supported in this situation.
Because of this, an individual may develop an addiction – this is where an individual will continuously seek out and consume alcohol despite any negative consequences that may arise or that they are aware of.
Long-term alcohol addictions are especially dangerous, as the individual is subject to the harmful build-up of chemicals and toxins within the body despite the body’s metabolism trying to break these down.
Alcohol addictions have also been shown to commonly co-occur with other substance use disorders (1), further adding to the danger that an individual is subject to.
Alcohol metabolism refers to the process in which alcohol is broken down and removed from the body. This is done via several different organs, chemicals, and enzymes – the process of which will be covered across this blog post.
The process of alcohol metabolism means that the body removes alcohol from the system, reducing its effects.
However, too much alcohol or a slower rate of metabolism can mean that the metabolism cannot keep up with the consumption of alcohol, leading to feelings of ‘drunkenness’ and other associated effects of alcohol.
The process of this is covered over the remainder of the blog post.
In general, most of the metabolising of alcohol occurs within the liver. As the largest internal organ, the liver plays a role in many different processes of the body, including digestion, metabolism of foods, and the removal of toxins via the production of bile and other waste products.
Most of the liver is made up of hepatocytes – liver cells – which are the primary source of nutrient absorption and the cleaning of blood.
However, this means that the liver is also one of the most impacted organs in the body when it comes to alcohol misuse, abuse, and addiction.
Leading to possible liver disease, this can cause potential issues when an individual is attempting to withdraw from alcohol or undergo a different form of rehabilitation (2).
Within the liver itself, there are smaller processes which occur in order to break down alcohol into non-harmful substances and chemicals.
In general, these processes are mediated by enzymes – biological catalysts that accelerate chemical reactions without being used up in the process.
The most commonly used enzymes/pathways to break down alcohol are listed below:
Now that the enzymes and areas of the body in which alcohol metabolism takes place has been outlined, the entire process can now be pieced together.
First, alcohol is consumed by the individual and enters the bloodstream. This happens quickly as there are many blood vessels within the mouth i.e., where alcohol is consumed.
From the bloodstream, alcohol then travels to the liver where it begins to be metabolised. This is first assisted by ADH, converting alcohol to acetaldehyde, before ALDH then further converts this to acetate.
Acetate can be broken down further into water and carbon dioxide – two chemicals which can be removed/eliminated from the body through the normal digestive processes, or by being reused by the body.
Like most bodily functions, every individual will metabolise alcohol at different rates and with varying effects within the liver.
Every individual is different, so every alcohol metabolism will occur at different rates and with varying effects on the individual’s health and well-being.
For example, some individuals may not metabolise alcohol very quickly, meaning that they feel ‘drunk’ at lower quantities and the effects of this can last for longer.
This is due to a number of factors, the most common of which are outlined in the following three subheadings.
At its basis, every individual’s body works differently, and this means that processes will occur and happen at different rates with different results.
One of the main differences that occurs to alcohol metabolism is the speed at which alcohol is broken down. This is due to the different enzymes involved in the process.
The speed may be affected by other factors such as whether or not the individual regularly consumes alcohol, if they consume large quantities at a time, and if they have developed an addiction.
If an individual is struggling with an addiction, then their alcohol metabolism rate is greatly affected. Individuals struggling with an addiction may have issues metabolising alcohol due to the presence of harmful toxins and chemicals that have built up over time.
This is often due to the rate at which individuals consume alcohol; the average individual can metabolise the equivalent of one standard unit of alcohol per hour and any more than this can cause serious health problems and an increased risk of developing liver disease.
The pre-existing condition of an individual’s liver health can also be a huge indicator of how well their body processes and breaks down alcohol.
For example, if an individual is already struggling with liver damage and/or disease, then their body will be far less prepared to metabolise alcohol, as well as potentially having a deficit in enzymes that are available to help process alcohol in the first place.
In some cases, the liver may process alcohol differently which can lead to the presence of some harmful and damaging chemicals and toxins – something that the body is already trying to fight and avoid.
Research in the past has been driven to this point again and again; individuals struggling with an alcohol use disorder (AUD) – otherwise known as an addiction – are at the most risk of liver disease and the treatment of this can be complex (3).
In general, the type of food that we consume can affect many areas of our bodies and many of the processes within, so this is also applicable specifically to the liver and the metabolising of alcohol.
If an individual consumes a large amount of food before drinking, then they are likely to experience a slower alcohol absorption rate.
This means that they are unlikely to feel as ‘drunk’ as they normally would when consuming the same amount of alcohol, but that alcohol metabolism is also slowed as a result of this.
Eating food before or with drinking alcohol is generally recommended, as it means that the body is nourished before beginning to break down alcohol. Without eating to nourish the body, the effects of alcohol are likely to be felt far more severely.
It is never recommended to mix alcohol with other substances (whether this is recreational or prescribed substances) due to the dangerous interactions that these substances can have.
For example, there is a strong link between alcohol metabolism and some specific medication interactions (4), though the applications of this are still very much debated.
Drugs and medications that have strong conflicting interactions with alcohol include diazepam, cannabis, opioids, and methylphenidates, and physicians are informed by this research to always recommend not drinking alcohol while taking any form of medication (5).
To learn more about how alcohol is metabolised, what may affect this, and alcohol-related struggles in general, get in touch with Rehab 4 Addiction today.
We have years of experience in referring individuals who are struggling with addiction and its related effects to the most suitable and appropriate form of rehabilitation for them.
To get free and confidential advice on anything you have read today, or any related queries, please do not hesitate to contact our addiction support team on X today.
[1] Dick, D.M. and Agrawal, A., 2008. The genetics of alcohol and other drug dependence. Alcohol Research & Health, 31(2), p.111.
[2] Addolorato, G., Mirijello, A., Leggio, L., Ferrulli, A. and Landolfi, R., 2013. Management of alcohol dependence in patients with liver disease. CNS drugs, 27, pp.287-299.
[3] Addolorato, G., Mirijello, A., Barrio, P. and Gual, A., 2016. Treatment of alcohol use disorders in patients with alcoholic liver disease. Journal of hepatology, 65(3), pp.618-630.
[4] Zakhari, S., 2006. Overview: how is alcohol metabolized by the body?. Alcohol research & health, 29(4), p.245.
[5] Traccis, F., Presciuttini, R., Pani, P.P., Sinclair, J.M., Leggio, L. and Agabio, R., 2022. Alcohol-medication interactions: A systematic review and meta-analysis of placebo-controlled trials. Neuroscience & Biobehavioral Reviews, 132, pp.519-541.
Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field. His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline. You can connect with Boris online at LinkedIn or X.com.
