Alcohol

What is alcohol?

Alcohol is a narcotic. The chemical name for alcohol is ethanol (C2H5OH). Alcohol is the most commonly used drug in western society.


Effects of alcohol

The effect a substance has is determined by the properties of the substance itself, but also by the user’s set and setting. Here we describe the effects of alcohol in general.

The effect alcohol has strongly depends on the dose, or more precisely: on the blood alcohol concentration (BAC).

Positive effects (negative) Side effects

Cheerful, happy, euphoric feelings

You feel energetic and comfortable in your own skin. This is often accompanied by cheerfulness and happiness.

Disinhibition

This substance leads to an increase in impulsive behaviour and can make you less aware of the possible consequences that certain actions have. This can be nice because, for example, it is easier to approach someone and have a chat. However, it can also lead to negative situations as you can get into an argument or physical altercation more quickly.

Disinhibition

This substance leads to an increase in impulsive behaviour and can make you less aware of the possible consequences that certain actions have. This can be nice because, for example, it is easier to approach someone and have a chat. However, it can also lead to negative situations as you can get into an argument or physical altercation more quickly.

Aggressive

Some drugs can make you more aggressive.

Relaxation

Reduction of stress, uneasiness, sadness, panic, and feelings of depression.

Confusion

You can get confused. Logical thinking is then difficult. It is also possible that you do not remember what you just did.

Increase in self-confidence

You feel more confident. It may be easier to ignore the opinions of others, and you will feel less self-conscious about yourself and your own actions.

Amplified emotions

You may feel happier, but you may also feel sadder or angrier. It may at times be a positive effect and at other times a negative effect.

Easier talking and social contact

Inhibitions that you might normally experience in social contact may be less present. For example, while drinking alcohol at a party, it may be easier to approach someone or connect with other people.

Vasodilation (blood vessel dilation)

Some drugs cause your blood vessels to dilate (widen).

Amplified emotions

You may feel happier, but you may also feel sadder or angrier. It may at times be a positive effect and at other times a negative effect.

Bradycardia (decrease in heart rate)

Sorry, this entry is only available in Dutch.

Slowed breathing

Sorry, this entry is only available in Dutch.

Impaired reaction time

Drug use can negatively affect reaction time.

Impaired coordination

Drug use can negatively affect the coordination of your body parts.

Impaired sensory perception

Drug use can negatively affect sensory perception.

Dilated pupils

Due to an increased noradrenaline level in the body after taking certain drugs, the pupils become larger. The pupil size is influenced by many different processes. Increase in noradrenaline plays a role in some of those processes.

Black-out & grey-out

If you drink a lot of alcohol in one sitting, you may experience a blackout. This is a temporary memory disorder in which there is a disruption in information transfer from short-term memory to long-term memory. The next day you no longer know what you have done and where you have been. Even if somebody helps you out with some cues.

You can also experience a grey-out; you still remember things, but only fragments. Again, an error has occurred in the transfer of information from short-term to long-term memory.

If you have often experience black- or grey-outs, it is harmful to your brain. Furthermore, this can be an indication that you drink too much too often.

After a night of binge drinking, your memory functions poorly the day after, even though the alcohol has completely disappeared from your blood. Short-term memory in particular is (temporarily) affected.

Decreased long-term memory

Drug use can affect long-term memory in a negative way.

Dizziness

Nausea/vomiting

An uneasy and tense feeling in the abdomen, which may cause discomfort. Nausea often precedes vomiting.

Dehydration

Some drugs have a diuretic effect. The kidneys then excrete more water than is normally the case. This ends up in the bladder and leaves the body by urinating.

If you lose too much water by urinating and sweating a lot and drinking too little, you can become dehydrated. There is a shortage of water in the body.


Dosage and route of administration

Alcohol is taken orally and is found in beverages such as beer, wine, vodka or cocktails. Alcohol makes its way through the oesophagus into the stomach where it’s digested. The alcohol is partially absorbed from the stomach directly into the bloodstream. See also: The body. Drinks with a high alcohol content are absorbed faster than weak alcoholic drinks. Carbonated drinks and hot drinks are also absorbed faster.

Dosage of alcohol is often indicated in standard drink, or standard glass. The standard sizes of glasses in the Netherlands are made in such a way that one drink will contain 10 grams of pure alcohol. Beer contains an average of about 5% alcohol, wine about 12% and vodka 40%. A glass of beer is bigger than a glass of wine or a shot glass. There is no difference in the amount of alcohol, but you knock back a shot of vodka a lot faster than a mixed drink, which means you can increase your alcohol intake more quickly.

Please note: not everyone uses standard glasses, or precisely pours 1 measure of vodka into your glass. 


Duration of action of alcohol

Alcohol is first metabolised by the liver into acetaldehyde, then into acetic acid. This process is commonly referred to when talking about the breakdown of alcohol. Within 1.5 hours, a standard glass of alcohol is converted from alcohol to acetaldehyde to acetic acid. The effect of 1 standard glass of alcohol is therefore approximately 1.5 hours.


Risks of alcohol use

Short-term risks of use

Alcohol hangover

When you drink a lot of alcohol you can get a hangover; unpleasant and debilitating effects felt after alcohol consumption that can make you feel ill. When you have a hangover, detoxification of the body is taking place. Symptoms of a hangover include nausea, vomiting, tremors, dizziness, headaches, thirstiness and sweating. This can last for several hours.

A hangover has various causes, most importantly dehydration. The kidneys are stimulated to secrete extra fluids. The result is that you urinate more and more frequently, and therefore dehydrate faster. With spirits, the hangover is even more severe due to stronger alcohols containing less water, unlike weaker alcohols like beer.

Another cause is the conversion of alcohol into the toxic substances ADH (acetaldehyde) and ALDH (alcohol dehydrogenase). This substance is created during the breakdown of alcohol and causes headaches and trembling. The more you drink, the more of these substances are metabolised by your liver.

A third cause for a hangover are fusel alcohols. These are types of alcohol different to regular alcohol, and these toxic substances are broken down at a slower rate. Alcohol irritates your stomach lining, causing you to feel nauseous and to vomit.

Aspects personal to the user also play a role. If you are tired or not feeling well, the hangover will also be worse.

Alcohol poisoning

If you drink copious amounts of alcohol in one sitting, you can get alcohol poisoning. The alcohol concentration in blood and in the brain becomes so high that you can lose consciousness or slip into a coma. 

Ultimately, the central nervous system can become slowed down to such a degree that it paralyzes the respiratory system. This can be fatal. In adults, alcohol poisoning can already occur at four per mille, in younger and inexperienced drinkers this is much lower.

Unsafe sex

Drugs can blur your boundaries and allows you to do things that you would never dare to do in a sober state. Unprotected sex can be the result.

Alcohol and unsafe sex

Alcohol has an inhibiting effect, which can increase your sex drive.

In addition, alcohol lowers testosterone levels in men, making it more difficult to get an erection and ejaculate. In contrast, testosterone levels are increased in women which causes an orgasm to be experienced as more intense. However, high alcohol consumption can decrease a woman’s sex drive.

Sleep quality

Alcohol relaxes and you usually fall asleep quickly. When you drink a lot, your sleep becomes disrupted and you wake up earlier. You don’t get enough deep sleep causing you to feel less rested. Alcohol reduces your REM sleep. Read more: What happens when alcohol and the effects of sleep deprivation come together?

Bad breath

Alcohol is transported through your blood and passes through various organs, including your lungs. Part of the alcohol is excreted via the alveoli. This is how police can measure the amount of alcohol in your body via a breath alcohol test.

Black-out & grey-out

If you drink a lot of alcohol in one sitting, you may experience a blackout. This is a temporary memory disorder in which there is a disruption in information transfer from short-term memory to long-term memory. The next day you no longer know what you have done and where you have been. Even if somebody helps you out with some cues.

You can also experience a grey-out; you still remember things, but only fragments. Again, an error has occurred in the transfer of information from short-term to long-term memory.

If you have often experience black- or grey-outs, it is harmful to your brain. Furthermore, this can be an indication that you drink too much too often.

After a night of binge drinking, your memory functions poorly the day after, even though the alcohol has completely disappeared from your blood. Short-term memory in particular is (temporarily) affected.

Long-term risks of use

Weight gain

Whether alcohol makes you gain weight depends on your lifestyle; what you eat, drink and how much you exercise. Alcoholic drinks are high in carbohydrates (7 calories per gram alcohol). Alcoholic beverages and mixed drinks often also contain high amounts of sugar. Additional, alcohol cannot be stored in the body and is quickly burned for energy. This suppresses the burning of other energy sources, especially fat. The fat that remains is stored, mostly around the abdominal area.

Small amounts of alcohol can increase your appetite (by stimulating the stomach). In contrast, larger amounts of alcohol may make you feel full, but do not contribute to a healthy diet as alcohol provides a lot of calories and hardly any important nutrients such as proteins, vitamins and minerals.

Cardiovascular disease

Upward of three glasses of alcohol a day has a negative impact on the heart; the risk of high blood pressure and consequently a heart attack increases. Alcohol can also lead to heart failure and cardiac arrhythmias as the heart muscle no longer able to contract or relax properly. The risk of brain haemorrhages and stroke likewise increases with prolonged alcohol abuse.

Moderate alcohol usage (maximum one to two glasses per day) has a protective effect on the heart and blood vessels. It can somewhat prevent clogging of the blood vessels by cholesterol. It does not matter whether you drink wine or any other alcoholic beverage. However, this beneficial effect only applies to healthy men over 40 and healthy women after menopause. Because of other negative health effects and the risk of addiction, alcohol has no medicinal value. Exercise, healthy eating and not smoking are better ways to prevent cardiovascular disease.

Stomach and liver diseases

Stomach lining

Excessive alcohol consumption can inflame the stomach lining. You may experience bloating, belching, stomach pain and heartburn.

Liver diseases

Alcohol is broken down by the liver. Because alcohol is a toxic substance, it will always be the first in line to be metabolized by the liver. Excessive alcohol consumption can damage the liver.

Fatty liver

Excessive alcohol consumption interferes with liver functioning and can lead to a build-up of fat in the liver (fatty liver) and blood, which can cause the liver to swell. This can already happen after a few days of heavy drinking and is accompanied by pain, poor appetite, nausea and vomiting, and sometimes jaundice. Fat accumulation can damage liver cells and lead to cell death. When you stop drinking the liver can, depending on the damage, recover after a few weeks.

Alcoholic hepatitis and Liver cirrhosis

In addition to a fatty liver, alcohol can also cause two other liver diseases: alcohol hepatitis and liver cirrhosis. Alcoholic hepatitis is an inflammation of the liver that can make you seriously ill with severe abdominal pain, fever, poor appetite and jaundice. Alcoholic hepatitis is a serious disease with potentially fatal consequences and additionally it can be a precursor to liver cirrhosis. Cirrhosis is a severe condition in which liver cells die and are replaced by connective tissue. Blood vessels running  through the liver are narrowed which severely impairs liver function. The liver shrivels and shrinks. Liver cirrhosis is irreversible, however it can become stable when you stop drinking alcohol. When the liver can no longer detoxify your blood, metabolites may end up in the brain and cause drowsiness, confusion and coma, ultimately resulting in death.

Cancer

Alcohol increases the risk of cancer. There is an increased risk of colon cancer upward of three glasses of alcohol a day. The risk of breast cancer in women is already increased from one glass per day, probably due to the effect alcohol has on the endocrine system. Upward of four glasses a day for women and six glasses a day for men increases the risk of oesophageal cancer. For oral cavity cancer, it is six glasses a day for women and eight glasses a day for men. The risk of these types of cancers is extra high for those who both drink and smoke. Only heavy alcohol consumption leads to an increased risk of liver cancer and pancreatitis, which in turn increases the risk of pancreatic cancer.

Pancreatitis

Alcoholics can develop inflammation of the pancreas. Alcohol stimulates the pancreas to make more digestive liquids. Abnormal activation of inactive enzyme precursors within the pancreas leads to acute inflammation.

Korsakoff

Alcohol causes inflammation of the stomach lining, leading to a vitamin B1 deficiency. Drinking alcohol excessively for years, in combination with poor diet nd a vitaminB1 deficiency, can lead to irreparable brain damage. The most severe form is Korsakoff’s syndrome. Korsakoff patients suffer from amnesia, loss of the ability to learn something new, and a disturbed understanding of time and place.

Weight loss

There is a short-term risk of weight gain from alcohol, but drinking more and more often increases the chances of becoming emaciated or malnourished. This is because alcohol in large quantities makes you feel full and you are less hungry. Alcohol does provide energy but has no nutritional value and if the drinker also neglects their diet, there is a risk of malnutrition. Alcoholics often eat poorly and the alcohol also damages the intestinal wall, making the body less able to absorb nutrients.

Physical addiction

Regular use of this drug can lead to physical addiction. This means that in addition to the psychological urge to take more, withdrawal symptoms arise when using is interrupted or stopped. Withdrawal symptoms include but are not limited to: poor sleep, sweating and becoming restless.

Withdrawal symptoms are often a reason to start drinking or using again. In actuality, those phenomena are only temporarily  suppressed.

Tolerance or habituation also occurs. That means if you use it regularly, you need more to feel the same effect.

Tolerance and stimulants

With stimulant use, tolerance will build-up for both the mental changes and appetite-suppressing effect, but not for cardiovascular effects. The higher your dose, the higher your blood pressure.

Psychological dependency

When someone has a psychological dependency, they are convinced that they cannot function without using the substance.

However, there is no physical change in body chemistry that would produce bodily side effects from quitting the substance.


Interactions

Combining different types of drugs can be risky and unpredictable. When you combine drugs you can have a higher risk of health problems. In the following paragraphs you can read about the effects and the risks of a number of combinations that occur frequently and also a about few that are extra hazardous. Also check our theme combining drugs.

Alcohol and benzodiazepines (anxiety or sleeping medication)

Both alcohol and benzodiazepines have a depressant effect in the body. They inhibit activity in your brain. The combination could put you in a coma, stop breathing or make you choke on your own vomit. Your body can then no longer respond properly if you vomit and if you lie on your back, for example, you can choke on your own vomit. This combination can also lead to unpredictable and reckless behavior. After using benzodiazepines, you often don’t remember what you did.

Alcohol and caffeine

You feel the effects of alcohol less after using caffeine. For example, think about energy drinks. Because of the caffeine you can  drink more and longer. On the other hand, the alcohol can help to weaken the effect of the caffeine. You are more relaxed, but a bit more awake. This can also cause you to drink more caffeine than if you didn’t drink alcohol. You’re more likely to overestimate yourself.
Keep in mind that if you drink faster and more, the hangover is also considerably bigger. This is also because the combination also causes the body to lose more fluid than if you only drink alcohol or caffeine.

Alcohol and cannabis

How you will feel depends on, among other things, the order and the amounts you take. And whether you smoke and/or drink more often.

If you drink first and then smoke weed, there is a good chance that you will feel quite nauseous. You may have to throw up. The more you drink, the more likely it is.

Smoking weed first and then drink? Then the amount of alcohol someone drinks is often much smaller than the other way around. You can then easier feel what is still pleasant. And it’s easier to stop drinking if you notice that you’re feeling a bit nauseous.

The combination of smoking and drinking therefore increases the risk of nausea and vomiting. You can then feel really bad. So before you take the ‘second’ drug, think about whether it will make you feel better. If in doubt, stick to one of them.

Alcohol and cocaine

You feel the effects of alcohol less after using cocaine. That is why you can continue to drink more and longer. On the other hand, the alcohol can help to soften the effects of the cocaine. You are more relaxed and less tense. This interaction is often experienced as pleasant. But keep in mind that if you drink (and snort) faster and more, the hangover is also considerably bigger. Consider whether the combination actually gives you the effects that you want.

You can associate alcohol with coke use after a while. When you drink alcohol you feel the urge to snort more quickly and when you are snorting you want to continue drinking. When both substances are in your body, the substance cocaethylene is also produced. This is an extra burden and is harmful to your heart and blood vessels. In addition, cocaine also gives you the feeling that you are not or less drunk than you really are. This can be very dangerous, for example in traffic. Therefore, think carefully in advance how much you want to use, so the risks are limited.

Alcohol and GHB

The combination of GHB with alcohol increases the risk of overdose, passing out and respiratory depression. We therefore advise against the combination of GHB and alcohol. Especially if you drink first and then take GHB.

Alcohol and nitrous oxide

Combination with alcohol or other downers can increase the anesthetic effect of nitrous oxide and the risks. The chance that you’ll get nausea and dizziness increases.

Alcohol and speed or other stimulants

Using speed makes you feel awake and cheerful. As a result, you may feel the sedating effects of the alcohol less and you may tend to drink more alcohol. Be careful, because this can cause an extra large hangover. So do not drink alcohol while taking speed use or make an agreement in advance with yourself or your friends how many glasses of alcohol you want to drink. This prevents headaches the next day and is better for your health!


Unity tips for using alcohol

  • Drink a glass of water with every glass of alcohol to prevent dehydration and a hangover.
  • Do not drink alcohol to quench thirst.
  • Rest well before and after alcohol use and eat healthy. Take extra vitamin B.
  • Do not drink alcohol daily, or in any case no more than one glass of alcohol per day. And keep at least two alcohol-free days a week.
  • Drink only for pleasure or relaxation. Don’t drink to drink away stress or problems.
  • Only drink when you feel good mentally and physically.
  • Do not combine alcohol with drugs, sleeping pills, tranquilizers or other medicines.
  • Don’t drink while driving.
  • Do not drink during pregnancy or breastfeeding.
  • Keep in mind that alcohol can be an aphrodisiac. Protect yourself against STDs and AIDS during sex by using a condom.

Unity tips for using drugs

  • When using a drug for the first time, take only a small dose to see how your body reacts to the substance
  • Only use drugs when you are feeling well
  • Use drugs recreationally, not to combat psychological issues like fatigue
  • Avoid using drugs if you have (had) psychological afflictions or if you have a family history of psychological diseases (such as depression) in your family
  • Test your drugs before use at a drugs-testing service
  • Make sure to prepare a good set and setting for drug use
  • Only use drugs sparingly. Keep track of your use over time.
  • Decide in advance how much you are planning to use over the evening, and stick to that. 
  • Do not combine drugs with other substances or medicines
  • Do not participate in traffic after drug use
  • Prevent infectious diseases; Use your own snorter/sniffer and do not share paraphernalia with others
  • After insufflating, rinse your nose well with lukewarm saline water (for example, by using a nasal spray or nasal douche)
  • Are you, or one of your friends not feeling well? Keep an eye out for one another, take care of each other and visit the first aid (if one is available)
  • Call 112 in a life-threatening situation
  • Eat healthy before and after drug use. In particular, foods with lots of antioxidants and vitamins (blueberries, raspberries, blackberries, grapes, raisins, oranges, kiwi, broccoli). This is perhaps the most important tip! It can be difficult to eat during and after drug use, but make sure to try to eat something anyway. Eating well is a great way to reduce the hangover! If you can’t hold in solid foods, try juices, breakfast drinks, and smoothies.

Unity tips for using sedatives

  • Do not use sedatives (downers) in combination with other sedatives (alcohol, GHB, sleeping pills, opiates) or ketamine. This is dangerous because you can fall unconscious and suffocate on your vomit.
  • Write down the time of intake and your dose, text the dose and time to each other or put it in your phone to keep track of it yourself.
  • If you feel that you are getting falling asleep, you can try to keep moving to avoid falling asleep. But beware; if moving takes a lot of effort, there is a chance that you may fall or trip, so be careful.
  • An overdose is more likely on an empty stomach, a full stomach increases the chance of vomiting.
  • Less is more; taking a small, extra dose later because you did not feel anything after your first dose is better than taking too much and having an overdose.
  • Ensure that the people around you are aware of what you are going to use and have been using.

FAQ

What does the blood alcohol level mean?

Alcohol does not cause the same blood alcohol level (BAC) in everyone. BAC is the number of grams of alcohol per liter of blood. There are all kinds of personal factors that influence this:

  • The alcohol is distributed over the total amount of body water. Someone who weighs a lot therefore notices less of the same number of glasses than someone who weighs little.
  • Whether you are a man or a woman also influences the blood alcohol level. A woman’s body contains less fluid per kilogram of weight than a man’s. That is why the alcohol is less diluted in women and women are on average more intoxicated than men.
  • Stomach filling may also play a role. The food in the stomach and the beginning of the intestines ensures that the alcohol is absorbed more evenly and more slowly into the blood. In short: with a full stomach you are less quickly to be under the influence of alcohol than if you drink on an empty stomach.
  • Your physical condition and whether you use medication or drugs also influence the blood alcohol level.
  • One standard glass of alcohol contains 10 grams of alcohol and leads on average to a blood alcohol level of 0.2 in men and 0.3 in women.
    Strong drinks are absorbed faster than low alcoholic drinks. Carbonated drinks and hot drinks are also absorbed faster.

So the blood alcohol level is an indication of how much you had to drink.

What is the norm for responsible alcohol use?

In the Netherlands, the Health Council applies a medically responsible standard for alcohol consumption. Based on an extensive consideration of the positive and negative effects of alcohol on health, the Health Council has arrived at the following standard: Do not drink alcohol or in any case no more than one standard glass of alcohol per day. Preferably with two consecutive alcohol-free days. However, women may also have a slightly increased risk of breast cancer if they drink one glass of alcohol.

If you drink more alcohol than the norm for responsible alcohol consumption, you run the risk of low iron levels in your blood, fatty liver, fatigue, depression, problems at work, cancer and high blood pressure.

If you drink more than this standard, you are not automatically an alcoholic.

How is alcohol created? And in what forms does it come?

Alcohol is created from fermentation. Grapes are used for wine, barley and wheat for beer and grains or fruits for spirits. The natural fermentation process stops at about 15% alcohol. We call this fermented alcohol. Higher alcohol percentages can be created by heating and cooling low-alcohol drinks (distillations), which we call spirits or distilled alcohol.
In addition to beers, wines and all kinds of spirits and liqueurs, there are also mixed drinks, shooters, alcopops and blasters on the market. A mixed drink is spirits mixed with soft drinks; think, for example, of a rum with cola or vodka with orange juice. The alcohol percentage is between 5 and 7%, depending on who pours it. Shooters are liqueurs with a high alcohol content (around 20%), usually in small bottles of 20ml. Alcopops are made by fermenting fruit juices, but alcohol and carbon dioxide are often added as well. An alcopop contains as much alcohol as a glass of beer, a glass of wine or a glass of spirits, because it is mixed with a non-alcoholic drink. Breezers are, for example, alcopops. Blasters are similar to mixed drinks but usually contain a stimulant such as caffeine or guarana as a non-alcoholic additive. Vodka Red Bull is the best known.

What are the risks when you drink alcohol during pregnancy?

Drinking one or more glasses of alcohol reduces fertility in both men and women. Drinking alcohol during pregnancy can lead to miscarriages, premature birth and problems in mental development, such as memory, intelligence and math. Six drinks or more increases the risk of FAS, fetal alcohol syndrome. This causes the baby to have a low birth weight, smaller skull, short height and possible facial abnormalities.

Someone close to me uses this substance almost every weekend. Should I worry?

When someone close to you uses a substance often it is normal to worry. There are risks: to physical health; that he/she will gradually use more and more and become dependent. When only using it on weekends, there is the possibility that he/she is able anymore to go out without using. It can then be useful to have a conversation with each other in an open, non-judgmental way. Mention the impact the use has on you as a person, for example that you are worried. If you would like tips or advice for this, please contact the addiction care institution in your region.

 


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