Drink?: The New Science of Alcohol and Health

by David J. Nutt

Because what drinking alcohol needs to be, above all, is a conscious act. You should treat it as more special than eating, more like—I would argue—it used to be treated in the past. Make drinking a positive, active pleasure rather than a reflex and habit, or something you’ve always done, or self-medication for stress or anxiety.

The sedative effect works for around four hours. At this point, you may wake up with a headache and perhaps with lights flashing in your eyes, feeling alert and unhappy, and find it hard to get back to sleep. If you don’t wake up, you’re likely to sleep badly or fitfully. This is happening because your brain knows being intoxicated is potentially dangerous—so it doesn’t want to be intoxicated. As soon as you started to drink the previous night, your brain started to change. Because alcohol blocks glutamate receptors, your brain up-regulated the glutamate system to compensate for this, by increasing the quantity of glutamate receptors. Then, as your blood alcohol level goes down during the night, you’re left with too many receptors and so too much glutamate activity. And that is why you are too awake and alert, and why the world seems too bright, too noisy, too much.

New research also suggests alcohol may cause your immune system to attack your body. It seems alcohol can turn on your immune cells; they are supposed to protect you from bugs and toxins, and they do so by releasing chemicals that cause irritation in blood vessels and nerves, which can lead to pain, including headaches.

Alcohol is a poison, and the liver is in charge of breaking down poisons, as well as other drugs and chemicals. That’s why alcohol, like other poisons, can destroy your liver. The problem is, most people don’t know they have liver damage until it’s very advanced—and possibly too late.

list of other cancers for which alcohol is known to be a significant risk factor: breast, colorectal, esophageal, pharynx and larynx, lip and oral cavity, and nasal.

Ethanol is a carcinogen, a teratogen, and toxic to many body organs.

More important, alcohol is also the leading preventable cause of hypertension (high blood pressure).

Why is increased blood pressure dangerous? Because it leads to two main outcomes: heart attacks and strokes.

It seems the effect on blood pressure is reversible if you stop drinking. In one study,25 13 out of 18 heavy drinkers saw their blood pressure return to normal levels after one month of abstinence.

drinking causes brain damage. In fact, the leading preventable causes of dementia are head injury and the damage alcohol does to the brain.

That’s why, for almost a century, some doctors have been saying that all alcoholic drinks should have added vitamin B1. I’d support this. Although people with acutely inflamed brains are relatively rare, it’s likely there are a lot of people walking around with milder forms. That is why when anyone seeks help with their drinking, we give them high doses of vitamin B1—up to 1 gram per day.

It’s likely that the hormonal fluctuation of the perimenopause years are the reason why women find their relationship with alcohol changes, whether it’s that they can no longer tolerate it or they want to drink more.

drinking came out as giving the best buzz—followed by yoga, exercise, socializing, meditation, food, then caffeine. It scored pretty highly as being energizing too.

Research shows that people who drink socially—especially those who have a regular local watering hole—tend to have more friends and so more emotional support, a key source of mental health. They also feel more contented and more involved in their local community.