People have sometimes joked that drinking kills brain cells, but is that really true? What kind of effect does heavy drinking have on the brain?
Here to give us the facts is Dr. Jesse Corry, neurologist at Allina Health’s United Hospital.
Your Brain 101: The Affects of Alcohol
Featured Speaker:
Learn more about Jesse Corry, MD
Jesse Corry, MD
Jesse Corry, MD, is board certified in critical care and neurology, and serves as a neurologist at Allina Health’s United Hospital in St. Paul. His clinical interest is in the stroke continuum of care.Learn more about Jesse Corry, MD
Transcription:
Your Brain 101: The Affects of Alcohol
Melanie Cole (Host): We’ve sometimes heard people joke that drinking kills brain cells, but is that really true? What kind of effect does heavy drinking have on the brain? Here to give us the facts is my guest today, Dr. Jessie Corry. He’s a Neurologist at Allina Health’s United Hospital. Welcome to the show, Dr. Corry. What is generally considered an acceptable level of alcohol consumption? How much does it really take to start affecting a person’s functionality, safety, well-being; all of those kinds of thought processes?
Dr. Jessie Corry (Guest): Well, that’s for having me. It’s actually kind of interesting. When we look at what’s considered a “standard drink,” it actually tends to vary a bit country to country in how they measure as far as the number of beverages a week, or a day, what have you, but in the United States we typically consider a standard drink to be twelve ounces of a regular beer – it’s what, five percent alcohol, or five ounces of wine, which is -- wine typically runs twelve percent alcohol, or an ounce and a half of eighty proof distilled spirits. In the US we typically say for men, two beverages a day, for women, one beverage a day, each beverage typically having about 14 grams of alcohol. Where that number came up with is that it takes about an hour to metabolize that much alcohol and again, that will differ depending on the person’s body size, metabolism, and that sort of thing. When we look at -- as far as then – at what point do people become disinhibited? At what point does a person tend to have it affect their functionality? It varies individual to individual. People who drank more will typically have more of a tolerance. That doesn’t mean they necessarily have a lower blood alcohol content, they’re just able to function with a little bit higher blood alcohol content. Typically we start seeing people having impairment in their ability to operate motor vehicles and to do basic mechanical skills at a blood alcohol content of about 0.08, which is typically what we consider legally intoxicated in most states.
Melanie: Is that one of the ways that it was figured out about intoxication and driving, Dr. Corry? Did they take those numbers and – obviously, as you say it depends on the person’s size and weight and how much alcohol they can actually metabolize and tolerate, but is that how you think they may have come up with those 0.08 blood levels?
Dr. Corry: It’s interesting when they’ve done – a lot of this was probably developed on studies where they would measure a person’s motor skills and reaction time based on different blood alcohol content. Typically, at about 0.08 is about where a person’s reflex time starts to decrease, so I would imagine that’s where these numbers came from as far as how they would say for each state what’s considered intoxicated or not intoxicated.
Melanie: What actually does alcohol do? Based on your metabolism, what does it do to the blood-brain-barrier and to your neurotransmitters? Obviously, for some people, serotonin levels may rise because they feel better, but that’s not true for everybody.
Dr. Corry: Correct. What I think is really fascinating about alcohol is that at first – alcohol we evolved with. There’s a big school of thought that agriculture may have come out of man’s desire not for bread, but for beer. I think that’s kind of interesting. And then we look at the brain – alcohol crosses, very easily, into the brain. It has the ability to cross that blood-brain-barrier very easily, so it’s able to get into the brain, but the brain itself does not have a dedicated alcohol receptor. Alcohol, rather, seems to affect how other receptors in the brain work. When we think about alcohol and those feel-good aspects of alcohol, alcohol tends to work on the dopamine receptors in that nucleus accumbens. That’s the little nucleus in the brain that helps mediate reward and pleasure experience. Alcohol also is very good at reducing pain and actually having the brain release them as endogenous opiates, the brain’s own morphine so to say. Probably what is that most known is the alcohol’s ability to stimulate what’s called the GABA receptor -- the GABA-A receptor. This acts to reduce anxiety, and this is the social lubricant aspect if you will, of alcohol. Then you bring up serotonin, there’s lots of evidence that with alcohol, it will stimulate those serotonin receptors making a person have a more pleasurable experience, but it also, at certain levels, will stimulate the third serotonin receptor, which is actually what mediates nausea. That’s why when you’ve imbibed in too much, oftentimes people get very nauseated after they drink.
Melanie: Wow, that’s an interesting point about nauseous and how some people can even have seizures. If you drink too much you get nauseous; you throw up, maybe you get dizzy, you get the spins, whatever it is that you get -- is that our brain, or is that like a poisoning? Is that a blood thing?
Dr. Corry: That’s a great question. When a person’s had too much for themselves where they do feel the nausea and the spinning and whatnot, that’s a combination of a couple of things. That can be the direct stimulation from the alcohol itself, or when alcohol is metabolized, some of its byproducts may cause the effect at various receptors within the brain itself to cause these things. We do know that alcohol itself does seem to have a toxic effect to certain cells in the brain, particularly cells in what’s called the cerebellum. This is the part of the brain that helps control balance both for coordination of your hands, but for walking and eye movements. If this part of the brain is affected – if you’ve had those receptors for nausea affected -- you very well may also have the receptors that help integrate what you’re seeing with what you’re body’s feeling. If there’s a little bit of a mishmash, let’s say where what you’re seeing and your balance isn’t quite working, you feel a little bit nauseated, this can, as you can imagine, have a very deleterious effect to that individual.
Melanie: What about binge drinking? We’re heard about the dangers. I certainly speak to my teenagers about this. What is considered binge drinking?
Dr. Corry: Typically, binge drinking is considered anytime a person drinks more than what’s recommended in a day, so again, for a person who’s a male who drinks more than two or three beverages at a time, or a woman more than two beverages at a time. When we colloquially think about binge drinking, it’s a person who’s going to have many, many drinks at one sitting where they’re going to become intoxicated and then some. Binge drinking is probably among one of the worst things you can do for your person because not only do you have the acute result – the acute complications of alcohol intoxication, which can be everything from just simple nausea to full-blown withdrawal -- but you can also do things that may potentiate other, long-term, more chronic problems of drinking and as well as it – if a person – you are stimulating that reward system, and if you’re binge drinking at a regular level, you’re reinforcing what can be – which is considered a quite bad behavior and you may run the risk of becoming alcoholic long-term.
Melanie: What about food and coffee, Dr. Corry, because people hear, “Well, if you eat, it will absorb the alcohol,” but if this is a brain response, how does that work and then, certain things like caffeine, can they really counteract the effects?
Dr. Corry: Okay, great questions. When people drink, it’s always recommended to consume food with your drink. The food will actually help bind the alcohol and will help it release slower. Further, alcohol is an emulsifying agent, so it’s going to bind to those fats and either pass through your gut unmetabolized, or will be released slower into your blood stream. If a person – if they’re enjoying a good meal with their glass of wine and their bottle of beer, that alcohol will be probably consumed at a slower pace and absorb it a little bit slower so the person may not feel the adverse effects. You asked, then, about caffeine? Typically the main way many of us get our caffeine is through coffee, and there actually has been some evidence that shows that coffee itself may actually help preserve the liver and may actually help reverse some of the effects of long-term alcohol use. In fact, for many guidelines, looking at recommendations for people who have fatty liver disease, regular coffee is actually something that’s recommended.
Melanie: But then they say also that if you drink coffee after somebody who’s imbibed way too much, then you’re just a wide awake drunk?
Dr. Corry: I think that’s something that’s very individual. People will tend to drink those energy drinks with their alcohol. Yeah, they tend to be made more alert, so they’re the alert, less-inhibited individual, so that’s always a possibility, but it really depends on each individual and what they can handle.
Melanie: If somebody is consuming alcohol, and maybe they’re not a binge drinking or maybe they’re not an excessive alcohol drinker, what’s your best advice for them about moderating, keeping track of some symptoms, red flags, that you might want them to know about that lets them know, “Hey, you know what? Maybe you’re just crossing the line a little bit, and maybe you need to dial it back.”
Dr. Corry: Excellent, great question. I think the first thing is to try to make alcohol when you’re using it, part of something else, such as a meal, something where you’re going to be consuming and doing other things other than drinking. The focus shouldn’t be just on the consumption of alcohol. That’s first. The next thing is that when you’re consuming alcohol, make sure you take some time off. If you’re going to have, let’s say, a celebration, a wedding, what have you, make sure the next day or two you try to limit or abstain from alcohol. Give your body a chance to recover. The symptoms that people can look for that say, “Maybe you need to start worrying about this. Maybe you need to start drawing back,” is if that person can’t remember the last time they went without drinking or that person who says, “Well it’s five O’clock, and I’m starting to get the shakes right now,” or when you start to associate too many things with alcohol consumption. Those are things where you may want to say, “Okay, do I have a problem here and what should I do about that?” Another big thing is looking for why you’re drinking. Is it to help alleviate problems with depression, anxiety? Oftentimes, people use alcohol to medicate for other problems and so the solution may be to identify those problems and then treat it with an agent better than alcohol.
Melanie: And it certainly is important to keep hydrated both during and the next day, for sure.
Dr. Corry: Absolutely.
Melanie: Now, Dr. Corry, if someone has been consuming too much alcohol – wrap it up for is – and if they want to quit, what do you recommend as a way to take charge of the situation and get started?
Dr. Corry: I think the first thing is to find a support group, be it – talk to your physician. Find a group l like Alcoholics Anonymous. Find some group who’s going to help you keep on the straight and narrow, so to say. The next thing you need to do is you need to have an understanding of how much you’re drinking and understand what’s your baseline consumption and if your goal is to wean off that. If you’re a person who drinks excessively – we’re talking 15, 20 drinks per day or more – then you very well may need professional help, such as a detoxification center. It’s again, great advice to get to your Psychiatrist, get to your Primary Care Doctor and help you either enroll in this or work with somebody in the medical field because often times if you’re going through withdrawal, you may not know when you are withdrawing if, in fact, you are having problems with hallucinations or seizures, what have you. If you’re not drinking to that extent, but you still want to cut back, knowing your baseline will help you then say, “Okay, I’m going to reduce by 25, 50% every so many days.” It’s not as though you’re drinking for fun is a matter that you’re drinking for medication to help you come down for a gentle landing. The goal then is bringing your body down to where it’s no longer alcohol-dependent and then, hopefully with that support group, with people around you who care for you, be able to maintain off of alcohol for the time being.
Melanie: Absolutely. Excellent advice. Thank you, so much, Dr. Corry, for being with us today.
Dr. Corry: No Problem.
Melanie: It’s always a pleasure to have you on.
Dr. Corry: Well, thank you.
Melanie: You’re listening to the Well Cast with Allina Health, and for more information, you can go to AllinaHealth.org, that’s AllinaHealth.org. This is Melanie Cole. Thanks, so much, for listening.
Your Brain 101: The Affects of Alcohol
Melanie Cole (Host): We’ve sometimes heard people joke that drinking kills brain cells, but is that really true? What kind of effect does heavy drinking have on the brain? Here to give us the facts is my guest today, Dr. Jessie Corry. He’s a Neurologist at Allina Health’s United Hospital. Welcome to the show, Dr. Corry. What is generally considered an acceptable level of alcohol consumption? How much does it really take to start affecting a person’s functionality, safety, well-being; all of those kinds of thought processes?
Dr. Jessie Corry (Guest): Well, that’s for having me. It’s actually kind of interesting. When we look at what’s considered a “standard drink,” it actually tends to vary a bit country to country in how they measure as far as the number of beverages a week, or a day, what have you, but in the United States we typically consider a standard drink to be twelve ounces of a regular beer – it’s what, five percent alcohol, or five ounces of wine, which is -- wine typically runs twelve percent alcohol, or an ounce and a half of eighty proof distilled spirits. In the US we typically say for men, two beverages a day, for women, one beverage a day, each beverage typically having about 14 grams of alcohol. Where that number came up with is that it takes about an hour to metabolize that much alcohol and again, that will differ depending on the person’s body size, metabolism, and that sort of thing. When we look at -- as far as then – at what point do people become disinhibited? At what point does a person tend to have it affect their functionality? It varies individual to individual. People who drank more will typically have more of a tolerance. That doesn’t mean they necessarily have a lower blood alcohol content, they’re just able to function with a little bit higher blood alcohol content. Typically we start seeing people having impairment in their ability to operate motor vehicles and to do basic mechanical skills at a blood alcohol content of about 0.08, which is typically what we consider legally intoxicated in most states.
Melanie: Is that one of the ways that it was figured out about intoxication and driving, Dr. Corry? Did they take those numbers and – obviously, as you say it depends on the person’s size and weight and how much alcohol they can actually metabolize and tolerate, but is that how you think they may have come up with those 0.08 blood levels?
Dr. Corry: It’s interesting when they’ve done – a lot of this was probably developed on studies where they would measure a person’s motor skills and reaction time based on different blood alcohol content. Typically, at about 0.08 is about where a person’s reflex time starts to decrease, so I would imagine that’s where these numbers came from as far as how they would say for each state what’s considered intoxicated or not intoxicated.
Melanie: What actually does alcohol do? Based on your metabolism, what does it do to the blood-brain-barrier and to your neurotransmitters? Obviously, for some people, serotonin levels may rise because they feel better, but that’s not true for everybody.
Dr. Corry: Correct. What I think is really fascinating about alcohol is that at first – alcohol we evolved with. There’s a big school of thought that agriculture may have come out of man’s desire not for bread, but for beer. I think that’s kind of interesting. And then we look at the brain – alcohol crosses, very easily, into the brain. It has the ability to cross that blood-brain-barrier very easily, so it’s able to get into the brain, but the brain itself does not have a dedicated alcohol receptor. Alcohol, rather, seems to affect how other receptors in the brain work. When we think about alcohol and those feel-good aspects of alcohol, alcohol tends to work on the dopamine receptors in that nucleus accumbens. That’s the little nucleus in the brain that helps mediate reward and pleasure experience. Alcohol also is very good at reducing pain and actually having the brain release them as endogenous opiates, the brain’s own morphine so to say. Probably what is that most known is the alcohol’s ability to stimulate what’s called the GABA receptor -- the GABA-A receptor. This acts to reduce anxiety, and this is the social lubricant aspect if you will, of alcohol. Then you bring up serotonin, there’s lots of evidence that with alcohol, it will stimulate those serotonin receptors making a person have a more pleasurable experience, but it also, at certain levels, will stimulate the third serotonin receptor, which is actually what mediates nausea. That’s why when you’ve imbibed in too much, oftentimes people get very nauseated after they drink.
Melanie: Wow, that’s an interesting point about nauseous and how some people can even have seizures. If you drink too much you get nauseous; you throw up, maybe you get dizzy, you get the spins, whatever it is that you get -- is that our brain, or is that like a poisoning? Is that a blood thing?
Dr. Corry: That’s a great question. When a person’s had too much for themselves where they do feel the nausea and the spinning and whatnot, that’s a combination of a couple of things. That can be the direct stimulation from the alcohol itself, or when alcohol is metabolized, some of its byproducts may cause the effect at various receptors within the brain itself to cause these things. We do know that alcohol itself does seem to have a toxic effect to certain cells in the brain, particularly cells in what’s called the cerebellum. This is the part of the brain that helps control balance both for coordination of your hands, but for walking and eye movements. If this part of the brain is affected – if you’ve had those receptors for nausea affected -- you very well may also have the receptors that help integrate what you’re seeing with what you’re body’s feeling. If there’s a little bit of a mishmash, let’s say where what you’re seeing and your balance isn’t quite working, you feel a little bit nauseated, this can, as you can imagine, have a very deleterious effect to that individual.
Melanie: What about binge drinking? We’re heard about the dangers. I certainly speak to my teenagers about this. What is considered binge drinking?
Dr. Corry: Typically, binge drinking is considered anytime a person drinks more than what’s recommended in a day, so again, for a person who’s a male who drinks more than two or three beverages at a time, or a woman more than two beverages at a time. When we colloquially think about binge drinking, it’s a person who’s going to have many, many drinks at one sitting where they’re going to become intoxicated and then some. Binge drinking is probably among one of the worst things you can do for your person because not only do you have the acute result – the acute complications of alcohol intoxication, which can be everything from just simple nausea to full-blown withdrawal -- but you can also do things that may potentiate other, long-term, more chronic problems of drinking and as well as it – if a person – you are stimulating that reward system, and if you’re binge drinking at a regular level, you’re reinforcing what can be – which is considered a quite bad behavior and you may run the risk of becoming alcoholic long-term.
Melanie: What about food and coffee, Dr. Corry, because people hear, “Well, if you eat, it will absorb the alcohol,” but if this is a brain response, how does that work and then, certain things like caffeine, can they really counteract the effects?
Dr. Corry: Okay, great questions. When people drink, it’s always recommended to consume food with your drink. The food will actually help bind the alcohol and will help it release slower. Further, alcohol is an emulsifying agent, so it’s going to bind to those fats and either pass through your gut unmetabolized, or will be released slower into your blood stream. If a person – if they’re enjoying a good meal with their glass of wine and their bottle of beer, that alcohol will be probably consumed at a slower pace and absorb it a little bit slower so the person may not feel the adverse effects. You asked, then, about caffeine? Typically the main way many of us get our caffeine is through coffee, and there actually has been some evidence that shows that coffee itself may actually help preserve the liver and may actually help reverse some of the effects of long-term alcohol use. In fact, for many guidelines, looking at recommendations for people who have fatty liver disease, regular coffee is actually something that’s recommended.
Melanie: But then they say also that if you drink coffee after somebody who’s imbibed way too much, then you’re just a wide awake drunk?
Dr. Corry: I think that’s something that’s very individual. People will tend to drink those energy drinks with their alcohol. Yeah, they tend to be made more alert, so they’re the alert, less-inhibited individual, so that’s always a possibility, but it really depends on each individual and what they can handle.
Melanie: If somebody is consuming alcohol, and maybe they’re not a binge drinking or maybe they’re not an excessive alcohol drinker, what’s your best advice for them about moderating, keeping track of some symptoms, red flags, that you might want them to know about that lets them know, “Hey, you know what? Maybe you’re just crossing the line a little bit, and maybe you need to dial it back.”
Dr. Corry: Excellent, great question. I think the first thing is to try to make alcohol when you’re using it, part of something else, such as a meal, something where you’re going to be consuming and doing other things other than drinking. The focus shouldn’t be just on the consumption of alcohol. That’s first. The next thing is that when you’re consuming alcohol, make sure you take some time off. If you’re going to have, let’s say, a celebration, a wedding, what have you, make sure the next day or two you try to limit or abstain from alcohol. Give your body a chance to recover. The symptoms that people can look for that say, “Maybe you need to start worrying about this. Maybe you need to start drawing back,” is if that person can’t remember the last time they went without drinking or that person who says, “Well it’s five O’clock, and I’m starting to get the shakes right now,” or when you start to associate too many things with alcohol consumption. Those are things where you may want to say, “Okay, do I have a problem here and what should I do about that?” Another big thing is looking for why you’re drinking. Is it to help alleviate problems with depression, anxiety? Oftentimes, people use alcohol to medicate for other problems and so the solution may be to identify those problems and then treat it with an agent better than alcohol.
Melanie: And it certainly is important to keep hydrated both during and the next day, for sure.
Dr. Corry: Absolutely.
Melanie: Now, Dr. Corry, if someone has been consuming too much alcohol – wrap it up for is – and if they want to quit, what do you recommend as a way to take charge of the situation and get started?
Dr. Corry: I think the first thing is to find a support group, be it – talk to your physician. Find a group l like Alcoholics Anonymous. Find some group who’s going to help you keep on the straight and narrow, so to say. The next thing you need to do is you need to have an understanding of how much you’re drinking and understand what’s your baseline consumption and if your goal is to wean off that. If you’re a person who drinks excessively – we’re talking 15, 20 drinks per day or more – then you very well may need professional help, such as a detoxification center. It’s again, great advice to get to your Psychiatrist, get to your Primary Care Doctor and help you either enroll in this or work with somebody in the medical field because often times if you’re going through withdrawal, you may not know when you are withdrawing if, in fact, you are having problems with hallucinations or seizures, what have you. If you’re not drinking to that extent, but you still want to cut back, knowing your baseline will help you then say, “Okay, I’m going to reduce by 25, 50% every so many days.” It’s not as though you’re drinking for fun is a matter that you’re drinking for medication to help you come down for a gentle landing. The goal then is bringing your body down to where it’s no longer alcohol-dependent and then, hopefully with that support group, with people around you who care for you, be able to maintain off of alcohol for the time being.
Melanie: Absolutely. Excellent advice. Thank you, so much, Dr. Corry, for being with us today.
Dr. Corry: No Problem.
Melanie: It’s always a pleasure to have you on.
Dr. Corry: Well, thank you.
Melanie: You’re listening to the Well Cast with Allina Health, and for more information, you can go to AllinaHealth.org, that’s AllinaHealth.org. This is Melanie Cole. Thanks, so much, for listening.