Use and effects
Main articles: Short-term effects of alcohol consumption and Alcohol intoxication
See also: Alcoholic drink § Short-term effects, and Alcohol and health § Short-term effects
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.
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[29] 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 g/L), ethanol acts as a central nervous system depressant,[29] 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.
Ethanol, alcohol increases levels of high-density lipoproteins (HDLs), which carry cholesterol through the blood.[30][better source needed] Alcohol is known to make blood less likely to clot, reducing risk of heart attack and stroke. This could be the reason that alcohol produces health benefits when consumed in moderate amounts.[31][better source needed] Also, alcohol dilates blood vessels. Consequently, a person feels warmer, and their skin may flush and appear pink.[30][better source needed]
Caloric content
Ethanol is a source of energy and pure ethanol provides 7 calories per gram. For distilled spirits, a standard serving in the United States is 44 ml (1.5 US fl oz), which at 40% ethanol (80 proof), would be 14 grams and 98 calories. Wine and beer contain a similar range of ethanol for servings of 150 ml (5 US fl oz) and 350 ml (12 US fl oz), respectively, but these beverages also contain non-ethanol calories. A 150 ml serving of wine contains 100 to 130 calories. A 350 ml serving of beer contains 95 to 200 calories. According to the U.S. Department of Agriculture, based on NHANES 2013–2014 surveys, women in the US ages 20 and up consume on average 6.8 grams/day and men consume on average 15.5 grams/day.[32] Ignoring the non-alcohol contribution of those beverages, the average ethanol calorie contributions are 48 and 108 cal/day, respectively. Alcoholic beverages are considered empty calorie foods because other than calories, these contribute no essential nutrients.
Adverse effects
See also: Alcohol and health and Health effects of wine
Addiction experts in psychiatry, chemistry, pharmacology, forensic science, epidemiology, and the police and legal services engaged in delphic analysis regarding 20 popular recreational substances. Alcohol was ranked 6th in dependence, 11th in physical harm, and 2nd in social harm.[33]
Alcohol has a variety of short-term and long-term adverse effects. It also has reinforcement-related adverse effects, including addiction, dependence, and withdrawal.
Short-term effects
Main articles: Short-term effects of alcohol consumption and Alcohol intoxication
Central depression
Alcohol causes generalized central nervous system depression and associated cognitive, memory, motor, and sensory impairment. It slows and impairs cognition and reaction time, reduces inhibition and impairs judgement, interferes with motor function resulting in motor incoordination, loss of balance, and slurred speech, impairs memory formation, and causes sensory impairment. At high concentrations, amnesia, stupor, and unconsciousness result.
At very high concentrations, markedly decreased heart rate, respiratory depression, and death can result due to profound suppression of central nervous system function and consequent shutdown of vegetative functions.
Gastrointestinal effects
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Diagram of mucosal layer
Alcohol can cause nausea and vomiting in sufficiently high amounts (varies 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 peptic ulcer disease (PUD), this mucosal layer is broken down. PUD is commonly associated with the bacteria H. pylori. H. pylori secrete a toxin that weakens the mucosal wall, which as a result lead to acid and protein enzymes penetrating the weakened barrier. Because alcohol stimulates a person's stomach to secrete acid, a person with PUD should avoid drinking alcohol on an empty stomach. Drinking alcohol causes more acid release, which further damages the already-weakened stomach wall.[34] Complications of this disease could include a burning pain in the abdomen, bloating and in severe cases, the presence of dark black stools indicate internal bleeding.[35] A person who drinks alcohol regularly is strongly advised to reduce their intake to prevent PUD aggravation.[35]
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 this (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 (ROS), leukotrienes, chemokin
