Alcohol (drug)
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| Pronunciation | /ˈɛθənɒl/ | ||
| Other names | Absolute alcohol; Alcohol (USP); Cologne spirit; Drinking alcohol; Ethanol (JAN); Ethylic alcohol; EtOH; Ethyl alcohol; Ethyl hydrate; Ethyl hydroxide; Ethylol; Grain alcohol; Hydroxyethane; Methylcarbinol | ||
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| Dependence liability | Physical: Very High
Euphoriant; GABAA receptor positive modulators; Sedative | ||
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JSmol) | |||
| Density | 0.7893 g/cm3 (at 20 °C)[10] | ||
| Melting point | −114.14 ± 0.03 °C (−173.45 ± 0.05 °F) [10] | ||
| Boiling point | 78.24 ± 0.09 °C (172.83 ± 0.16 °F) [10] | ||
| Solubility in water | Miscible mg/mL (20 °C) | ||
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Alcohol, sometimes referred to by the chemical name ethanol, is a depressant drug found in fermented beverages such as beer, wine, and distilled spirit[11] -- in particular, rectified spirit.[12] Ethanol is colloquially refereed to as "alcohol" because it is the most prevalent alcohol in alcoholic beverages, but technically all alcoholic beverages contain several types of psychoactive alcohols, that are categorized as
Ethanol is classified as a
Alcohol serves various purposes, for example, it is one of the oldest and most commonly consumed
Alcohol works in the brain primarily by increasing the effects of
Uses
Dutch courage
Dutch courage, also known as pot-valiance or liquid courage, refers to courage gained from intoxication with alcohol.
Alcohol use among college students is often used as "liquid courage" in the hookup culture, for them to make a sexual advance in the first place.[32]: 200
Criminal
Albeit not a valid
Consuming alcohol prior to visiting female sex workers is a common practice among some men.[33] Also, sex workers often resort to using drugs and alcohol to cope with stress. However, female sex workers in low- and middle-income countries have high rates of harmful alcohol use, which is associated with increased risk of risky sexual behavior.[34]
Warfare
Alcohol has a long association of military use, and has been called "
War has specific rules under international law, including the Geneva Conventions. These rules allow for the use of force against enemy combatants, but also prohibit targeting civilians or using unnecessary force. If a soldier kills an enemy combatant while intoxicated, it wouldn't necessarily be considered a crime under international law (though it might violate military regulations). However, intoxication leading to civilian casualties or unnecessary force constitutes a war crime.
Food energy
The use of alcohol as a staple food source is considered inconvenient due to the fact that it increases the blood alcohol content (BAC). However, alcohol is a significant source of food energy for individuals with alcoholism and those who engage in binge drinking; For example, individuals with drunkorexia, engage in the combination of self-imposed malnutrition and binge drinking to avoid weight gain from alcohol, to save money for purchasing alcohol,[37] and to facilitate alcohol intoxication.[38]
The
Alcoholic drinks are considered
Medical
When taken by mouth or
Ethanol, when used for toxicity,
Recreational
Common drinking styles include social drinking, binge drinking, drinking games, pub crawls, and sober curious.
Self-medication
The therapeutic index for ethanol is only 10%.[46]
Alcohol can have analgesic (pain-relieving) effects, which is why some people with chronic pain turn to alcohol to self-medicate and try to alleviate their physical discomfort.[47]
People with
Unscientific
In
"
Drinking alcohol will not prevent or cure COVID-19,[60] contrary to some claims.[61] Instead, drinking alcohol may cause subclinical immunosuppression.[62]
Spiritual
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Contraindication
In the US, alcohol is subject to the FDA drug labeling
Ethanol is classified as a
Minnesota, North Dakota, Oklahoma, South Dakota, and Wisconsin have laws that allow the state to involuntarily commit pregnant women to treatment if they abuse alcohol during pregnancy.[66]
Adverse effects
Alcohol has a variety of short-term and long-term
Alcohol is a common cause of
An inability to process or exhibit emotions in a proper manner has been shown to exist in people who consume excessive amounts of alcohol and those who were exposed to alcohol while fetuses (FAexp).[74]
Short-term effects
The amount of ethanol in the body is typically quantified by blood alcohol content (BAC); weight of ethanol per unit volume of blood. Small doses of ethanol, in general, are stimulant-like[75] and produce euphoria and relaxation; people experiencing these symptoms tend to become talkative and less inhibited, and may exhibit poor judgement. At higher dosages (BAC > 1 gram/liter), ethanol acts as a central nervous system (CNS) depressant,[75] producing at progressively higher dosages, impaired sensory and motor function, slowed cognition, stupefaction, unconsciousness, and possible death. Ethanol is commonly consumed as a recreational substance, especially while socializing, due to its psychoactive effects.
Central nervous system impairment
Alcohol causes generalized CNS depression, is a
as result of high levels of ethanol in blood.At very high concentrations, alcohol can cause
Gastrointestinal effects
Alcohol can cause nausea and vomiting in sufficiently high amounts (varying by person).
Alcohol stimulates gastric juice production, even when food is not present, and as a result, its consumption stimulates acidic secretions normally intended to digest protein molecules. Consequently, the excess acidity may harm the inner lining of the stomach. The stomach lining is normally protected by a mucosal layer that prevents the stomach from, essentially, digesting itself. However, in patients who have a
Ingestion of alcohol can initiate systemic pro-inflammatory changes through two intestinal routes: (1) altering intestinal microbiota composition (dysbiosis), which increases lipopolysaccharide (LPS) release, and (2) degrading intestinal mucosal barrier integrity – thus allowing LPS to enter the circulatory system. The major portion of the blood supply to the liver is provided by the portal vein. Therefore, while the liver is continuously fed nutrients from the intestine, it is also exposed to any bacteria and/or bacterial derivatives that breach the intestinal mucosal barrier. Consequently, LPS levels increase in the portal vein, liver and systemic circulation after alcohol intake. Immune cells in the liver respond to LPS with the production of reactive oxygen species, leukotrienes, chemokines and cytokines. These factors promote tissue inflammation and contribute to organ pathology.[78]
Holiday heart syndrome
Holiday heart syndrome, also known as alcohol-induced atrial arrhythmias, is a syndrome defined by an irregular heartbeat and palpitations[79] associated with high levels of ethanol consumption.[80][81] Holiday heart syndrome was discovered in 1978 when Philip Ettinger discovered the connection between arrhythmia and alcohol consumption.[82] It received its common name as it is associated with the binge drinking common during the holidays.[83] It is unclear how common this syndrome is. 5-10% of cases of atrial fibrillation may be related to this condition, but it could be as high 63%.[84]
Positional alcohol nystagmus
Positional alcohol nystagmus (PAN) is
Specific population
Allergic-like reactions
Ethanol-containing beverages can cause alcohol flush reactions, exacerbations of
- genetic abnormalities in the metabolism of ethanol, which can cause the ethanol metabolite, acetaldehyde, to accumulate in tissues and trigger the release of histamine, or
- true allergy reactions to allergens occurring naturally in, or contaminating, alcoholic beverages (particularly wine and beer), and
- other unknown causes.
Long-term effects
Due to the
Prolonged heavy consumption of alcohol can cause significant permanent damage to the brain and other organs, resulting in dysfunction or death. The impact of alcohol on aging is multifaceted. The relationship between alcohol consumption and body weight is the subject of inconclusive studies. Alcoholic lung disease is disease of the lungs caused by excessive alcohol. However, the term 'alcoholic lung disease' is not a generally accepted medical diagnosis.
Alcoholism
Alcoholism or its medical diagnosis alcohol use disorder refers to alcohol addiction, alcohol dependence, dipsomania, and/or alcohol abuse. It is a major problem and many health problems as well as death can result from excessive alcohol use.[89][67] Alcohol dependence is linked to a lifespan that is reduced by about 12 years relative to the average person.[89] In 2004, it was estimated that 4% of deaths worldwide were attributable to alcohol use.[67] Deaths from alcohol are split about evenly between acute causes (e.g., overdose, accidents) and chronic conditions.[67] The leading chronic alcohol-related condition associated with death is alcoholic liver disease.[67] Alcohol dependence is also associated with cognitive impairment and organic brain damage.[89] Some researchers have found that even one alcoholic drink a day increases an individual's risk of health problems by 0.4%.[90]
Two or more consecutive alcohol-free days a week have been recommended to improve health and break dependence.[91][92]
A high-functioning alcoholic (HFA) is a person who maintains jobs and relationships while exhibiting alcoholism.[95][96][97]
Many Native Americans in the United States have been harmed by, or become addicted to, drinking alcohol.[98]
Alcohol withdrawal syndrome
Discontinuation of alcohol after extended heavy use and associated
Delirium tremens is a condition that requires people with a long history of heavy drinking to undertake an alcohol detoxification regimen.
Alcohol is one of the more dangerous drugs to withdraw from.
Alcoholic ketoacidosis
Alcoholic ketoacidosis (AKA) is a specific group of symptoms and metabolic state related to alcohol use.[102] Symptoms often include abdominal pain, vomiting, agitation, a fast respiratory rate, and a specific "fruity" smell.[103] Consciousness is generally normal.[104] Complications may include sudden death.[104]
Alcoholic polyneuropathy
Alcoholic polyneuropathy is a
Alcohol-related dementia (ARD) is a form of
Alcohol and cardiovascular disease
Alcoholic cardiomyopathy
Alcoholic cardiomyopathy (ACM) is a disease in which the long-term consumption of alcohol leads to heart failure.[106] ACM is a type of dilated cardiomyopathy. The heart is unable to pump blood efficiently, leading to heart failure. It can affect other parts of the body if the heart failure is severe. It is most common in males between the ages of 35 and 50.
Austrian syndrome
The leading cause of Osler's triad (Austrian syndrome) is Streptococcus pneumoniae, which is usually associated with heavy alcohol use.
Brain damage
Alcohol can cause
Cancer
The
A 2001 meta-analysis did not find a clear safe level of alcohol consumption where there is no increased risk of cancer.
Cortisol
Research has looked into the effects of alcohol on the amount of cortisol that is produced in the human body. Continuous consumption of alcohol over an extended period of time has been shown to raise cortisol levels in the body. Cortisol is released during periods of high stress, and can result in the temporary shut down of other physical processes, causing physical damage to the body.
Liver damage
Consuming more than 30 grams of pure alcohol per day over an extended period can significantly increase the risk of developing alcoholic liver disease.[111] During the metabolism of alcohol via the respective dehydrogenases, nicotinamide adenine dinucleotide (NAD) is converted into reduced NAD. Normally, NAD is used to metabolize fats in the liver, and as such alcohol competes with these fats for the use of NAD. Prolonged exposure to alcohol means that fats accumulate in the liver, leading to the term 'fatty liver'. Continued consumption (such as in alcohol use disorder) then leads to cell death in the hepatocytes as the fat stores reduce the function of the cell to the point of death. These cells are then replaced with scar tissue, leading to the condition called cirrhosis.
Specific population
- Pregnant women: Babies exposed to alcohol, benzodiazepines, barbiturates, and some antidepressants (SSRIs) during pregnancy may experience neonatal withdrawal.[112]
Other effects
Frequent drinking of alcoholic beverages is a major contributing factor in cases of elevated blood levels of triglycerides.[113]
Social issues
Alcohol causes a plethora of detrimental effects in society.
Individuals who engage with or share alcohol-related content on social networking services tend to exhibit higher levels of alcohol use and related issues.[115] Alcohol availability and consumption rates and alcohol rates are positively associated with nuisance, loitering, panhandling, and disorderly conduct in public space.[116] Recent research indicates that the abundance of alcohol retailers and the availability of inexpensive alcoholic beverages are linked to heavy alcohol consumption among college students.[117] Also, joblessness can heighten the risk of alcohol consumption and smoking.[118]
Alcohol use is stereotypically associated with crime,
In the early 2000s, the monetary cost of alcohol-related crime in the United States alone has been estimated at over $205 billion, twice the economic cost of all other
Automobile accidents
A 2002 study found 41% of people fatally injured in traffic accidents were in alcohol-related crashes.
Most countries have passed laws prohibiting driving a
Methanol laced alcohol
Methanol is a toxic alcohol. If as little as 10 mL of pure methanol is ingested, for example, it can break down into
India has a thriving moonshine industry, and methanol-tainted batches have killed over 2,000 people in the last 3 decades.
Public drunkenness
Public drunkenness or intoxication is a common problem in many jurisdictions. Public intoxication laws vary widely by jurisdiction, but include public nuisance laws, open-container laws, and prohibitions on drinking alcohol in public or certain areas. The offenders are often lower class individuals and this crime has a very high recidivism rate, with numerous instances of repeated instances of the arrest, jail, release without treatment cycle. The high number of arrests for public drunkenness often reflects rearrests of the same offenders.[123]
Rape
Rape is any sexual activity that occurs without the freely given consent of one of the parties involved. This includes alcohol-facilitated sexual assault which is considered rape in most if not all jurisdictions,[138] or non-consensual condom removal which is criminalized in some countries (see the map below).
Risky sexual behaviors like unprotected sex can lead to sexually transmitted infections and unintended pregnancy.
Non-consensual condom removal
Non-consensual condom removal, or "stealthing",[139] is the practice of a person removing a condom during sexual intercourse without consent, when their sex partner has only consented to condom-protected sex.[140][141] Purposefully damaging a condom before or during intercourse may also be referred to as stealthing,[142] regardless of who damaged the condom.
Consuming alcohol can be risky in sexual situations. It can impair judgment and make it difficult for both people to give or receive informed sexual consent. However, a history of sexual aggression and alcohol intoxication are factors associated with an increased risk of men employing non-consensual condom removal and engaging in sexually aggressive behavior with female partners.[143][144]
Sexual assault
One of the most common date rape drugs is alcohol,[146][147][148] administered either surreptitiously[149] or consumed voluntarily,[146] rendering the victim unable to make informed decisions or give consent. The perpetrator then facilitates sexual assault or rape, a crime known as drug-facilitated sexual assault (DFSA).[138][150] However, sex with an unconscious victim is considered rape in most if not all jurisdictions, and some assailants have committed "rapes of convenience" whereby they have assaulted a victim after he or she had become unconscious from drinking too much.[151] The risk of individuals either experiencing or perpetrating sexual violence and risky sexual behavior increases with alcohol abuse,[152] and by the consumption of caffeinated alcoholic drinks.[153][154]
Violent crime
The World Health Organization has noted that out of social problems created by the harmful use of alcohol, "crime and violence related to alcohol consumption" are likely the most significant issue.[127] In the United States, 15% of robberies, 63% of intimate partner violence incidents, 37% of sexual assaults, 45–46% of physical assaults and 40–45% of homicides (murders) involved use of alcohol.[156][125] A 1983 study for the United States found that 54% of violent crime perpetrators, arrested in that country, had been consuming alcohol before their offenses.[123] In 2002, it was estimated that 1 million violent crimes in the U.S. were related to alcohol use.[89] More than 43% of violent encounters with police involve alcohol.[89] Alcohol is implicated in more than two-thirds of cases of intimate partner violence.[89] Studies also suggest there may be links between alcohol abuse and child abuse.[116] In the United Kingdom, in 2015/2016, 39% of those involved in violent crimes were under alcohol influence.[157] International studies are similar, with an estimate that 63% of violent crimes worldwide involves the use of alcohol.[125]
The relation between alcohol and violence is not yet fully understood, as its impact on different individuals varies.[
Binge drinking
Binge drinking is more common in males, during adolescence and young adulthood. Heavy regular binge drinking is associated with adverse effects on
Environment
Alcoholic beverage containers, particularly broken glass bottles, are a common source of litter that is difficult to clean up, which may puncture bicycle tires, hurt wild life animals, etc. Alcoholic bottles are often discarded improperly, not recycled, or left in public spaces, which have negative impacts on the environment. Alcohol may negatively impact decision making in taking environmental responsibility.
Hurtful communication
Alcohol may cause hurtful communication.
Drunk dialing
Drunk dialing refers to an intoxicated person making phone calls that they would not likely make if sober, often a lonely individual calling former or current love interests.
A 2021 study, that examined the relationship between drunk texting and emotional dysregulation, found a positive correlation. The findings suggest that interventions targeting emotional regulation skills may be beneficial.[164]
In vino veritas
In vino veritas is a Latin phrase that means 'in wine, there is truth', suggesting a person under the influence of alcohol is more likely to speak their hidden thoughts and desires.
Suicide
Most people are under the influence of sedative-hypnotic drugs (such as alcohol or benzodiazepines) when they die by suicide,[165] with alcoholism present in between 15% and 61% of cases.[166] Countries that have higher rates of alcohol use and a greater density of bars generally also have higher rates of suicide.[167] About 2.2–3.4% of those who have been treated for alcoholism at some point in their life die by suicide.[167] Alcoholics who attempt suicide are usually male, older, and have tried to take their own lives in the past.[166] In adolescents who misuse alcohol, neurological and psychological dysfunctions may contribute to the increased risk of suicide.[168]
Risky sexual behavior
Some studies have made a connection between hookup culture and substance use.[169] Most students said that their hookups occurred after drinking alcohol.[169][170][171] Frietas stated that in her study, the relationships between drinking and the party scene and between alcohol and hookup culture were "impossible to miss."[172]: 41
Studies suggest that the degree of alcoholic intoxication directly correlates with the level of risky behavior.[173]
In 2018, the first study of its kind, found that
Sexually transmitted infections and unintended pregnancy
Alcohol intoxication is associated with an increased risk that people will become involved in
Coitus interruptus, also known as withdrawal, pulling out or the pull-out method, is a method of birth control during penetrative sexual intercourse, whereby the penis is withdrawn from a vagina or anus prior to ejaculation so that the ejaculate (semen) may be directed away in an effort to avoid insemination.[178][179] Coitus interruptus carries a risk of STIs and unintended pregnancy. This risk is especially high during alcohol intoxication because lowered sexual inhibition can make it difficult to withdraw in time.
Women with unintended pregnancies are more likely to smoke tobacco,[180] drink alcohol during pregnancy,[181][182] and binge drink during pregnancy,[180] which results in poorer health outcomes.[181] (See also: fetal alcohol spectrum disorder)
Overdose
Symptoms of ethanol
Interactions
Disorders
Diabetes
See the insulin section.
Heptatitis
Alcohol consumption can be especially dangerous for those with pre-existing liver damage from hepatitis B or C. Even relatively low amounts of alcohol can be life-threatening in these cases,[22] so a strict adherence to abstinence is highly recommended.[185]
Hitamine intolerance
Alcohol may release histamine in individuals with histamine intolerance.[186]
Dosage forms
Alcohol induced dose dumping (AIDD)
This
Drugs
Alcohol can intensify the sedation caused by
Alcohol combined with cannabis (not to be confused with tincture of cannabis which contains minute quantities of alcohol) — known as cross-fading and may easily cause spins in people who are drunk and smoke potent cannabis; Ethanol increases plasma tetrahydrocannabinol levels, which suggests that ethanol may increase the absorption of tetrahydrocannabinol.[188]
TOMSO is a lesser-known psychedelic drug and a substituted amphetamine. TOMSO is inactive on its own; it is activated with the consumption of alcohol.
Hypnotics/sedatives
Alcohol can intensify the sedation caused by
Disulfiram-like drugs
Disulfiram
Metronidazole
Insulin
Alcohol consumption can cause
NSAIDs
The concomitant use of
Stimulants
Ethanol interacts with
A
Methanol and ethylene glycol
The rate-limiting steps for the elimination of ethanol are in common with certain other substances. As a result, the blood alcohol concentration can be used to modify the rate of metabolism of toxic alcohols, such as methanol and ethylene glycol. Methanol itself is not highly toxic, but its metabolites formaldehyde and formic acid are; therefore, to reduce the rate of production and concentration of these harmful metabolites, ethanol can be ingested.[197] Ethylene glycol poisoning can be treated in the same way.
Warfarin
Excessive use of alcohol is also known to affect the metabolism of warfarin and can elevate the INR, and thus increase the risk of bleeding.[198] The U.S. Food and Drug Administration (FDA) product insert on warfarin states that alcohol should be avoided.[199] The Cleveland Clinic suggests that when taking warfarin one should not drink more than "one beer, 6 oz of wine, or one shot of alcohol per day".[200]
Special population
Isoniazid
Levels of liver enzymes in the bloodstream should be frequently checked in daily alcohol drinkers, pregnant women, IV drug users, people over 35, and those who have chronic liver disease, severe kidney dysfunction, peripheral neuropathy, or HIV infection since they are more likely to develop hepatitis from INH.[201][202]
Pharmacology
Pharmacodynamics
_-_photographer_Charles_Percy_Pickering_(9610229733)_(2).jpg)
The principal
Much progress has been made in understanding the pharmacodynamics of ethanol over the last few decades.
In 2007, it was discovered that ethanol potentiates
A 2019 study showed the accumulation of an unnatural lipid phosphatidylethanol (PEth) competes with PIP2 agonist sites on lipid-gated ion channels.[212] This presents a novel indirect mechanism and suggests that a metabolite, not the ethanol itself, can affect the primary targets of ethanol intoxication. Many of the primary targets of ethanol are known to bind PIP2 including GABAA receptors,[213] but the role of PEth will need to be investigated for each of the primary targets.
Rewarding and reinforcing actions
The reinforcing effects of alcohol consumption are mediated by acetaldehyde generated by catalase and other oxidizing enzymes such as cytochrome P-4502E1 in the brain.[216] Although acetaldehyde has been associated with some of the adverse and toxic effects of ethanol, it appears to play a central role in the activation of the mesolimbic dopamine system.[217]
Ethanol's rewarding and reinforcing (i.e., addictive) properties are mediated through its effects on
With acute alcohol consumption, dopamine is released in the
With chronic alcohol intake, consumption of ethanol similarly induces CREB phosphorylation through the D1 receptor pathway, but it also alters NMDA receptor function through phosphorylation mechanisms;
Relationship between concentrations and effects
| mg/dL | mM | % v/v | Effects |
|---|---|---|---|
| 50 | 11 | 0.05% | Euphoria, talkativeness, relaxation, happiness, gladness, pleasure, joyfulness. |
| 100 | 22 | 0.1% | Central nervous system depression, anxiety suppression, stress suppression, sedation, nausea, possible vomiting. Impaired motor, memory, cognition and sensory function. |
| >140 | 30 | >0.14% | Decreased blood flow to brain, slurred speech, double or blurry vision. |
| 300 | 65 | 0.3% | Stupefaction, confusion, numbness, dizziness, loss of consciousness. |
| 400 | 87 | 0.4% | Ethylic intoxication, drunkenness, inebriation, alcohol poisoning or possible death. |
| 500 | 109 | >0.55% | Unconsciousness, coma and death. |
Recreational concentrations of ethanol are typically in the range of 1 to 50 mM.[210][27] Very low concentrations of 1 to 2 mM ethanol produce zero or undetectable effects except in alcohol-naive individuals.[210] Slightly higher levels of 5 to 10 mM, which are associated with light social drinking, produce measurable effects including changes in visual acuity, decreased anxiety, and modest behavioral disinhibition.[210] Further higher levels of 15 to 20 mM result in a degree of sedation and motor incoordination that is contraindicated with the operation of motor vehicles.[210] In jurisdictions in the U.S., maximum blood alcohol levels for legal driving are about 17 to 22 mM.[225][226] In the upper range of recreational ethanol concentrations of 20 to 50 mM, depression of the central nervous system is more marked, with effects including complete drunkenness, profound sedation, amnesia, emesis, hypnosis, and eventually unconsciousness.[210][225] Levels of ethanol above 50 mM are not typically experienced by normal individuals and hence are not usually physiologically relevant; however, such levels – ranging from 50 to 100 mM – may be experienced by alcoholics with high tolerance to ethanol.[210] Concentrations above this range, specifically in the range of 100 to 200 mM, would cause death in all people except alcoholics.[210]
List of known actions in the central nervous system
Ethanol has been reported to possess the following actions in functional assays at varying concentrations:[204]
- Decreased levels of nitric oxide in brain medulla[227]
- Increased levels of
- 5-HT3 receptor positive allosteric modulator
- AMPA receptor negative allosteric modulator[208]
- Adenosine reuptake inhibitor[228]
- GIRK channel opener
- Glycine receptor positive allosteric modulator[205]
- Glycine reuptake inhibitor[229]
- Kainate receptor negative allosteric modulator[208]
- L-type calcium channel blocker
- Muscarinic acetylcholine receptor positive allosteric modulator.
- Nicotinic acetylcholine receptor positive allosteric modulator[206][230]
- Opioid receptor endogenous positive allosteric modulator[208]
- Serotonin receptor positive allosteric modulator[205]
Some of the actions of ethanol on ligand-gated ion channels, specifically the nicotinic acetylcholine receptors and the glycine receptor, are
Pharmacokinetics
Absorption
Ethanol can be
Onset
Peak circulating levels of ethanol are usually reached within a range of 30 to 90 minutes of ingestion, with an average of 45 to 60 minutes.[6][4] People who have fasted overnight have been found to reach peak ethanol concentrations more rapidly, at within 30 minutes of ingestion.[6]
The onset varies depends on the type of alcoholic drink:[232]
- Vodka tonic: 36 ± 10 minutes
- Wine: 54 ± 14 minutes
- Beer: 62 ± 23 minutes
Also, carbonated alcoholic drinks seem to have a shorter onset compare to flat drinks in the same volume. One theory is that carbon dioxide in the bubbles somehow speeds the flow of alcohol into the intestines.[233]
Food in the
Distribution
Upon ingestion, ethanol is rapidly
Metabolism
Approximately 90% of the
At even low physiological concentrations, ethanol completely saturates alcohol dehydrogenase.
Some individuals have less effective forms of one or both of the metabolizing enzymes of ethanol, and can experience more marked symptoms from ethanol consumption than others.[234] However, those having acquired alcohol tolerance have a greater quantity of these enzymes, and metabolize ethanol more rapidly.[234]
Elimination
Ethanol is mainly
Chemistry
Ethanol is also known chemically as alcohol, ethyl alcohol, or drinking alcohol. It is a simple
Production
Ethanol is
Home-made alcoholic beverages
Homebrewing
Homebrewing is the brewing of beer or other alcoholic beverages on a small scale for personal, non-commercial purposes. Supplies, such as kits and fermentation tanks, can be purchased locally at specialty stores or online. Beer was brewed domestically for thousands of years before its commercial production, although its legality has varied according to local regulation. Homebrewing is closely related to the hobby of home distillation, the production of alcoholic spirits for personal consumption; however home distillation is generally more tightly regulated.
Moonshine
Although methanol is not produced in toxic amounts by fermentation of sugars from grain starches,[238] it is a major occurrence in fruit spirits.[239] However, in modern times, reducing methanol with the absorption of a molecular sieve is a practical method for production.[240]
Analogues
 | This article may require cleanup to meet Wikipedia's quality standards. The specific problem is: Puncuation in complex sounding sentences. (February 2021) |
Ethanol has a variety of
The
The Lucas test differentiates between primary, secondary, and tertiary alcohols.
Ethchlorvynol is not compatible with intravenous injection like ethanol—serious injury (including the loss of limbs due to vascular injury) or death can occur when it is used in this manner.[245]
Society and culture
Usage
Consumption recommendations
The recommended maximum intake (or safe limits) of alcohol varies from no intake, to daily, weekly, or daily/weekly guidelines provided by health agencies of governments. The World Health Organization published a statement in The Lancet Public Health in April 2023 that "there is no safe amount that does not affect health".[20]
According to a 2024
Drinking culture
Ethanol is typically consumed as a recreational substance by mouth in the form of alcoholic beverages such as beer, wine, and spirits. It is commonly used in social settings due to its capacity to enhance sociability.
Drinking alcohol is generally socially acceptable and is legal in most countries, unlike with many other recreational substances. Many students attending colleges, universities, and other higher education institutions
Research on the societal benefits of alcohol is rare, but a 2017 study suggested there it was beneficial.
Religion
The relationship between
The levels of alcohol use in spiritual context can be broken down into:
- Prohibition: Some religions, including Islam[251] prohibit alcohol consumption.
- Symbolic use: In some Christian denominations, the sacramental wine is alcoholic, however, only a sip is taken, and it does not raise the blood alcohol content, and other denominations are using nonalcoholic wine. See also Libation.
- Discourage consumption: Hinduism does not have a central authority which is followed by all Hindus, though religious texts generally discourage the use or consumption of alcohol.
- Entheogenic use: See the spiritual section.
- Recreational use: Recreational drug use of alcohol in moderation to celebrate joy, is allowed in some religions.
- Christian views on alcohol are varied. For example, in the mid-19th century, some Protestant Christians moved from a position of allowing moderate use of alcohol (sometimes called moderationism) to either deciding that not imbibing was wisest in the present circumstances (abstentionism) or prohibiting all ordinary consumption of alcohol because it was believed to be a sin (prohibitionism).[252]
- During the Jewish holiday of Purim, Jews are obligated to drink (especially Kosher wine) until their judgmental abilities become impaired according to the Book of Esther.[253][254][255] However, Purim has more of a national than a religious character.
Law
Legal status
Alcohol consumption is fully legal and available in most countries of the world.[256] Home made alcoholic beverages with low alcohol content like wine, and beer is also legal in most countries, but distilling moonshine outside of a registered distillery remains illegal in most of them.
Some majority-
In addition, there are regulations on alcohol sales and use in many countries throughout the world.
In Iran, consumption of alcohol (one glass) is punished by 80 lashes, but repeated offences may lead to death penalty, although rarely exercised. In 2012, two men were sentenced to death after a third offense in Khorasan.[260][261]
Alcohol packaging warning messages
Alcohol packaging warning messages (alcohol warning labels, AWLs
A World Health Organization report, published in 2017, stated:[263]
Alcohol product labelling could be considered as a component of a comprehensive public health strategy to reduce alcohol-related harm. Adding health labels to alcohol containers is an important first step in raising awareness and has a longer-term utility in helping to establish a social understanding of the harmful use of alcohol.
Criticism of the alcohol industry
A 2019 survey conducted by the American Institute for Cancer Research (AICR) showed that only 45% of Americans were aware of the associated risk of cancer due to alcohol consumption, up from 39% in 2017.[264] The AICR believes that alcohol-related advertisements about the healthy cardiovascular benefits of modest alcohol overshadow messages about the increased cancer risks.[264]
Drinking alcoholic beverages increase the risk for breast cancer. Several studies indicate that the use of marketing by the alcohol industry to associate their products with breast cancer awareness campaigns, known as pinkwashing, is misleading and potentially harmful.[265][266][267][268]
The alcohol industries have marketed products directly to the LGBT+ community. In 2010, of the sampled parades that listed sponsors, 61% of the prides were sponsored by the alcohol industry.[269]
Standard drink
A standard drink is a measure of alcohol consumption representing a fixed amount of pure ethanol, used in relation to recommendations about alcohol consumption and its relative risks to health. The size of a standard drink varies from 8g to 20g across countries, but 10g alcohol (12.7 millilitres) is used in the World Health Organization (WHO) Alcohol Use Disorders Identification Test (AUDIT)'s questionnaire form example,[270] and has been adopted by more countries than any other amount.[271]
Sober curious
Source: SAMHSA[272]
Sober curious is a cultural movement and lifestyle of consuming no or limited alcohol that started in the late 2010s.[citation needed] It differs from traditional abstinence in that it is not founded on asceticism, religious condemnation of alcohol or previous alcohol abuse, but motivated by a curiosity of a sober lifestyle. Markets have reacted by offering a wider selection of non-alcoholic beverages.[273]
Sober curiosity is often defined as having the option to question or change one's drinking habits, for mental or physical health reasons.[274] It may be practised in many ways, ranging from complete abstinence to more thought about when and how much is consumed.[275]
Since the onset of the COVID-19 pandemic, more people in Europe have reduced their alcohol consumption.[276]
History
Ancient World
Since
Beer is one of the earliest known ingredients for wound healing. A medical prescription from Mesopotamia describes a method for healing wounds:[278][279]
Pound together fur-turpentine, pine-turpentine, tamarisk, daisy, flour of inninnu strain; mix in milk and beer in a small copper pan; spread on skin; bind on him, and he shall recover.
Late Middle Ages
Alcohol has been used as an antiseptic as early as 1363 with evidence to support its use becoming available in the late 1800s.[citation needed]
Early modern period
The popular story dates the etymology of the term Dutch courage to English soldiers fighting in the Anglo-Dutch Wars[280] (1652–1674) and perhaps as early as the Thirty Years' War (1618–1648). One version states that jenever (or Dutch gin) was used by English soldiers for its calming effects before battle, and for its purported warming properties on the body in cold weather. Another version has it that English soldiers noted the bravery-inducing effects of jenever on Dutch soldiers.[281][282]
The
Modern period
The Andrew Johnson alcoholism debate is the dispute, originally conducted amongst the general public, and now typically a question for historians, about whether or not Andrew Johnson, the 17th president of the United States (1865–1869), drank to excess.
The Bratt System was a system that was used in Sweden (1919–1955) and similarly in Finland (1944–1970) to control alcohol consumption, by rationing of liquor. Every citizen allowed to consume alcohol was given a booklet called a motbok (viinakortti in Finland), in which a stamp was added each time a purchase was made at Systembolaget (in Sweden) and Alko (in Finland).[285] A similar system also existed in Estonia between July 1, 1920 to December 31, 1925.[286] The stamps were based on the amount of alcohol bought. When a certain amount of alcohol had been bought, the owner of the booklet had to wait until next month to buy more.
The Medicinal Liquor Prescriptions Act of 1933 was a law passed by Congress in response to the abuse of medicinal liquor prescriptions during Prohibition.
The rum ration (also called the tot) was a daily amount of rum given to sailors on Royal Navy ships. It started 1866 and was abolished in 1970 after concerns that the intake of strong alcohol would lead to unsteady hands when working machinery.
Gilbert Paul Jordan (aka The Boozing Barber) was a Canadian serial killer who is believed to have committed the so-called "alcohol murders" between 1965-c. 2004 in Vancouver, British Columbia.
See also
- Alcohol myopia
- Rum-running
- Responsible drug use
- GABAergics
- GABRD (δ subunit-containing receptors)
- Pigovian taxes, which are to pay for the damage to society caused by these goods.
- Sin taxes are used to increase the price in an effort to lower their use, or failing that, to increase and find new sources of revenue.
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Further reading
- The National Institute on Alcohol Abuse and Alcoholism maintains a database of alcohol-related health effects. ETOH Archival Database (1972–2003) Alcohol and Alcohol Problems Science Database.
External links
- WHO fact sheet on alcohol
- ChEBI – biology related
- Kyoto Encyclopedia of Genes and Genomes signal transduction pathway: KEGG – human alcohol addiction
- Benton SA. "The High-Functioning Alcoholic". Psychology Today.