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Alcohol and Your Health

How Alcohol Affects You Now and in the Future

Risky Behaviors/Injuries

Adolescents typically have an increased desire to experience new things, but experimenting with alcohol is not a good idea.

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Poor Decisions: Drinking can lead people to make poor decisions and engage in risky behaviors, such as drinking and driving, unsafe sexual behavior, and other substance use that can result in a range of negative consequences (e.g., injuries, sexual assaults, and even death).

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Recognizing Danger: Alcohol also slows down the ability to recognize—and respond to—potential danger. This could lead to fights and accidents. Alcohol can also lead to injuries in other ways. For example, it drastically increases the likelihood of head injuries from falls while skateboarding or riding a scooter.1

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Effect on Academics: Drinking has been associated with drops in academic performance, such as missing classes and getting lower grades, in teens and young adults. However, it is important to note that other life factors may be the root cause for both drinking alcohol and poor academic performance.2,3

  1. Sorenson TJ, Rich MD, Deitermann A, Gotlieb R, Garcia N, Barta RJ, Schubert W. Likelihood of craniofacial injury and hospitalization with alcohol use while skateboarding and scootering. Craniomaxillofac Trauma Reconstr. 2023;16(1):34-8. PubMed PMID: 36824181   
  2. Jennison KM. The short-term effects and unintended long-term consequences of binge drinking in college: a 10-year follow-up study. Am J Drug Alcohol Abuse. 2004 Aug:30(3):659-84. PubMed PMID: 15540499 
  3. Chassin L, Pitts SC, Prost J. Binge drinking trajectories from adolescence to emerging adulthood in a high-risk sample: predictors and substance abuse outcomes. J Consult Clin Psychol. 2002 Feb;70(1):67-78. PubMed PMID: 11860058 

Blackouts

  • Alcohol-related blackouts are gaps in a person's memory for events that occurred while they were intoxicated. These gaps happen when someone drinks enough alcohol to temporarily block the transfer of memories from short-term to long-term storage—known as memory consolidation—in an area of the brain called the hippocampus.1
  • There are two types of blackouts, which are defined by the severity of the memory impairment. 
    • The most common type is called a fragmentary blackout and is characterized by spotty memories for events, with “islands” of memories separated by missing periods of time in between. This type is sometimes referred to as a grayout or a brownout
    • Complete amnesia, often spanning hours, is known as an en bloc blackout. With this severe form of blackout, memories of events do not form and typically cannot be recovered. To the person experiencing the blackout, it is as if the events simply never occurred. 
  • Blackouts are quite common among adolescents. In one study, 1 in 5 older adolescents who drank alcohol in the previous 6 months reported an alcohol-induced memory blackout.2 
  • Research suggests that the earlier a teen starts drinking, the more likely they are to report experiencing blackouts years later, even if they decreased their drinking.3
  • Blackouts are not necessarily a sign of alcohol use disorder (AUD), but experiencing even one is a reason for concern. Teens who have a blackout should think about their relationship with alcohol and consider talking to their doctor about their drinking. 

For more information, see the National Institute on Alcohol Abuse and Alcoholism fact sheet Interrupted Memories: Alcohol-Induced Blackouts.

  1. White AM. What happened? Alcohol, memory blackouts, and the brain. Alcohol Res Health.2003;27(2):186-96. PubMed PMID: 15303630 
  2. Hingson R, Wenxing Z, Simons-Morton B, White A. Alcohol-induced blackouts as predictors of other drinking related harms among emerging young adults. Alcohol Clin Exp Res. 2016 Apr;40(4):776-84. PubMed PMID: 27012148 
  3. Marino EN, Fromme K. Early onset drinking predicts greater level but not growth of alcohol-induced blackouts beyond the effect of binge drinking during emerging adulthood. Alcohol Clin Exp Res. 2016 Mar;40(3):599-605. PubMed PMID: 26853696 

Alcohol Overdose

What Should You Do in an Emergency?

If you suspect someone is experiencing an alcohol overdose, get medical help immediately. Cold showers, hot coffee, food, or walking will NOT reverse the effects of alcohol overdose and could actually make things worse.

Do Not Delay—Call 911!
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Alcohol overdose occurs when there is so much alcohol in the bloodstream that the areas of the brain controlling basic life-support systems—such as breathing, heart rate, and temperature control—begin to shut down.

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Left untreated, alcohol overdose can lead to permanent brain damage or death.

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Blood alcohol concentration can continue to rise even when you stop drinking or are unconscious. Alcohol in the stomach and intestine continues to enter the bloodstream and to circulate throughout your body.

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What tips the balance from drinking that causes impairment to drinking that jeopardizes your life varies among individuals. Age, sensitivity to alcohol (tolerance), gender, speed of drinking, medications being taken, and amount of food eaten recently can all be factors.

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Symptoms of alcohol overdose include confusion, difficulty remaining conscious, vomiting, seizures, trouble with breathing, slow heart rate, clammy skin, dulled responses (such as no gag reflex, which prevents choking), and extremely low body temperature.

For more information, see the National Institute on Alcohol Abuse and Alcoholism fact sheet Understanding the Dangers of Alcohol Overdose.

Alcohol Use Disorder

What Is AUD?
  • Alcohol use disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term “alcoholism.”
  • Considered a brain disorder, AUD can be mild, moderate, or severe.
  • Research shows that people who start drinking at an earlier age are at a higher risk for developing AUD later in life. For example, adults ages 26 and older who began drinking before age 15 are 4 times more likely to report having AUD in the past year compared to those who waited until age 21 or later to begin drinking.1
  • It may be hard to imagine why people with AUD can’t just “use a little willpower” to stop drinking. But severe AUD creates an uncontrollable craving for alcohol. It can be as strong as the need for food and water. People may want to stop because they know that drinking harms their health and their loved ones. But quitting is extremely difficult.
  • No matter how severe the problem may seem, most people with AUD can benefit from treatment with behavioral therapies, medications, or both.
  • Research indicates that alcohol use during the teenage years can interfere with normal adolescent brain development and increase the risk of developing AUD. 
  • Research shows that genes are responsible for around 50% of the risk for AUD. Therefore, genes alone do not determine whether someone will develop AUD. Environmental factors play important roles in determining the outcomes, as with other conditions linked to a wide array of genes. For example, having a parent with a drinking problem increases a child's risk for developing an alcohol problem. About 10% of U.S. children ages 17 and younger live with a parent who has AUD.2 
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What Is Binge Drinking?

The National Institute on Alcohol Abuse and Alcoholism defines binge drinking* as a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08%—or 0.08 grams of alcohol per deciliter—or more. This typically happens if a woman has four or more drinks, or a man has five or more drinks, within about 2 hours. Research shows that fewer drinks in the same time frame result in the same BAC in youth; only three drinks for girls and three to five drinks for boys, depending on their age and size.

*Please note that this definition varies slightly from the definition used by the Substance Abuse and Mental Health Services Administration (SAMHSA), which conducts the annual National Survey on Drug Use and Health. SAMHSA defines binge drinking as five or more alcohol beverages for males or four or more alcohol beverages for females on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past month.

  1. The comparison of risk for an AUD between different ages at drinking onset is based on the prevalence ratio. The estimates are weighted by the person-level analysis weight and derived from the CBHSQ 2021 National Survey on Drug Use and Health (NSDUH-2021-DS0001) public-use data file. Age at drinking onset: age when first drank an alcohol beverage (a can or bottle of beer, a glass of wine or a wine cooler, a shot of liquor, or a mixed drink with liquor in it), not counting a sip or two from a drink. AUD: having met two or more of the 11 AUD diagnostic criteria in the past-year according to the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). https://www.datafiles.samhsa.gov/dataset/national-survey-drug-use-and-health-2021-nsduh-2021-ds0001. Accessed February 28, 2023. 
  2. Lipari RN, Van Horn SL. The CBHSQ report: children living with parents who have a substance use disorder. Rockville (MD): SAMHSA, Center for Behavioral Health Statistics and Quality; 2017 Aug 24 [cited 2020 Dec 8]. Available from: https://samhsa.gov/data/sites/default/files/report_3223/ShortReport-3223.html  

Brain and Mental Health

  • Although a person’s brain generally reaches its maximum size by age 10, the second decade of life brings widespread changes in the organization and functioning of the brain. Changes in brain circuits continue until at least the mid-20s. 
  • Alcohol misuse during adolescence might cause negative long-term effects because of physical changes in the brain during development.  
  • Alcohol misuse during adolescence is also associated with reduced size of the frontal lobe (involved in planning and decision-making), hippocampus (involved in memory), amygdala (involved in fear-sensing), and corpus callosum (involved in the communication between the two sides of the brain).1 
  • A growing body of evidence suggests that the earlier people start drinking alcohol, the more likely they are to experience a measurable negative impact on cognitive functions, memory, and school performance over time—perhaps even into adulthood.2,3 
  • In some people, a history of adolescent alcohol misuse could increase the likelihood of developing alcohol use disorder, and is associated with mental health disorders such as anxiety and depression during adolescence and later in life.4,5 
  • The good news is that the ability of the brain to change during adolescence can also help the brain recover from some alcohol-induced consequences.
  • Alcohol use and sleep problems in adolescence are linked to an increased risk of depression, which can be made even worse by environmental stressors.
  • As with adults, alcohol plays a role in suicide involving underage people who drink.7
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If you need suicide- or mental health-related crisis support, or are worried about someone else, please call or text the 988 Suicide and Crisis Lifeline or chat with Lifeline to connect with a trained crisis counselor. 

  1. Infante MA, Eberson SC, Zhang Y, Brumback T, Brown SA, Colrain IM, Baker FC, Clark DB, De Bellis MD, Goldston D, Nagel BJ, Nooner KB, Zhao Q, Pohl KM, Sullivan EV, Pfefferbaum A, Tapert SF, Thompson WK. Adolescent binge drinking is associated with accelerated decline of gray matter volume. Cereb Cortex. 2022 Jun;1;32(12:2611-20. PubMed PMID: 34729592 
  2. White AM, Hingson R. A primer on alcohol and adolescent brain development: implications for prevention. In: Sloboda Z, Petras H, Robertson E, Hingson R, editors. Prevention of substance use: advances in prevention science. Switzerland: Springer Cham; 2019, p. 3-18. Available from: doi.org/10.1007/978-3-030-00627-3_1 
  3. White AM. What happened? Alcohol, memory blackouts, and the brain. Alcohol Res Health. 2003;27(2):186-96. PubMed PMID: 15303630 
  4. Ning K, Gondek D, Patalay P, Ploubidis GB. The association between early life mental health and alcohol use behaviors in adulthood: a systematic review. PloS One. 2020 Feb;15(2):e0228667 PubMed PMID: 32069303 
  5. Chassin L, Pitts SC, Prost J. Binge drinking trajectories from adolescence to emerging adulthood in a high-risk sample: predictors and substance abuse outcomes. J Consult Clin Psychol. 2002 Feb;70(1):67-78. PubMed PMID: 11860058 
  6. Alzueta E, Podhajsky S, Zhao Q, Tapert SF, Thompson WK, de Zambotti M, Yuksel D, Kiss O, Wang R, Volpe L, Prouty D, Colrain IM, Clark DB, Goldston DB, Nooner KB, De Bellis MD, Brown SA, Nagel BJ, Pfefferbaum A, Sullivan EV, et al. Risk for depression tripled during the COVID-19 pandemic in emerging adults followed for the last 8 years. Psychol Med. 2023 Apr: 53(5):2156-63. PubMed PMID: 34726149 
  7. Harding FM, Hingson RW, Klitzner M, Mosher JF, Brown J, Vincent RM, Dahl E, Cannon CL. Underage drinking: a review of trends and prevention strategies. Am J Prev Med. 2016 Oct;51(4 Suppl 2): S148-57. PubMed PMID: 27476384 

Diseases and Health Conditions

Nearly every organ system of the body is affected by alcohol.

The World Health Organization estimates that alcohol contributes to more than 200 diseases and injury-related health conditions.1 Conditions associated with alcohol misuse include:

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Alcohol use disorder

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Injuries

Liver

Liver cirrhosis

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Cancers, especially breast cancer. Studies show that women who consume about one alcohol drink per day have a higher risk of developing breast cancer than women who do not drink at all.2,3,4

  1. World Health Organization (WHO). Global status report on alcohol and health 2018. Geneva, Switzerland: WHO, 2018 [cited 2021 Jun 25]. Available from: https://www.who.int/publications/i/item/9789241565639
  2. Shield KD, Soerjomataram I, Rehm J. Alcohol use and breast cancer: a critical review. Alcohol Clin Exp Res. 2016 Jun;40(6):1155-81, 2016. PubMed PMID: 27130687 
  3. Li CI, Chlebowski RT, Freiberg M, Johnson KC, Kuller L, Lane D, Lessin L, O’Sullivan MJ, Wactawski-Wende J, Yasmeen S, Prentice R. Alcohol consumption and risk of postmenopausal breast cancer by subtype: the Women's Health Initiative Observational Study. J Natl Cancer Inst. 2010 Sep;102(18):1422-31. PubMed PMID: 20733117 
  4. Allen NE, Beral V, Casabonne D, Wan Kan S, Reeves GK, Brown A, Green J, Million Women Study Collaborators. Moderate alcohol intake and cancer incidence in women. J Natl Cancer Inst. 2009 Mar;101(5):296-305. PubMed PMID: 19244173 

For more information about alcohol's effects on the body, please see the NIAAA Interactive Body.

Other sections:

Signs of a Problem
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depression young boy looking looking directly ahead
If you’re worried about yourself or a friend or family member who drinks, explore the following resources to learn more about how to identify the signs of an alcohol problem.
Getting Help
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A teenager consoling another crying teenager.
Learn who to talk to about getting help for an alcohol-related problem, what to do in case of overdose (also called “alcohol poisoning”), and where to find treatment and support resources for teens.

Need immediate help for mental health and/or substance use problems?

Call the SAMHSA National Helpline at 1-800-662-HELP (4357), or call or text 988 to reach the 988 Suicide & Crisis Helpline

NIAAAforTeens.niaaa.nih.gov

An official website of the National Institutes of Health

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