We’ve all seen the headlines: “6 Reasons Why a Little Glass of Wine Each Day May Do You Good,” or “Study Finds Drinking Wine with Meals Was Associated with Lower Risk of Type 2 Diabetes.” But for every study or story touting the purported benefits of occasional alcohol consumption, there’s another warning that, even in moderation, alcohol is dangerous (see: “No Amount of Alcohol Is Good for Your Heart, New Report Says”). So we were curious: What happens to your brain when you drink alcohol, whether that’s a glass of wine, a couple of beers or enough martinis that you blackout? We asked Dr. Dave Rabin, MD, PhD, a neuroscientist and psychiatrist, to break down what’s going on in our noggins when we’re under the influence.
What Happens to Your Brain When You Drink Alcohol (According to a Neuroscientist)
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Published Aug 8, 2023
Meet the Expert
Dr. Dave Rabin, MD, PhD, is a neuroscientist, psychiatrist and co-founder of Apollo Neuroscience, a company that makes a wearable wellness device intended to help manage stress and to promote a healthy lifestyle. In addition to focusing on integration therapy, plant and natural medicines, couples therapy and medicine-assisted psychotherapy, Dr. Rabin specializes in treatment-resistant mental illnesses including depression, anxiety, post-traumatic stress disorder (PTSD), psychosomatic disorders, personality disorders, chronic pain disorders, insomnia and substance use disorders using minimal and non-invasive treatment strategies.
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What Happens to Your Brain After One Drink?
“When you have one drink of alcohol, the alcohol works by activating what we call GABA receptors in the front of our brains which suppress brain activity,” Dr. Rabin explains. “Ultimately what happens when we suppress frontal brain activity is we impair two things that are very important to decision making and to emotion regulation.” He tells us that this is part of the reason why a drink or two can feel good to people—especially those who have anxiety—because the alcohol activates the GABA receptors, resulting in “impaired insight, decreased ability to look inside ourselves, impaired judgment, decreased ability to make thoughtful decisions and to be critically thinking about anything.” He adds that this is why having a drink while out can be such an enjoyable experience, since it takes the edge off. “That can be really helpful in social situations for some people, although it's not necessarily the best way to cope with social anxiety because again, it does impair our insight and judgment.”
What Happens to Your Brain When You’re Tipsy or Drunk?
So you’re out with your friends, you’ve all had a couple of drinks and—in the immortal words of J-Kwon—"e’rybody in this bitch gettin’ tipsy.” What’s going on in your brain now? First, Dr. Rabin points out that everyone has different levels of sensitivity to alcohol, and while some people might feel tipsy after one drink, others might be able to drink a couple of cocktails before really feeling the effects. “But whether you are having just one or two, you're feeling tipsy or drunk or blacked out, these are all different levels of what we call sedation or increase in the GABA receptor,” he says. “The downstream effects of GABA receptor activation is the inhibition of the decision making judgment parts of our brains, which are very important for us to function and for our survival response.”
What Happens to Your Brain When You Blackout?
OK, so you’ve passed the point of tipsy/drunk and you’re firmly in blackout territory. What now? Dr. Rabin tells us, “When we talk about a ‘blackout,’ the brain has an overwhelming activation of GABA receptors in the frontal cortex that decreases our insight, judgment and, eventually, our complete awareness of what's going on around us to the point that we no longer take in any information or store memories. It literally sedates us.”
What Are the Long-Term Effects of Alcohol on Your Brain?
It feels like we’re constantly seeing conflicting studies on whether any amount of alcohol (even a glass of red wine occasionally) is beneficial to our health, but what does long-term alcohol use do to our brains, specifically? According to Dr. Rabin, the first thing to note is that long-term alcohol use—particularly heavy alcohol use—has a lot of negative impact on memory. He specifically flags Wernicke-Korsakoff syndrome, “which is a very, very serious syndrome that people generally don't recover from once they have it, because the chronic alcohol use inhibiting these parts of our brains actually causes an eventual degeneration of those parts of our brains that are critical for survival and memory formation.” He assures us that most people don’t ever get to the point of Wernicke-Korsakoff syndrome because most people don’t consume that much alcohol, but he stresses that it’s important to remember that serious conditions are a possibility when we think about the impact of chronic alcohol use.
And speaking of folks who use alcohol to quell social anxiety (or generalized anxiety), Dr. Rabin explains, “As we get used to sedating ourselves and impairing our insight and judgment, relying on alcohol's effects to do that when we're stressed or when we're anxious in social situations…what ends up happening is our bodies and our brains develop a [dependence] on alcohol to achieve that effect of winding down or anxiety reduction, stress reduction, those kinds of things.” The thing is, he notes, anxiety is neither good nor bad, and over time our brains get used to not feeling certain feelings. “We get used to not feeling anxiety, so biologically those networks in our brains learn that they don't need to build anxiety tolerance, or what we sometimes call discomfort tolerance. So the body actually learns to rely on alcohol and external substances from the environment to reduce our anxiety and to reduce our stress or to help us fall asleep rather than actually strengthening the ability to do that [itself], which our bodies are completely capable of doing.” The end outcome, he concludes, “is what we call a deconditioned brain, or a brain that is not prepared to handle what is coming at it naturally from the environment without reliance on a substance.”
The bottom line is this: While a drink or two can help us feel more comfortable in social settings or help us unwind after a long day, it’s important to be aware of the potential consequences of heavy, prolonged alcohol use. If you’re going to drink, please drink responsibly, folks.
