Which of the following statements best describes how the body processes alcohol?

Once alcohol is swallowed, it is not digested like food. First, a small amount is absorbed directly by the tongue and mucosal lining of the mouth. Once in the stomach, alcohol is absorbed directly into your blood stream through the tissue lining of the stomach and small intestine.

Table of Contents Show

How does alcohol move through the body?
What is "one drink"?
Knowing your Blood Alcohol Content (BAC)
Effects of blood alcohol content on thinking, feeling and behavior:
Why are men and women different?
What other factors affect your response to alcohol?
What is the difference between a blackout and passing out?
What is a hangover and can I prevent it?
Links you can use

Food in the stomach can inhibit the absorption of alcohol in two ways:

First, it physically obstructs the alcohol from coming in contact with the stomach lining. Food can either absorb alcohol, or simply “take up space” so the alcohol does not enter the bloodstream through contact with the wall of the stomach.

Second, food in the stomach will prevent alcohol from passing into the duodenum, which is the upper portion of the small intestine. The surface area of the small intestine is very large (about the size of a tennis court), so alcohol has more access to enter the bloodstream once it leaves the stomach. If alcohol is sequestered in the stomach it will be absorbed slower.

Transporting

Once alcohol is in your bloodstream, it is carried to all organs of your body. In the majority of healthy people, blood circulates through the body in 90 seconds, thereby allowing alcohol to affect your brain and all other organs in a short amount of time. The full effects of a drink are felt within 15 to 45 minutes depending on the speed of absorption.

Alcohol enters all tissues of the body except bone and fat. In an adult male, alcohol can penetrate approximately 68% of body tissues. Body composition is important, because if the percentage of adipose tissue is high, the alcohol can only be distributed throughout the remaining lean tissue – resulting in a higher concentration for those areas.

The effects of alcohol on the body will vary according to the individual: their sex, body composition, the amount of alcohol consumed, the presence of food, and the ability of the liver to produce the alcohol dehydrogenase enzymes.

Alcohol is a toxin that must be neutralized or eliminated from the body. Ten percent of alcohol is eliminated through sweat, breath, and urine.

Alcohol is volatile (will evaporate in air), so when alcohol in the blood comes in contact with air in the alveoli of the lungs, it can be transferred out of the body through breath.

The liver is the primary organ responsible for the detoxification of alcohol. Liver cells produce the enzyme alcohol dehydrogenase which breaks alcohol into ketones at a rate of about 0.015 g/100mL/hour (reduces BAC by 0.015 per hour).

Nothing will speed up the rate of detoxification, but the effective metabolism of alcohol can be limited by medications and liver damage.

When the rate of consumption exceeds the rate of detoxification, BAC will continue to rise.

How Fast Can You Sober Up?

Alcohol leaves the body at an average rate of 0.015 g/100mL/hour, which is the same as reducing your BAC level by 0.015 per hour. For men, this is usually a rate of about one standard drink per hour. However, there are other factors that affect intoxication level (gender, some medications, illness) that will cause BAC to rise more quickly, and fall more slowly.

Example: At an average rate of -0.015/hr, how long would it take someone with a BAC of 0.20 to sober up?

Drinking in Moderation:

According to the "Dietary Guidelines for Americans 2020-2025,” U.S. Department of Health and Human Services and U.S. Department of Agriculture, adults of legal drinking age can choose not to drink or to drink in moderation by limiting intake to 2 drinks or less in a day for men and 1 drink or less in a day for women, when alcohol is consumed. Drinking less is better for health than drinking more.

NIAAA defines binge drinking as a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 percent - or 0.08 grams of alcohol per deciliter - or higher. For a typical adult, this pattern corresponds to consuming 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours.

The Substance Abuse and Mental Health Services Administration (SAMHSA), which conducts the annual National Survey on Drug Use and Health (NSDUH), defines binge drinking as 5 or more alcoholic drinks for males or 4 or more alcoholic drinks 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.

NIAAA defines heavy drinking as follows:
- For men, consuming more than 4 drinks on any day or more than 14 drinks per week
- For women, consuming more than 3 drinks on any day or more than 7 drinks per week
SAMHSA defines heavy alcohol use as binge drinking on 5 or more days in the past month.

Patterns of Drinking Associated with Alcohol Use Disorder:

Binge drinking and heavy alcohol use can increase an individual's risk of alcohol use disorder.

Certain people should avoid alcohol completely, including those who:

Plan to drive or operate machinery, or participate in activities that require skill, coordination, and alertness
Take certain over-the-counter or prescription medications
Have certain medical conditions
Are recovering from alcohol use disorder or are unable to control the amount that they drink
Are younger than age 21
Are pregnant or may become pregnant

Alcohol is classified as a depressant because it slows down the central nervous system, causing a decrease in motor coordination, reaction time and intellectual performance. At high doses, the respiratory system slows down drastically and can cause a coma or death.

It is particularly dangerous to mix alcohol with other depressants, such as GHB, Rohypnol, Ketamine, tranquilizers or sleeping pills. Combining depressants multiplies the effects of both drugs and can lead to memory loss, coma or death.

How does alcohol move through the body?

Once swallowed, a drink enters the stomach and small intestine, where small blood vessels carry it to the bloodstream. Approximately 20% of alcohol is absorbed through the stomach and most of the remaining 80% is absorbed through the small intestine.

Alcohol is metabolized by the liver, where enzymes break down the alcohol. Understanding the rate of metabolism is critical to understanding the effects of alcohol. In general, the liver can process one ounce of liquor (or one standard drink) in one hour. If you consume more than this, your system becomes saturated, and the additional alcohol will accumulate in the blood and body tissues until it can be metabolized. This is why pounding shots or playing drinking games can result in high blood alcohol concentrations that last for several hours.

For an interactive look at alcohol moving through the human body, click here

What is "one drink"?

Knowing how to count a standard drink is necessary for calculating blood alcohol concentrations. Too often, people underestimate how much they have had to drink because they aren't using standard measurements.

Beer
One drink = one 12-ounce beer. This is normal-strength beer (4% alcohol). Micro-brews and malt liquor have a higher percentage of alcohol (look at the label).

Liquor
One drink = 1.5 ounces of liquor (40% alcohol or 80 proof). This is how much whiskey, vodka, gin, etc. is in a measured mixed drink or in a "shot."

REMEMBER: mixed drinks may not be measured and often contain far more than 1.5 ounces of alcohol. Drinks with a higher proof (like grain alcohol, Everclear, or 151 proof rum) should also be treated with caution.

Wine
One drink = 5 ounces of standard wine -- this is most table wines: white, red, rosé, champagne.

One drink = 3 ounces of fortified wine -- this is wine with more than 13% alcohol content, such as brandy, cognac or sherry.

Knowing your Blood Alcohol Content (BAC)

Understanding BAC is key to understanding how alcohol affects your body and the serious danger zones of alcohol poisoning. BAC measures the ratio of alcohol in the blood. So, a BAC of .10 means one part alcohol for every 1000 parts of blood.

To calculate your BAC, select the appropriate chart--for males or for females--then find the row with your approximate weight. Then select the number of drinks consumed. This BAC figure would result if the total number of drinks were consumed in one hour. The Time Factor table can be used to calculate BAC over more than one hour.

BAC Chart for Men

BAC Chart for Women

The Time Factor

Hours since first drink Subtract this from BAC 1 .015 2 .030 3 .045 4 .060 5 .075

6 .090

Note: these charts give you good general guidelines, but there are many factors involved in a person's reaction to alcohol, including body composition, use of medication or other drugs, mood changes and metabolism.

The BAC Calculator is a fun, interactive way to look at BAC levels. Once you input your gender and weight, you can choose the time of drink and how quickly you drink it. You can compare yourself to friends of different weights and gender.

Effects of blood alcohol content on thinking, feeling and behavior:

Now that you know how to calculate BAC, see how alcohol affects your body at different levels.

0.02 - 0.03 Few obvious effects; slight intensification of mood.

0.05 - 0.06 Feeling of warmth, relaxation, mild sedation; exaggeration of emotion and behavior; slight decrease in reaction time and in fine-muscle coordination; impaired judgment about continued drinking.

0.07 - 0.09 More noticeable speech impairment and disturbance of balance; impaired motor coordination, hearing and vision; feeling of elation or depression; increased confidence; may not recognize impairment.

0.08 Legal definition of intoxication in CA for people 21 years and older.

0.11 - 0.12 Coordination and balance becoming difficult; distinct impairment of mental faculties and judgment.

0.14 - 0.15 Major impairment of mental and physical control; slurred speech, blurred vision and lack of motor skills; needs medical evaluation.

0.20 Loss of motor control; must have assistance moving about; mental confusion; needs medical assistance.

0.30 Severe intoxication; minimum conscious control of mind and body; needs hospitalization.

0.30 - 0.60 This level of alcohol has been measured in people who have died of alcohol intoxication.

0.40 Unconsciousness; coma; needs hospitalization.

Why are men and women different?

Because of several physiological reasons, a woman will feel the effects of alcohol more than a man, even if they are the same size. There is also increasing evidence that women are more susceptible to alcohol's damaging effects than are men. Below are explanations of why men and women process alcohol differently.

Ability to dilute alcohol

Women have less body water (52% for the average woman v. 61% for the average man). This means that a man's body will automatically dilute the alcohol more than a woman's body, even if the two people weigh the same amount.

Ability to metabolize alcohol

Women have less dehydrogenase, a liver enzyme that breaks down alcohol, than men. So a woman's body will break down alcohol more slowly than a man's.

Hormonal factors

Premenstrual hormonal changes cause intoxication to set in faster during the days right before a woman gets her period. Birth control pills or other medication with estrogen will slow down the rate at which alcohol is eliminated from the body.

Women are more susceptible to long-term alcohol-induced damage.

Women who are heavy drinkers are at greater risk of liver disease, damage to the pancreas and high blood pressure than male heavy drinkers. Proportionately more alcoholic women die from cirrhosis than do alcoholic men.

What other factors affect your response to alcohol?

Food

Having food in your stomach can have a powerful influence on the absorption of alcohol. The food will dilute the alcohol and slow the emptying of the stomach into the small intestine, where alcohol is very rapidly absorbed. Peak BAC could be as much as 3 times higher in someone with an empty stomach than in someone who has eaten a meal before drinking. Eating regular meals and having snacks while drinking will keep you from getting too drunk too quickly.

Asian descent

Some people of Asian descent have more difficulty metabolizing alcohol. They may experience facial flushing, nausea, headache, dizziness and rapid heartbeat. It appears that one of the liver enzymes that is needed to process alcohol is not active in these individuals. It is estimated that up to 50% of Asians are susceptible to these reactions to alcohol.

Family History

First-degree relatives (children, siblings or parents) of alcoholics have been estimated to have a seven times greater chance of developing alcoholism. The male relatives of male alcoholics are at particularly high risk, with the expectancy of becoming an alcoholic ranging from 20% to 50%. It appears that this risk factor is not just genetic; growing up with an alcoholic parent contributes to a person's drinking behavior.

What is the difference between a blackout and passing out?

"Blackouts" (sometimes referred to as alcohol-related memory loss or "alcoholic amnesia") occur when people have no memory of what happened while intoxicated. These periods may last from a few hours to several days. During a blackout, someone may appear fine to others; however, the next day they cannot remember parts of the night and what they did. The cause of blackouts is not well understood but may involve the interference of short-term memory storage, deep seizures, or in some cases, psychological depression.

Blackouts shouldn't be confused with "passing out," which happens when people lose consciousness from drinking excessive amounts of alcohol. Losing consciousness means that the person has reached a very dangerous level of intoxication; they could slip into a coma and die. If someone has passed out, call EMS immediately (831-459-2231). S/he needs immediate medical attention.

What is a hangover and can I prevent it?

Hangovers are the body's reaction to poisoning and withdrawal from alcohol. Hangovers begin 8 to 12 hours after the last drink and symptoms include fatigue, depression, headache, thirst, nausea, and vomiting. The severity of symptoms varies according to the individual and the quantity of alcohol consumed.

People have tried many different things to relieve the effects of "the morning after," and there are a lot of myths about what to do to prevent or alleviate a hangover. The only way to prevent a hangover is to drink in moderation:

Eat a good dinner and continue to snack throughout the night.
Alternate one alcoholic drink with one non-alcoholic drink.
Avoid drinking games or shots. Drinking a large amount of alcohol in a short amount of time is the most likely way to become dangerously intoxicated.

Here are some of the things that WON'T help a hangover:

Drinking a little more alcohol the next day. This simply puts more alcohol in your body and prolongs the effects of the alcohol intoxication.
Having caffeine while drinking will not counteract the intoxication of alcohol; you simply get a more alert drunk person. Excessive caffeine will continue to lower your blood sugar and dehydrate you even more than alcohol alone.
Giving water to someone who is throwing up. Once the stomach is irritated enough to cause vomiting, it doesn't matter what you put into it -- it's going to come back up. Any liquid will cause a spasm reaction and more vomiting.
It's best not to take a pain reliever before going to bed. Give your body a chance to process the alcohol before taking any medication.

Here are some things that MIGHT help a hangover:

When you wake up, it's important to eat a healthy meal. Processing alcohol causes a drop in blood sugar and can contribute to headaches.
Drink plenty of water and juice to get rehydrated.
Take a pain reliever, such as ibuprofen or acetaminophen when you wake up. Do NOT take one of these pain relievers BEFORE going to bed because it will tax your liver. Let your body process the alcohol while you are sleeping. We do not recommend aspirin because of Reyes syndrome, a rare but serious illness in teenagers and children.
Avoid excessive caffeine as it may contribute to dehydration. However, if you drink coffee every morning, have your first cup not more than a couple of hours after your regular time. Don't force your body to go through caffeine withdrawal in addition to alcohol withdrawal.
An over-the-counter antacid (Tums, Pepto Bismol or Maalox) may relieve some of the symptoms of an upset stomach.
Do not go too many hours without food as this will increase the effect of the low blood sugar caused by alcohol.
Eat complex carbohydrates like crackers, bagels, bread, cereal or pasta.

Links you can use

e-CHUG
http://interwork.sdsu.edu/echeckup/usa/alc/coll/UCSC
A free, anonymous assessment tool that provides individualized feedback on the role alcohol is playing in your life. You can also see how your use compares with other college students. If you would like to talk to someone about your use, you can call SHOP for an appointment (459-3772).

The Blood Alcohol Educator
http://www.dot.wisconsin.gov/safety/motorist/drunkdriving/calculator.htm
Learn how gender, body weight, food and how fast you drink can affect your blood alcohol concentration. This is an interactive tool that shows you how much alcohol is in different drinks and how your BAC would compare to male and female friends.

College Drinking – Changing the Culture
http://www.collegedrinkingprevention.gov/
Click on the section for students to find out about myths and facts, take an interactive tour of the flow of alcohol through the body or learn about alcohol poisoning. You can use the Calorie Counter to learn about the number of calories in different drinks and you can send an eCard to someone who's drinking worries you.

National Institute on Alcohol Abuse and Alcoholism (NIAAA)
http://www.niaaa.nih.gov/
NIAAA publishes research on many aspects of alcohol, answers frequently asked questions and provides pamphlets and brochures. The research papers and reports can be downloaded.