April is Alcohol Awareness Month, a time each year reserved to raise awareness and understanding of alcohol abuse. Part of understanding alcohol abuse is forming an understanding of the effects alcohol has on the brain while a person is consuming it.

The National Institute on Alcohol Abuse and Alcoholism states that alcohol interferes with the brain’s communication pathways and can affect the way the brain looks and works. Alcohol makes it harder for the brain areas controlling balance, memory, speech, and judgment to function, resulting in a higher likelihood of injuries and other negative outcomes. Long-term heavy drinking causes alterations in the neurons, such as reductions in their size.

Many people who have drunk to intoxication have experienced what is called a black-out. NIH explains blackouts as gaps in a person’s memory of events that occurred while they were intoxicated. These gaps happen when a person drinks enough alcohol that it temporarily blocks the transfer of memories from short-term to long-term storage -known as memory consolidation — in a brain area called the hippocampus.

Northwestern Medicine’s website discusses seven stages of intoxication —

≤ Subliminal intoxication: A blood-alcohol content between 0.01 and 0.05, is the first stage of intoxication.

“You may not look like you have been drinking, but your reaction time, behavior and judgment may be slightly altered,” the website states. “Depending on weight, most people enter this stage after one drink.

≤ Euphoria: During the early stages of drinking, your brain releases more dopamine. This chemical is linked with pleasure. During euphoria, you may feel relaxed and confident. But your reasoning and memory may be slightly impaired. Often referred to as “tipsy,” this stage occurs when your BAC is between 0.03 and 0.12.

≤ Excitement: At this stage, with a BAC from 0.08 to 0.25, a person is legally intoxicated. This level of intoxication affects the occipital lobe, temporal lobe and frontal lobe in the brain. Drinking too much can cause side effects specific to each lobe’s role, including blurred vision, slurred speech and hearing, and lack of control, respectively. The parietal lobe, which processes sensory information, is also affected. The person may have a loss of fine motor skills and a slower reaction time. This stage is often marked by mood swings, impaired judgment, and even nausea or vomiting.

≤ Confusion: A BAC of 0.18 to 0.3 often looks like disorientation. the brain’s cerebellum, which helps with coordination, is impacted. As a result, a person may need help walking or standing. Blackouts, or the temporary loss of consciousness or short-term memory, are also likely to occur at this stage. This is a result of the hippocampus, the region of the brain that is responsible for making new memories, not functioning properly. The person may also have a higher pain threshold, which may increase the risk for injury.

≤ Stupor: At a BAC of 0.25, the person may have concerning signs of alcohol poisoning. At this time, all mental, physical and sensory functions are severely impaired. The risk for passing out, suffocation and injury is high.

≤ Coma: At a BAC of 0.35, a person is at risk for going into a coma. This occurs due to compromised respiration and circulation, motor responses and reflexes. A person in this stage is at risk of death.

≤ Death. A BAC over 0.45 may cause death due to alcohol poisoning or failure of the brain to control the body’s vital functions.

Long-term use of alcohol can lead to what is commonly termed alcoholism. The Mayo Clinic defines alcoholism as the inability to control drinking due to both a physical and emotional dependence on alcohol.

Symptoms include a strong need or urge to use alcohol. Those with alcohol use disorder may have problems controlling their drinking, continue to use alcohol even when it causes problems or have withdrawal symptoms when they rapidly decrease or stop drinking.

More than 3 million new cases of alcohol use disorder occur each year. There is help, though.

The Substance Abuse and Mental Health Services Administration’s national helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders. The number is 1-800-662-HELP (4375).

For more information, go to the SAMHSA site at https://www.samhsa.gov/find-help/national-helpline.