After a big glass of wine, almost anyone feels a little warm and wobbly. Those who keep drinking may begin to slur their words, and they may trip and stagger when they walk. Someone who continues to drink may just pass out and can’t respond to the outside world at all.
That same person may awaken the next day feeling a little queasy, and that nausea may be accompanied by a terrible headache. In time, those hangover symptoms wear off, and the person is back to normal once more — unless scientists look closely at the brain of that person. Long-term, repeated alcohol use can lead to persistent changes within the brain. Those changes can make clear thinking difficult, and in some cases, the damage cannot be reversed.
Other forms of alcohol-related harm can be cured, but it takes time to make the changes felt.
The Alzheimer’s Society in Britain reports that people who drink a great deal of alcohol for a long time are more likely to have a reduction in white brain matter volume, compared to those who do not follow this drinking pattern.
The brain’s white matter helps signals move from one part of the brain to another. When there is a smaller volume of white matter, some signals could get dropped or lost, and that can begin to look a little like brain damage.
In addition to reductions in white matter, people with a history of repeated heavy drinking can also develop reductions in a portion of the brain known as the hippocampus. This part of the brain helps to regulate emotions, and it assists with long-term memory.
In a study published by The BMJ, researchers found that high alcohol consumption and hippocampal shrinkage were dose-dependent. In other words, the more someone drank, the smaller the hippocampus was.
Those who drank more than 30 drinks per week were at the highest risk of anyone in the study, but even those who drank moderately developed shrinkage.
Shrinkage in this part of the brain could lead to long-term problems with memory, as well as difficulty in regulating emotions or understanding the emotions of others. And this problem with emotions has been associated with another symptom of alcohol abuse.
People with long-standing alcohol problems often try to quit drinking, and they may relapse at the end of most sobriety attempts. With each episode of sobriety and relapse, they are doing damage to the cells in the brain.
In a study published in the journal Alcohol and Alcoholism, researchers found that people who had been through multiple detoxification episodes were more impulsive and fearful than those who had not been through detox multiple times. These repeaters also could not learn from their mistakes, which made it harder for them to understand the consequences of their actions. All of that damage, put together, made it more likely that they would keep drinking despite the consequences.
In addition to causing shrinkage within specific portions of the brain, and sparking the death or damage of some brain cells, alcoholism can also cause deficiencies that can kill brain cells in another manner.
The National Institute on Alcohol Abuse and Alcoholism reports that alcoholism can cause a deficiency in vitamin B1, also known as thiamine. This vitamin is required for optimal brain health, and when it is absent, it can cause a very specific type of brain disease. This Wernicke-Korsakoff syndrome can cause short-term symptoms such as confusion or stiff muscles, and if left untreated, it may move into a debilitating form of psychosis that often requires around-the-clock care.
The Alzheimer’s Association reports that researchers aren’t sure why alcohol abuse causes a thiamine deficiency, but they suspect it is caused by alcohol’s impact on the stomach, liver, and other vital organs. It may also be spurred by other health issues, such as anorexia.
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The damage alcohol can cause begins with the very first sip you take. The Mayo Clinic reports that alcohol is a neurotoxin, meaning it is considered poisonous to the delicate cells that reside in the nervous system, including the brain. When you drink alcohol, it moves from the digestive system into the bloodstream. From there, it crosses into spaces within the brain, and it causes harm to the cells there.
Alcohol’s toxicity is responsible, in part, for the symptoms people feel when they drink. A lack of coordination, speech difficulty, and a reduced ability to make sound decisions could all be caused by damaged brain cells, and alcohol directly causes that damage.
The organization Drinkaware also points out that alcohol can reduce the production and/or uptake of chemicals brain cells use to communicate with one another. That reduction in neurotransmitter ability can also help us to feel relaxed and at ease with a drink, but those feelings are caused by damage to brain cells.
These changes are often associated with an episode of drinking, and they do tend to pass when the body has metabolized all of the ingested alcohol. But those who drink repeatedly may develop brain damage that does not go away when sobriety returns.
For people with Wernicke-Korsakoff syndrome, therapy involving thiamine can be a great help. As researchers writing in Nature make clear, when the therapy is provided early in the progression of the disease, people can make a remarkable and rapid recovery and come back to normal. If the therapy is provided too late in the progression of the disease, it is less helpful, and those people may not see the same kind of benefit.
Some people can heal from more moderate levels of alcohol-induced damage by embracing sobriety.
Researchers quoted by Scientific American suggest that abstaining from alcohol can allow the brain to plump and return to previous volume levels, and with that healing, connections between brain regions can be restored.
But some people do not experience this form of spontaneous healing, and they see only some parts of the brain return to their pre-drinking size.
Researchers are looking for ways to help, and in the future, there may be new therapies that can speed healing.
For example, ScienceDaily suggests that researchers have developed a new medication that could help the brain to repair the damage done by binge drinking, but the studies have only been performed on mice.
More studies are required before this therapy could be made available to people.
It’s clear that drinking can have a deep and profound impact on the health of your brain. If you’re dealing with alcoholism, what can you do to protect your brain cells?
The most important step you can take is to stop drinking, and if you’ve been drinking heavily, you need professional help as you transition to sobriety. When the sedating power of alcohol is removed, your brain cells may erupt with activity that overwhelms your brain. That can cause hallucinations or even seizures. Doctors can provide monitoring and medications to help you transition without putting your health or your life at risk.
(December 2015). Q&A: Does Drinking Alcohol Kill Brain Cells? Mayo Clinic. Retrieved December 2018 from https://mayoclinichealthsystem.org/hometown-health/speaking-of-health/does-drinking-alcohol-kill-brain-cells
(March 2016). Alcohol and Mental Health. Drinkaware. Retrieved December 2018 from https://www.drinkaware.co.uk/alcohol-facts/health-effects-of-alcohol/mental-health/alcohol-and-mental-health/
Alcohol and Dementia. Alzheimer's Society. Retrieved December 2018 from https://www.alzheimers.org.uk/about-dementia/risk-factors-and-prevention/alcohol
(June 2017). Moderate Alcohol Consumption as Risk Factor for Adverse Brain Outcomes and Cognitive Decline: Longitudinal Cohort Study. The BMJ. Retrieved December 2018 from https://www.bmj.com/content/357/bmj.j2353
(March 2012). Alcohol-Related Brain Damage: Report From a Medical Council on Alcohol Symposium, June 2010. Alcohol and Alcoholism. Retrieved December 2018 from https://academic.oup.com/alcalc/article/47/2/84/188084
(October 2004). Alcohol's Damaging Effects on the Brain. National Institute on Alcohol Abuse and Alcoholism. Retrieved December 2018 from https://pubs.niaaa.nih.gov/publications/aa63/aa63.htm
Korsakoff Syndrome. Alzheimer's Association. Retrieved December 2018 from https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/korsakoff-syndrome
(April 2011). Clinical and Pathological Features of Alcohol-Related Brain Damage. Nature. Retrieved December 2018 from https://www.nature.com/articles/nrneurol.2011.42
(September 2011). How Much Can the Brain Recover From Years of Excessive Alcohol Consumption? Scientific American. Retrieved December 2018 from https://www.scientificamerican.com/article/how-much-can-the-brain-recover/
(February 2018). Drug Shown to Reverse Brain Deficits Caused by Alcohol. ScienceDaily. Retrieved December 2018 from https://www.sciencedaily.com/releases/2018/02/180208104233.htm