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Alcohol’s Impact on the Brain

Elena Hill, MD, MPH profile image
Medically Reviewed By Elena Hill, MD, MPH • Updated Sep 8, 2022 • 4 cited sources

Alcohol consumption can negatively affect the health of multiple organs in the body, including the liver, kidneys, stomach, gastrointestinal tract, kidneys, and brain. This article will focus on the effects alcohol can have on the brain specifically.

Alcohol can damage brain cells both acutely and more long term. The severity of symptoms depends on a number of factors including age at which a person starts drinking, their personal genetics, the amount they drink and the number of years they drink, as well as any other concurrent medical conditions they have. [1] 

Short-Term & Long-Term Effects on the Brain

It’s helpful to split the effects of drinking alcohol into short-term and long-term effects. 

Short-Term Effects

In the short term, alcohol can influence the brain in several different ways, affecting the following:[2]

  • Balance and coordination
  • Speech
  • Reflexes
  • Mood
  • Judgment

The more a person drinks, the more pronounced these effects can become. Typically, a person will begin noticeably experiencing these effects at a blood alcohol content (BAC) around 0.08% to 0.40%. For reference, in most states, it is illegal to drive at a BAC of around 0.08%.  At a BAC of 0.40% critical bodily functions may begin to operate incorrectly or shut down, and they risk coma and death.[2]

Long-Term Effects

Misuse of alcohol can result in long-term brain damage. Studies looking at brain imaging have found that alcoholics have smaller brains and atrophy of the brain structures compared to moderate or nondrinkers.[3] Long term drinkers can experience vitamin deficiencies that contribute to impaired cognition. This is clinically recognized as a syndrome called “Wernicke-Korsakoff” syndrome in which depleted levels of thiamine and other vitamins cause confusion, confabulation, and memory loss. This damage can sometimes be reversible with thiamine treatment, but is sometimes permanent in more advanced stages. 

Signs That Alcohol Is Affecting the Brain

These signs of both short term and more permanent brain damage secondary to alcohol use can start subtly but can progress quickly. Look out for short or long term memory loss, tremulousness, confusion, slow response times, etc. 

Can Damage From Drinking Be Reversed?

The discussion of whether brain damage and degeneration caused by drinking alcohol can be reversed is complex. It largely depends on the type of brain damage that is occurring. For example, certain patients who drink heavily develop vitamin deficiencies, specifically B12 and thiamine deficiency. With supplementation of these vitamins and re-feeding, these symptoms can certainly be improved, however there may still be some degree of irreversible damage. Another example is called hepatic encephalopathy: in patients who have liver damage from heavy alcohol use, the liver cannot properly process ammonia, which builds up in the blood and causes confusion, lethargy, altered mental status and brain damage. This can be treated with lactulose and other medications and can certainly be improved, however it is still not known if exposure to ammonia can result in small degrees of neuronal injury and more permanent damage over time.

In other situations, damage that is due to actual death of brain neurons and resulting brain atrophy may be irreversible. 

How to Get Help for Alcohol Use Disorder

The best way to avoid both short and long term brain damage from heavy drinking is to cut back or even discontinue drinking altogether. This can be daunting to do independently, and many individuals require treatment for AUD. Luckily, treatment consists of both medications/pharmacological therapy (called MAT, or Medication for Addiction Treatment) and behavioral interventions such as therapy, support groups, alcoholics anonymous, among others. For best results, most clinicians recommend a combination of both medications and behavioral interventions to be used at the same time. 

Alcohol & Brain Cells FAQs

Do brain cells regenerate after drinking?

Neurogenesis, the process by which new neurons are formed, can improve when a person abstains from alcohol, depending on the etiology of the damage. However, some damage from alcohol use can be permanent and irreversible. 

Can alcohol affect intelligence?

“Intelligence” is defined in multiple ways. We know that heavy alcohol use can cause neurodegeneration and affect cognitive function which can in turn lead to lower IQ: For example, a study of Swedish conscripts found heavy drinkers typically scored lower on IQ tests. We also know that heavy drinking can impact other measures of “intelligence” including short and long term memory, ability to perform tasks, etc. So yes, alcohol arguably causes loss of “intelligence”.

However, stopping drinking and abstaining for a prolonged period is likely to improve cognitive function. If you are concerned about your brain health as a result of your drinking, reach out to your doctor or to us here at Bicycle health for more information about treatment.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More

  1. Alcohol and the Brain: An Overview. National Institute on Alcohol Abuse and Alcoholism. Accessed August 2022.
  2. Blood Alcohol Level. MedlinePlus. December 2020. Accessed August 2022. 
  3. Alcohol-Related Neurodegeneration and Recovery. Alcohol Research & Health. 2008. Accessed August 2022.
  4. IQ and Level of Alcohol Consumption—Findings from a National Survey of Swedish Conscripts. Alcoholism, Clinical and Experimental Research. February 2015. Accessed August 2022.

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