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Alcohol's main effect on the brain is sedation," Darria Long-Gillespie, M.D., an emergency room doctor and clinical assistant professor at the University of Tennessee School of Medicine, tells SELF. As the CDC explains, alcohol is a depressant that impacts your central nervous system, which is comprised of your brain and spinal cord. With that in mind, it's no surprise that alcohol's sweeping effects can impact mental functions like decision-making along with physical ones like your ability to stay alert.
"When alcohol is first being absorbed and our blood alcohol concentration (BAC) is on the way up, we may feel stimulated," Susan Stoner, Ph.D., a research consultant at the University of Washington Alcohol & Drug Abuse Institute, tells SELF. This is because alcohol acts on your brain's "reward" system by prompting the release of dopamine, a neurotransmitter that can induce good feelings. But the more alcohol you drink, the more your body builds up adenosine, a chemical that makes you tired - hence why you might feel gently relaxed after half a glass of wine but fall asleep after two.
Alcohol also affects neurotransmitters such as glutamate, which governs brain function. If you drink enough alcohol, its depressant effects can reduce your breathing and heart rate, which is when alcohol intoxication can become life-threatening. Alcohol intoxication can also kill someone more indirectly, Dr. Long-Gillespie says. A drunk person can fall and hit their head, think they're fine to drive and crash, pass out and choke on their vomit, or get into other life-threatening situations.
"Everyone who drinks four or more drinks in one setting - or spends time with someone who does - should become familiar with a blood alcohol chart that shows how many 'standard drinks' result in a dangerous BAC," Stoner says. A standard drink is around 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of an 80-proof spirit like rum or tequila.

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