Drinking and your body
How does drinking affect you physically? It depends on who you are
Why do some people get tipsy quickly, while others can ‘hold their drink’? And why should some people not drink at all? Here are some factors that determine how drinking can affect each of us differently.
Women are generally smaller than men and their bodies contain more fat and less water. This means that the alcohol in each drink a woman takes will end up being more concentrated in her body than the same amount in a man’s body, and she will feel the effect of alcohol more quickly (1, 2)..
Women’s bodies also break down alcohol at a slower rate than men’s bodies. It takes longer for the alcohol to clear. These differences play a role in the effect drinking may have on the health of men and women (3, 4).. Transgender people and those who are transitioning should consult their doctors about how alcohol may affect them.
How your body processes alcohol depends on your age
It’s well established that children and adolescents process alcohol differently than adults because their bodies are still developing. Because of this, drinking at a young age can lead to harmful effects later in life (5, 6). Most countries have laws that set a legal age limit below which drinking is not allowed and underage youth should not drink alcohol (7).
But age also determines how older people process alcohol (8). Drinking affects the elderly differently to younger and middle-aged adults. As we age, we lose some of our ability to break down alcohol (9). It may stay in our bodies longer and we may therefore experience its effects in a different way.
As we age, we’re more likely than younger adults to have general health problems, and some of these may be worsened by drinking. We’re also more likely to be taking medications that can interact with alcohol (10). It’s always advisable to consult with health professionals about drinking and how it may affect us, particularly as we get older.
Your body size and your weight matter
It generally takes longer for larger people to feel the effect of drinking than smaller people. Body size and weight affect how quickly or how slowly alcohol is processed (11). They also affect how soon you feel an intoxicating effect.
Despite these differences, everyone – whether large or small, thin or overweight – is susceptible to the effects of alcohol and harm from drinking too much.
How you experience drinking alcohol depends on your general health
Illustration of a heart with a cog and heart rate pulse line to depict overall health
How you feel after drinking can depend on whether you are healthy or ill and on whether you are taking medications, and which ones. People who have certain diseases or conditions may be advised to reduce how much they drink or to not drink at all (12-15). If you’re being treated for an illness, you should consult a health professional about whether to drink alcohol beverages.
Medications often include important warnings that advise against drinking alcohol, as there may be interactions that can affect how you feel, your state of mind, and how effective the medication will be (10).
Genetic traits you inherit play a role in how alcohol may affect you
Illustration of three double-stranded helix
Some people are unable to process alcohol efficiently because of a genetic difference that affects how it’s broken down by their bodies (16, 17). This genetic variant is most common among people of Chinese, Japanese and Korean origin than among other groups (18). Even if they are otherwise healthy, people who have this deficiency may become flushed in the face when they drink, and feel ill and dizzy even after drinking small amounts of alcohol.
Family history and genetics are also part of the reason some people develop Alcohol Use Disorder (AUD) or ‘alcoholism’ (16, 19). This condition can be passed down through generations in some families (20, 21). People who experience problems with their drinking or are unable to stop should consult with a health professional for advice and may require treatment.
Using drugs alters your experience with drinking
Alcohol acts on the brain and nervous system, where it produces many of its effects. The nature and extent of those effects depends on how much you are drinking, as well as your age, weight, gender and various other factors discussed in this section.
Drugs like cannabis, opiates, amphetamines and others, whether legal or illegal, also act on the brain (22, 23). They may interact with alcohol and the combined effect may be strong and unpredictable (24). Combining drugs and alcohol can be dangerous and potentially lethal, depending on how much you’re drinking and the drugs you’re using. You should not mix alcohol with prescription drugs without consulting a health professional. Of course, you should never take illegal drugs, but especially mixed with alcohol.
Eating and drinking affect how your body processes alcohol
The reason for this is simple. Eating slows the rate at which alcohol is absorbed into your bloodstream and how quickly you feel its effects(11). Being well hydrated, by drinking non-alcohol drinks and water, helps your body process the alcohol and flush it out of your system after it has been broken down. It is always a good idea to eat when you drink and to alternate drinking alcohol with other beverages.
But eating and drinking fluids will not prevent you from getting drunk or mitigate the effects that drinking too much can have on your body.
References
- Harvard Health Publishing. Alcohol's effects on the body. 2014; Available from:
- Thomasson, H.R., Gender differences in alcohol metabolism. Physiological responses to ethanol. Recent Dev Alcohol, 1995. 12: p. 163-79.
- Erol, A. and V.M. Karpyak, Sex and gender-related differences in alcohol use and its consequences: Contemporary knowledge and future research considerations. Drug Alcohol Depend, 2015. 156: p. 1-13.
- National Institute on Alcohol Abuse and Alcoholism (NIAAA). Women and alcohol. 2019; Available from:
- Spear, L.P., Effects of adolescent alcohol consumption on the brain and behavior. Nat Rev Neurosci, 2018. 19(4): p. 197-214.
- Lees, B., et al., Effect of alcohol use on the adolescent brain and behavior. Pharmacol Biochem Behav, 2020. 192: p. 172906.
- International Alliance for Responsible Drinking (IARD). Minimum legal age limits. 2020; Available from:
- National Institute on Alcohol Abuse and Alcoholism (NIAAA). Older adults. 2020; Available from:
- Meier, P. and H.K. Seitz, Age, alcohol metabolism and liver diseases. Current Opinions in Clinical Nutrition and Metabolic Care, 2008. 11: p. 21026.
- National Institute on Alcohol Abuse and Alcoholism (NIAAA). Harmful interactions: mixing alcohol with medicines. 2014; Available from:
- Cederbaum, A.I., Alcohol metabolism. Clin Liver Dis, 2012. 16(4): p. 667-85.
- Puddey, I.B. and L.J. Beilin, Alcohol is bad for blood pressure. Clin Exp Pharmacol Physiol, 2006. 33(9): p. 847-52.
- Mental Health Foundation. Alcohol and mental health. 2020; Available from:
- Engler, P.A., S.E. Ramsey, and R.J. Smith, Alcohol use of diabetes patients: the need for assessment and intervention. Acta Diabetol, 2013. 50(2): p. 93-9.
- British Heart Foundation (BHF). Heart conditions and alcohol. 2020; Available from:
- Bierut, L.J., et al., A genome-wide association study of alcohol dependence. Proc Natl Acad Sci U S A, 2010. 107(11): p. 5082-7.
- Edenberg, H.J., The genetics of alcohol metabolism: role of alcohol dehydrogenase and aldehyde dehydrogenase variants. Alcohol Res Health, 2007. 30(1): p. 5-13.
- Iwahashi, K. and H. Suwaki, Ethanol metabolism, toxicity and genetic polymorphism. Addict Biol, 1998. 3(3): p. 249-59.
- Edenberg, H.J., J. Gelernter, and A. Agrawal, Genetics of Alcoholism. Curr Psychiatry Rep, 2019. 21(4): p. 26.
- Cservenka, A., Neurobiological phenotypes associated with a family history of alcoholism. Drug Alcohol Depend, 2016. 158: p. 8-21.
- Sanchez-Roige, S., A.A. Palmer, and T.K. Clarke, Recent Efforts to Dissect the Genetic Basis of Alcohol Use and Abuse. Biol Psychiatry, 2020. 87(7): p. 609-618.
- Volkow, N.D. and M. Morales, The Brain on Drugs: From Reward to Addiction. Cell, 2015. 162(4): p. 712-25.
- Koob, G.F. and N.D. Volkow, Neurobiology of addiction: a neurocircuitry analysis. Lancet Psychiatry, 2016. 3(8): p. 760-773.
- Singh, A.K., Alcohol Interaction with Cocaine, Methamphetamine, Opioids, Nicotine, Cannabis, and gamma-Hydroxybutyric Acid. Biomedicines, 2019. 7(1).
