Alcohol (ethanol or ethyl alcohol) is the main active ingredient in alcoholic beverages, such as beer, wine, and liquor. Alcohol is produced by a process called fermentation – that is, the breakdown of sugars in fruits, vegetables and grains by yeast or bacteria. For example, wine is made from the fermentation of sugar in grapes, beer is made from that same process in grains, cider from apples, and vodka from potatoes.

Alcohol is an intoxicating, psychoactive substance that acts as a stimulant of the nervous system in low doses, creating a sense of euphoria, but as a depressant in high doses.

Alcohol is absorbed quickly in the blood through the digestive system, and its effects can be felt about 5 to 10 minutes after drinking an alcoholic beverage. The concentration of alcohol in the blood peaks about 30 to 90 minutes after consumption, reaching all parts of the body.

Alcohol is broken down into water and carbon dioxide mainly by the liver, and loses its toxicity through this metabolic process. However, the liver can only break down about one drink an hour, and a sense of drunkenness occurs when the rate of drinking exceeds the rate of alcohol metabolism. Nonetheless, it is important to emphasize that blood alcohol levels, as well as rates of alcohol absorption and metabolism, vary from person to person due to genetic differences, liver enzyme levels, body fat, muscle mass, age, gender, ethnicity, presence of food in the gastrointestinal tract, frequency of alcohol consumption, and so on.

A bit of history

Alcohol is an important element and regular part of the diet in many cultures around the world. It is used in religious rituals for healing and celebration in Christianity and Judaism. The oldest evidence of alcohol brewing was found in archaeological excavations in China and Georgia, dating back to 7,000 BCE. Evidence of alcoholic beverages was also found in later periods, including in ancient Egypt and Central and South America. Wine is mentioned in the Bible as that which “makes man’s heart glad,” and was consumed in ancient Greece and ancient Rome during meals, feasts, and social and cultural events. Chemical analyses of the remains found in archaeological excavations reveal that the ancients fermented drinks from grapes, various grains, honey, and even rice.  

Why do people drink alcohol?

  Studies indicate that alcohol consumption is mainly driven by the desire to cope with stress, and by certain social and cultural interactions. As mentioned above, alcohol is an intoxicating substance that can act as either a stimulant or sedative of the nervous system, depending on the dosage consumed. In addition, alcohol affects the activity of the limbic system in the brain, which regulates emotions. As a result, alcohol can intensify certain feelings, such as happiness and joy, and can reduce fear and anxiety — but it can also intensify negative emotions, such as sadness, irritability, and bad moods.

 What are the adverse health effects of alcohol?

  Every year, over 3 million men and women die as a result of the excessive and harmful use of alcohol. Death from alcohol-related causes accounts for 5.3% of all deaths worldwide. Alcohol use is associated with over 200 diseases, including liver and pancreatic diseases, infectious diseases (such as tuberculosis and HIV), various forms of cancer, cardiovascular disease, as well as injuries and accidents. The risk level associated with drinking is defined by two main factors: the amount and the pattern of drinking – that is, by the quantity and frequency of alcohol consumption. The recommendations for safe drinking are different for men and women because of the physiological and metabolic differences between the sexes. It is customary to calculate these recommendations using a standard serving of alcohol, but also important to note that this definition varies by country. In Israel, a standard beverage contains about 14 grams of pure alcohol, which translates roughly into a small glass of beer (333 ml), a small glass of wine (133 ml), or a small shot of hard liquor (43 ml of vodka, whiskey, gin, etc.). In order to reduce alcohol-related bodily harm, the recommendation for men is to consume no more than 3 servings of alcohol on a given day, and no more than 14 servings per week. The recommendation for women is no more than 2 servings per day, with a maximum of 7 drinks per week. Despite these guidelines, certain populations are urged to avoid alcohol completely, or to abide by lower consumption limits. These include people suffering from serious physical illnesses, especially liver disease, people with certain psychiatric disorders, adults over the age of 56, as well as those taking medications that interact with alcohol. It is also important to emphasize that there is a direct link between alcohol use and a variety of mental and behavioral disorders, involvement in violent behavior and events, and suicide. Another adverse physical effect of alcohol is the phenomenon of hangovers, which are characterized by headaches, irritability, thirst, nausea, vomiting, vertigo, fatigue, sweating, chills and more. These symptoms are mainly the result of dehydration, electrolyte imbalances, and hypoglycemia (low blood sugar). Alcohol consumption by pregnant women can cause fetal damage, premature birth and fetal alcohol syndrome. Another danger of heavy drinking is alcohol poisoning, especially when drinking counterfeit or low-quality alcohol, which can lead to deformities and even death. Beyond the health consequences, alcohol abuse causes significant social and economic damage, at the individual, societal and national levels.  

What causes alcohol addiction?  

As with many addictive substances, the body develops tolerance to the toxic effects of alcohol over time. Moreover, drinking alcohol frequently and in large quantities can affect brain functioning, especially the areas related to pleasure, judgment and behavior. Most of the theories that attempt to explain the wide range in alcohol tolerance and propensity for addiction among individuals attribute the differences to various genetic and environmental risk factors, including drinking alcohol from an early age, family history, exposure to trauma, and a genetic predisposition to mood disorders, especially depression and anxiety. In other words, not everyone who drinks occasionally will develop a compulsive drinking habit, which is referred to today in the medical literature as Alcohol Use Disorder (AUD). According to various estimates, in the United States over 16 million people suffer from AUD. The diagnosis is based on criteria described in the world’s leading psychiatric diagnosis manual, the DSM. AUD, like other addictive disorders, is defined as a treatable chronic disease.

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