Alcohol is consumed by 79% of people in the UK and it is often viewed as a core part of British culture. [1]
From British pub culture to the student club scene, drinking alcohol is so normalised that the majority of people do not view it as a drug at all.
However, alcohol is a psychoactive substance, meaning that it has an effect on people’s cognition, emotions, thoughts and behaviours, and can be just as dangerous as any other addiction.
An alcoholic drink (generally just referred to as alcohol) is a drink that contains ethanol; a type of alcohol produced by the fermentation of sugars in fruits, grains and vegetables by yeast. [2]
This fermentation – which creates the ethanol – is what makes a drink intoxicating, impacting the mind and body of the drinker.
Alcoholic drinks will have a percentage of alcohol in them (ABV), which makes the drink ‘stronger’ or ‘weaker’ in terms of its effect on the person drinking it.
The effects of alcohol consumption [3] in the short term (getting tipsy or drunk) can include:
Alcohol addiction is classified as a type of substance use disorder [4] according to the Diagnostic and Statistical Manual of Mental Disorders V (DSM V), alongside addictions to other drugs such as cannabis, heroin, cocaine and tobacco.
Although alcohol can initially evoke feelings of euphoria and reduced inhibitions, it is classified as a ‘depressant’ drug [5] due to its relation to drowsiness and sedation which come after the initial euphoria (often in the form of a late-stage binge drinking or a hangover).
Functionally, alcohol acts as a physical depressant within the body, slowing down the central nervous system (CNS) and causing psychomotor depression, [6] which results in the slowed reaction times, poor coordination and decision-making skills and slurring of speech.
Other examples of depressant drugs [7] which slow down the CNS include anti-anxiety medications such as valium, librium and Prozac, barbiturates, antidepressants and Rohypnol.
This is different to other drug categories such as stimulants (e.g. cocaine and methamphetamine), hallucinogens (such as LSD), analgesics (such as heroin) and cannabis (e.g. cannabis and synthetic cannabinoids).
However, alcohol also shares characteristics with other drugs such as heroin, in that the body can become physically dependent on it.
This means that the withdrawal symptoms from alcohol can be incredibly severe and even fatal.
Alcohol has several long and short term health effects, [8] similar to other drugs, such as impaired judgement, affecting motor skills, increasing one’s risk of various cancers and of course the risk of developing an addiction.
Alcohol affects the body in several ways, and can have lasting negative effects on your physical health.
Some of the short-term physical health risks of alcohol consumption include:
Some of the long-term physical health risks [9] of alcohol include:
Many of the above physical ailments are heavily associated with excessive drinking and alcohol addiction, therefore it is highly advisable to seek help if you find that your alcohol consumption is getting out of your control.
Because of the psychoactive and addictive qualities of alcohol, alcohol consumption can also have a great impact on mental health.
In fact, around 86% of people who seek treatment for alcohol addiction [10] have been found to have a co-occurring mental health condition.
There are several specific mental health disorders which commonly co-occur alongside alcohol addiction [11], most commonly mood disorders such as depression, anxiety disorder PTSD and trauma-related disorders, other substance use disorders, sleep disorders and psychotic disorders.
The interaction between substance use (alcohol or other drugs) and mental health is complex, as it is difficult to determine how they impact one another.
For example, in some circumstances a person may already be experiencing mental health issues and then go on to use alcohol as a form of self-medication.
However, substances such as alcohol can also exacerbate and potentially be a direct cause of the development of some mental health issues, due to the influence it has on the brain.
Not only does alcohol alter brain chemistry, but it can also alter the function and structures within the brain. [12]
This has been found to be even more true in teenagers, as early alcohol use can affect brain development.
Although it is hard to know the cause-and-effect relationship between alcohol and mental health issues, it is clear that they influence one another in very negative ways.
Even in individuals who do not have diagnosed mental health problems, alcohol can cause short-term stress and anxiety, as well as affect their loved ones’ mental health.
Alongside the mental and physical effects of alcohol, excessive drinking and alcohol addiction impact the lives of individuals and their families in a number of ways.
Alcohol addiction, like drug addiction, is the compulsion to continue to consume the substance even in the face of negative consequences.
This can be the mental and/or physical effects of alcohol use, but it can also be other problems that alcohol can cause such as:
Alcohol is an addictive drug as it is able to activate the reward system within the brain (making the person feel euphoric) whilst simultaneously reducing negative systems [13] (limiting feelings of stress and anxiety).
The impact of alcohol on the brain then leads many people to become dependent on alcohol, whether that be psychologically, physically or both.
Often it can begin as a form of excitement or self-medication, and then through more frequent use an alcohol addiction can develop.
However, addiction is different for everyone.
For some people, it can take far less alcohol to develop an addiction or the desire to keep consuming more.
The psychological impact of alcohol on the brain (feeding the reward system and reducing the negative systems), coupled with the way that the body can react to alcohol addiction (by compensating for the effects of the alcohol) leads some people with moderate to severe alcohol addiction to develop alcohol withdrawal symptoms when they abstain from or reduce their intake.
This can, in turn, make it even more difficult for a person who is addicted to alcohol to stop drinking.
Whether a person is dealing with a severe physical and psychological addiction or is in the early stages of a psychological addiction, their addiction needs to be taken as seriously and handled as professionally as when someone has an addiction to any other drug.
Alcohol withdrawal occurs when someone who drinks heavily suddenly stops or decreases their alcohol intake. [14]
It happens due to the person’s CNS becoming accustomed to the constant presence of alcohol, [15] and therefore compensating for its depressive effects.
The accustomed nature of the body demonstrates a physical addiction to alcohol, similarly to a physical addiction to other drugs such as heroin, and withdrawal symptoms happen when the body tries to maintain homeostasis after changing its mechanisms to account for the presence of the substance (which is now absent).
Some examples of alcohol withdrawal symptoms include:
In severe cases, people going through alcohol withdrawal can experience:
Delirium Tremens is a set of severe alcohol withdrawal symptoms including confusion and hyperactivity of the nervous systems which can lead to cardiac collapse and even death.
Approximately 3%-5% of people with alcohol addiction will go through DT’s, but it has a substantial mortality rate at 37%.
Due to the high mortality rate, as well as the high risk of relapse due to often extreme discomfort and cravings, it is highly recommended to seek professional help if you have alcoholism and are attempting to reduce or completely stop your alcohol intake.
There is no ‘safe’ amount of alcohol to drink, as alcohol is still a drug which impacts the consumer physically and psychologically, and everybody is different in terms of how they process alcohol.
However, there are guidelines for the maximum amount of alcohol it is recommended to drink in order to reduce your chances of developing physical or mental health issues.
According to the NHS, [17] it is recommended to drink a maximum of 14 units of alcohol per week.
This should be spread across at least 3 days, in order to prevent binge drinking.
14 units is equivalent to approximately 6 medium glasses of wine or 6 pints of 4% ABV beer.
Although there is no safe amount of alcohol to drink, there are ways to reduce the risks that alcohol can pose to your health.
As well as following the NHS guidelines of drinking no more than 14 units per week over 3 days, there are a number of steps you can take which will make it easier to cut down on your alcohol consumption and make your drinking safer.
Some of the top tips for reducing the risks of alcohol [18] include:
Not only is alcohol a drug itself, it is also commonly used alongside other substances too.
An addiction to alcohol and other substances is known as polysubstance dependence, and this affects around 50% of all drug-related deaths involving the use of more than one drug.
When it comes to alcohol, around 50% of people who abuse alcohol also use other drugs [19] either concurrently (not necessarily at the same time) or simultaneously (at the same time).
Due to little research into polysubstance abuse in alcoholics, [20] exact numbers are not clear but it is evident that alcohol addiction often occurs alongside the use of other substances.
Cannabis is used most commonly by alcoholics, with benzodiazepines, cocaine and heroin being less common choices.
This could be for multiple reasons such as the strong desire to experience other highs after experiencing the high of alcohol, or having lower inhibitions whilst intoxicated with alcohol and therefore being more open to trying other substances.
If you are struggling with alcohol addiction, then there is plenty of help on hand.
Seeking professional addiction treatment might seem daunting at first, but addiction specialists are experts in helping people through their addiction and providing an opportunity to live free from the restrictions of addiction.
Help can be found in the following places:
Alcohol is often not taken seriously as a drug, due to its popularity and heavy usage within society.
It has been placed at the forefront of many cultural activities and celebrations, with having a drink at the pub or getting drunk on a night out being viewed as entirely different from using other drugs to get ‘high’.
However, it is important to acknowledge that alcohol is a type of drug, and is capable of presenting many physical and psychological health problems.
From addiction to numerous health risks, being aware of how alcohol can affect a person’s life is essential.
By reducing the risk to oneself through managing the amount one drinks, and seeking professional help for alcohol addiction when it is needed, we can avoid the many risks to health and mental health that this drug can have.
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7466055/
[3] https://www.nhs.uk/conditions/alcohol-misuse/risks/
[4] https://www.ncbi.nlm.nih.gov/books/NBK519702/
[5] https://www.ncbi.nlm.nih.gov/books/NBK20360/
[6] https://pubmed.ncbi.nlm.nih.gov/26466222/
[7] https://www.theiacp.org/7-drug-categories
[8] https://www.ncbi.nlm.nih.gov/books/NBK424847/
[9] https://web.archive.org/web/20240229160851/https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
[10]https://www.ias.org.uk/uploads/pdf/IAS%20reports/rp31042018.pdf
[12] https://www.niaaa.nih.gov/publications/alcohol-and-brain-overview
[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761824/
[15] https://www.ncbi.nlm.nih.gov/books/NBK459239/
[16] https://www.ncbi.nlm.nih.gov/books/NBK482134/
[17] https://www.nhs.uk/better-health/drink-less/
[19] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2043125/
[20] https://pubmed.ncbi.nlm.nih.gov/11760926/
[21] https://alcoholchange.org.uk/
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.
