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==Alcohol and health==
{{See also|Template:Alcohol and health}}

] consumption include ] and ]. ] include changes in the metabolism of the liver and brain and ] (addiction to alcohol).

Alcohol intoxication affects the brain, causing slurred speech, clumsiness, and delayed reflexes. Alcohol stimulates ] production, which speeds up ] ] and can result in low ], causing irritability and (for ]) possible death. Severe alcohol poisoning can be fatal.

A ] of 0.45% in test animals results in a median lethal dose of {{LD50}}. This means that 0.45% is the concentration of blood alcohol that is fatal in 50% of the test subjects. That is about six times the level of ordinary intoxication (0.08%), but ] or unconsciousness may occur much sooner in people who have a low tolerance for alcohol.<ref name="psychopharm">Meyer, Jerold S. and Linda F. Quenzer. Psychopharmacology: Drugs, the Brain, and Behavior. Sinauer Associates, Inc: Sunderland, Massachusetts. 2005. Page 228.</ref> The high tolerance of chronic heavy drinkers may allow some of them to remain conscious at levels above 0.40%, although serious health dangers are incurred at this level.

Alcohol also limits the production of ] (ADH) from the ] and the secretion of this ] from the ] gland. This is what causes severe ] when large amounts of alcohol are drunk. It also causes a high concentration of water in the ] and vomit and the intense thirst that goes along with a ].

], ]s and ] may increase the desire<!--crave?--> for alcohol because these things will lower the level of testosterone and alcohol will acutely elevate it.<ref>, Helsinki 2001</ref> ] has the same effect of increasing the craving for alcohol.<ref>, ESBRA 2009</ref>

===Abuse prevention===
{{see also|Substance abuse prevention}}

====Alcohol abuse prevention programs====
{{see also|Prevention Science}}

=====0-1-2-3=====
The Army at Fort Drum has taken the “0-0-1-3” and exchanged it for the new “0-1-2-3” described in the Prime-For-Life Program, which highlights the ill effects of alcohol abuse as more than just an individual’s “driving while intoxicated.” The Prime-For-Life program identifies alcohol abuse to be a health and impairment problem, leading to adverse legal as well as health outcomes associated with misuse.

The 0-1-2-3 now represents low-risk guidelines:
* 0 – Zero drinks for those driving a vehicle.
* 1 – One drink per hour
* 2 – No more than two drinks per day
* 3 – Not to exceed three drinks on any one day

====Recommended maximum intake====
{{Main|Recommended maximum intake of alcoholic beverages}}

Binge drinking is becoming a major problem in the UK. Advice on weekly consumption is avoided in United Kingdom.<ref>{{cite web|url=http://www.aim-digest.com/gateway/pages/guide/articles/biggy.htm |title=Sensible Drinking |publisher=Aim-digest.com |date= |accessdate=2013-02-05}}</ref>

Since 1995 the UK government has advised that regular consumption of 3–4 units a day for men, or 2–3 units a day for women, would not pose significant health risks, but that consistently drinking four or more units a day (men), or three or more units a day (women), is not advisable.<ref>{{cite web|url=http://www.dh.gov.uk/en/Publichealth/Healthimprovement/Alcoholmisuse/index.htm |title=Alcohol misuse : Department of Health |publisher=Dh.gov.uk |date= |accessdate=2013-02-05}}</ref>

Previously (from 1992 until 1995), the advice was that men should drink no more than 21 units per week, and women no more than 14.<ref>{{cite web|url=http://www.drinkaware.co.uk/facts/factsheets/health-fact-sample-2 |title=Alcohol and health: how alcohol can affect your long and short term health |publisher=Drinkaware.co.uk |date= |accessdate=2013-02-05}}</ref> (The difference between the sexes was due to the typically lower weight and water-to-body-mass ratio of women.) This was changed because a government study showed that many people were in effect "saving up" their units and using them at the end of the week, a phenomenon referred to as ].{{Citation needed|date= October 2007}} ] reported in October 2007 that these limits had been "plucked out of the air" and had no scientific basis.<ref>, The Times, 20 October 2007</ref>

====Sobriety====
{{see also|Sobriety}}

] is subjected to a random ] test to see if he is sober or not.]]
'''Sobriety''' is the condition of not having any measurable levels, or effects from ]s. According to WHO "Lexicon of alcohol and drug terms..." '''sobriety''' is continued abstinence from psychoactive drug use.<ref>{{cite web|url=http://www.who.int/substance_abuse/terminology/who_lexicon/en/ |title=Lexicon and drug terms |publisher=Who.int |date=2010-12-09 |accessdate=2013-02-05}}</ref> Sobriety is also considered to be the natural state of a human being given at a birth. In a treatment setting, sobriety is the achieved goal of independence from consuming or craving mind-altering substances. As such, sustained abstinence is a prerequisite for sobriety. Early in abstinence, residual effects of mind-altering substances can preclude sobriety. These effects are labeled "PAWS", or "post acute withdrawal syndrome". Someone who abstains, but has a latent desire to resume use, is not considered truly sober. An abstainer may be subconsciously motivated to resume drug use, but for a variety of reasons, abstains (e.g. such as a medical or legal concern precluding use).<ref name="basharin">{{cite web|url=http://www.video.sbnt.ru/vl/Newspapers/Podsporie/Podsporie_111.pdf |title=Scientific grounding for sobriety: Western experience |authors=MD Basharin K.G., Yakutsk State University |format=PDF |date=2010 |accessdate=2013-02-05}}</ref> Sobriety has more specific meanings within specific contexts, such as the culture of ], other 12 step programs, law enforcement, and some schools of psychology. In some cases, '''sobriety''' implies achieving "life balance."<ref>{{dead link|date=February 2013}}</ref>

===Mortality rate===
{{Main|Long-term effects of alcohol#Alcohol-related deaths}}

A report of the United States ] estimated that medium and high consumption of alcohol led to 75,754 deaths in the U.S. in 2001. Low consumption of alcohol had some beneficial effects, so a net 59,180 deaths were attributed to alcohol.<ref>{{cite web|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5337a2.htm|title=Alcohol-Attributable Deaths and Years of Potential Life Lost — United States, 2001|date=2004-09-24|publisher=]}}</ref>

In the ], heavy drinking is blamed for about 33,000 deaths a year.<ref>{{Cite news|publisher=BBC News|url=http://news.bbc.co.uk/1/hi/health/medical_notes/a-b/872428.stm|title=Alcohol|date=2000-08-09}}</ref>

A study in ] found that 29% to 44% of "unnatural" deaths (those not caused by illness) were related to alcohol. The causes of death included murder, suicide, falls, ], ], and ].<ref>{{Cite news|publisher=BBC News|date=2000-07-14|title=Alcohol linked to thousands of deaths|url=http://news.bbc.co.uk/1/hi/health/833483.stm}}</ref>

A global study found that 3.6% of all cancer cases worldwide are caused by alcohol drinking, resulting in 3.5% of all global cancer deaths.<ref name="abramson">{{Cite news|title=Burden of alcohol-related cancer substantial|url=http://www.oncolink.com/resources/article.cfm?c=3&s=8&ss=23&id=13383&month=08&year=2006| date=2006-08-03|publisher=Abramson Cancer Center of the University of Pennsylvania}}</ref> A study in the ] found that alcohol causes about 6% of cancer deaths in the UK (9,000 deaths per year).<ref name="cancer1"/>

====ISCD====
] 2010 study ranking the levels of damage caused by drugs, in the opinion of drug-harm experts. When harm to self and others is summed, alcohol was the most harmful of all drugs considered, scoring 72%.]]
]'' in 2007 by David Nutt (now chair of ]) shows alcohol in comparison to other psychoactive drugs, scoring 1.40, 1.93, and 2.21 of possible 3 ranking points for physical harm, dependence, and social harm respectively.<ref name="Nutt">{{cite pmid|17382831}}</ref>]]

A 2010 study by the ], led by ], Leslie King and Lawrence Phillips, asked drug-harm experts to rank a selection of illegal and legal drugs on various measures of harm both to the user and to others in society. These measures include damage to health, drug dependency, economic costs and crime. The researchers claim that the rankings are stable because they are based on so many different measures and would require significant discoveries about these drugs to affect the rankings.<ref>{{cite web|url=http://www.economist.com/blogs/dailychart/2010/11/drugs_cause_most_harm |title=Drugs that cause most harm: Scoring drugs |publisher=The Economist |date=2010-11-02 |accessdate=2013-02-05}}</ref>

Despite being legal more often than the other drugs, alcohol was considered to be by far the most harmful; not only was it regarded as the most damaging to societies, it was also seen as the fourth most dangerous for the user. Most of the drugs were rated significantly less harmful than alcohol, with most of the harm befalling the user.

The authors explain that one of the limitation of this study is that drug harms are functions of their availability and legal status in the UK, and so other cultures' control systems could yield different rankings.

===Alcohol expectations===
Alcohol expectations are ]s and ] that people have about the effects they will experience when drinking alcoholic beverages. They are largely beliefs about alcohol's effects on a person’s behaviors, abilities, and emotions. Some people believe that if alcohol expectations can be changed, then ] might be reduced.<ref name=Grattan>{{cite journal |last1=Grattan |first1=Karen E. |last2=Vogel-Sprott |first2=M. |title=Maintaining Intentional Control of Behavior Under Alcohol |journal=Alcoholism: Clinical and Experimental Research |volume=25 |issue=2 |pages=192–7 |year=2001 |doi=10.1111/j.1530-0277.2001.tb02198.x |pmid=11236832}}</ref>

The phenomenon of alcohol expectations recognizes that intoxication has real physiological consequences that alter a drinker's perception of space and time, reduce psychomotor skills, and disrupt ].<ref name=MacAndrew/> The manner and degree to which alcohol expectations interact with the physiological short-term effects of alcohol, resulting in specific behaviors, is unclear.

A single study found, if a society believes that intoxication leads to ], rowdy behavior, or aggression, then people tend to act that way when intoxicated. But if a society believes that intoxication leads to relaxation and tranquil behavior, then it usually leads to those outcomes. Alcohol expectations vary within a society, so these outcomes are not certain.<ref name="The think-drink effect">{{cite journal | last1 = Marlatt | first1 = G. A. | last2 = Rosenow | first2 = | author-separator =, | author-name-separator= | year = 1981 | title = The think-drink effect | url = | journal = Psychology Today | volume = 15 | issue = | pages = 60–93 }}</ref>

People tend to conform to social expectations, and some societies expect that drinking alcohol will cause ]. However, in societies in which the people do not expect that alcohol will disinhibit, intoxication seldom leads to disinhibition and bad behavior.<ref name=MacAndrew>MacAndrew, C. and Edgerton. ''Drunken Comportment: A Social Explanation''. Chicago: Aldine, 1969.</ref>

Alcohol expectations can operate in the absence of actual consumption of alcohol. Research in the United States over a period of decades has shown that men tend to become more sexually aroused when they think they have been drinking alcohol, — even when they have not been drinking it. Women report feeling more sexually aroused when they falsely believe the beverages they have been drinking contained alcohol (although one measure of their physiological arousal shows that they became less aroused).{{Citation needed|date=June 2010}}

Men tend to become more aggressive in laboratory studies in which they are drinking only ] but believe that it contains alcohol. They also become less aggressive when they believe they are drinking only tonic water, but are actually drinking tonic water that contains alcohol.<ref name=Grattan/>

===Genetic differences===

====Alcohol flush reaction====
{{see also|Alcohol flush reaction}}
Alcohol flush reaction is best known as a condition that is experienced by people of Asian descent. According to the analysis by ] project, the rs671 allele of the ALDH2 gene responsible for the flush reaction is rare among Europeans and Africans, and it is very rare among Mexican-Americans. 30% to 50% of people of Chinese and Japanese ancestry have at least one ALDH*2 allele.<ref>{{cite web|url=http://www.snpedia.com/index.php/Rs671|title=Rs671}}</ref> The rs671 form of ALDH2, which accounts for most incidents of alcohol flush reaction worldwide, is native to East Asia and most common in southeastern China. It most likely originated among Han Chinese in central China,<ref>{{cite journal|title=Refined Geographic Distribution of the Oriental ALDH2*504Lys (nee 487Lys) Variant|author=Hui Li et al|journal=Ann Hum Genet|year=2009|pmc=2846302|pmid=19456322|doi=10.1111/j.1469-1809.2009.00517.x|volume=73|issue=Pt 3|pages=335–45}}</ref> and it appears to have been positively selected in the past. Another analysis correlates the rise and spread of rice cultivation in Southern China with the spread of the allele.<ref name="Yi Peng, Hong Shi, Xue-bin Qi, Chun-jie Xiao, Hua Zhong, Run-lin Z Ma, Bing Su 2010 15">{{cite journal |author=Yi Peng, Hong Shi, Xue-bin Qi, Chun-jie Xiao, Hua Zhong, Run-lin Z Ma, Bing Su |title=The ADH1B Arg47His polymorphism in East Asian populations and expansion of rice domestication in history |journal=BMC Evolutionary Biology |volume=10 |page= 15|year=2010 |pmid=20089146 |pmc=2823730 |doi= 10.1186/1471-2148-10-15|url=http://www.biomedcentral.com/1471-2148/10/15}}</ref> The reasons for this positive selection aren't known, but it's been hypothesized that elevated concentrations of acetaldehyde may have conferred protection against certain parasitic infections, such as '']''.<ref>{{cite journal|author=Oota et al|title=The evolution and population genetics of the ALDH2 locus: random genetic drift, selection, and low levels of recombination|year=2004|journal=Annals of Human Genetics}}</ref>

====American Indian alcoholism====
{{see also|American Indian alcoholism}}
While little detailed genetic research has been done, it has been shown that alcoholism tends to run in families with possible involvement of differences in alcohol metabolism and the genotype of alcohol-metabolizing enzymes.

===Gender differences===

====Sensitivity====
Several biological factors make women more vulnerable to the effects of alcohol than men.<ref>{{cite web|url=http://www.helpguide.org/harvard/women_alcohol.htm |title=Women & Alcohol: The Hidden Risks of Drinking |publisher=Helpguide.org |date= |accessdate=2013-02-05}}</ref>

* Body fat. Women tend to weigh less than men, and—pound for pound—a woman’s body contains less water and more fatty tissue than a man’s. Because fat retains alcohol while water dilutes it, alcohol remains at higher concentrations for longer periods of time in a woman’s body, exposing her brain and other organs to more alcohol.
* Enzymes. Women have lower levels of two enzymes—alcohol dehydrogenase and aldehyde dehydrogenase—that metabolize (break down) alcohol in the stomach and liver. As a result, women absorb more alcohol into their bloodstreams than men.
* Hormones. Changes in hormone levels during the menstrual cycle may also affect how a woman metabolizes alcohol.

====Metabolism====
Females demonstrated a higher average rate of elimination (mean, 0.017; range, 0.014-0.021 g/210 L) than males (mean, 0.015; range, 0.013-0.017 g/210 L). Female subjects on average had a higher percentage of body fat (mean, 26.0; range, 16.7-36.8%) than males (mean, 18.0; range, 10.2-25.3%).<ref>http://www.ncbi.nlm.nih.gov/pubmed/8872236</ref>

====Depression====
The link between alcohol consumption, depression, and gender was examined by the Centre for Addiction and Mental Health (Canada). The study found that women taking antidepressants consumed more alcohol than women who did not experience depression as well as men taking antidepressants. The researchers, Dr. Kathryn Graham and a PhD Student Agnes Massak analyzed the responses to a survey by 14,063 Canadian residents aged 18–76 years. The survey included measures of quantity, frequency of drinking, depression and antidepressants use, over the period of a year. The researchers used data from the GENACIS Canada survey, part of an international collaboration to investigate the influence of cultural variation on gender differences in alcohol use and related problems. The purpose of the study was to examine whether, like in other studies already conducted on male depression and alcohol consumption, depressed women also consumed less alcohol when taking anti-depressants.<ref>“Antidepressants Help Men, But Not Women, Decrease Alcohol Consumption.” Science Daily. Feb. 27, 2007.</ref>
According to the study, both men and women experiencing depression (but not on anti-depressants) drank more than non-depressed counterparts. Men taking antidepressants consumed significantly less alcohol than depressed men who did not use antidepressants. Non-depressed men consumed 436 drinks per year, compared to 579 drinks for depressed men not using antidepressants, and 414 drinks for depressed men who used antidepressants. Alcohol consumption remained higher whether the depressed women were taking anti-depressants or not. 179 drinks per year for non-depressed women, 235 drinks for depressed women not using antidepressants, and 264 drinks for depressed women who used antidepressants. The lead researcher argued that the study "suggests that the use of antidepressants is associated with lower alcohol consumption among men suffering from depression. But this does not appear to be true for women."<ref>Graham, Katherine and Massak, Agnes. “Alcohol consumption and the use of antidepressants.” UK Pubmed Central (2007). June 20, 2012.</ref>

===Short-term effects of alcohol===
{{See also|Alcohol and sex|Blood alcohol content|Alcohol intoxication|Short-term effects of alcohol}}

====Blood ethanol concentration (BEC)====
{{See also|Blood alcohol content}}
]

=====Vehicle operation=====
The number of serious errors committed by pilots dramatically increases at or above concentrations of 0.04% blood alcohol. This is not to say that problems don't occur below this value. Some studies have shown decrements in pilot performance with blood alcohol concentrations as low as the 0.025%.<ref><http://flightphysical.com/pilot/alcohol.htm/</ref> Also, a BEC of ≥0.080 or more is legally intoxicated for driving in MOST states. And, ≤0.050 is considered NOT impaired in most.<ref>http://info.insure.com/auto/baccalc.html</ref>

=====Estimated blood ethanol concentration (EBAC)=====
In order to calculate estimated peak blood alcohol concentration (EBAC) a variation, including drinking period in hours, of the Widmark formula was used. The formula is:<ref name=PMC2724514/>

:<math>EBAC = 10 \cdot \frac {0.806 \cdot SD \cdot 1.2}{BW \cdot Wt} - (MR \cdot DP)</math>

where 0.806 is a constant for body water in the blood (mean 80.6%), SD is the number of standard drinks containing 10 grams of ethanol, 1.2 is a factor in order to convert the amount in grams to Swedish standards set by The Swedish National Institute of Public Health, BW is a body water constant (0.58 for men and 0.49 for women), Wt is body weight (kilogram), MR is the metabolism constant (0.017), DP is the drinking period in hours and 10 converts the result to permillage of alcohol.<ref name=PMC2724514>{{cite journal |doi=10.1186/1471-2458-9-229 |title=Alcohol use among university students in Sweden measured by an electronic screening instrument |year=2009 |last1=Andersson |first1=Agneta |last2=Wiréhn |first2=Ann-Britt |last3=Ölvander |first3=Christina |last4=Ekman |first4=Diana |last5=Bendtsen |first5=Preben |journal=BMC Public Health |volume=9 |page=229 |pmid=19594906 |pmc=2724514}}</ref> Regarding metabolism (MR) in the formula; Females demonstrated a higher average rate of elimination (mean, 0.017; range, 0.014-0.021 g/210 L) than males (mean, 0.015; range, 0.013-0.017 g/210 L). Female subjects on average had a higher percentage of body fat (mean, 26.0; range, 16.7-36.8%) than males (mean, 18.0; range, 10.2-25.3%).<ref>{{cite journal |pmid=8872236 |url=http://jat.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=8872236 |doi=10.1093/jat/20.5.287 |year=1996 |last1=Cowan Jr |first1=JM |last2=Weathermon |first2=A |last3=McCutcheon |first3=JR |last4=Oliver |first4=RD |title=Determination of volume of distribution for ethanol in male and female subjects |volume=20 |issue=5 |pages=287–90 |journal=Journal of analytical toxicology |doi_brokendate=February 5, 2013}}</ref> Additionally, men are, on average, heavier than women but it is not strictly accurate to say that the water content of a person alone is responsible for the dissolution of alcohol within the body, because alcohol does dissolve in fatty tissue as well. When it does, a certain amount of alcohol is temporarily taken out of the blood and briefly stored in the fat. For this reason, most calculations of alcohol to body mass simply use the weight of the individual, and not specifically his water content. Further, studies have shown that women's alcohol metabolism varies from that of men due to such biochemical factors as different levels of ] (the enzyme which breaks down alcohol) and the effects of oral contraceptives.<ref></ref> Finally, it is speculated that the bubbles in sparkling wine may speed up ] by helping the alcohol to reach the bloodstream faster. A study conducted at the ] in the United Kingdom gave subjects equal amounts of flat and sparkling Champagne which contained the same ]. After 5 minutes following consumption, the group that had the sparkling wine had 54 milligrams of alcohol in their blood while the group that had the same sparkling wine, only flat, had 39 milligrams.<ref name="Miscellany">G. Harding ''"A Wine Miscellany"'' pg 136–137, Clarkson Potter Publishing, New York 2005 ISBN 0-307-34635-8</ref>

Examples:
* 80 kg male drinking 3 standard drinks in two hours:
:<math> EBAC = (0.806 \cdot 3 \cdot 1.2)/(0.58 \cdot 80) - (0.015 \cdot 2) = 0.032534483 \approx 0.033 g/dL</math>
* 70 kg woman drinking 2.5 standard drinks in two hours:
:<math> EBAC = (0.806 \cdot 3 \cdot 1.2)/(0.49 \cdot 70) - (0.017 \cdot 2) = 0.036495627 \approx 0.037 g/dL</math>

Useful tools:
*
*

=====Binge drinking=====
{{see also|Binge drinking}}
In most jurisdictions a measurement such as a blood alcohol content (BAC) in excess of a specific threshold level, such as 0.05% or 0.08% defines the offense. Also, the ] (NIAAA) define the term "]" as any time one reaches a peak BAC of 0.08% or higher as opposed to some (arguably) arbitrary number of drinks in an evening.<ref name="cdc.gov">"Quick Stats: Binge Drinking." The Centers for Disease Control and Prevention. April 2008..</ref>

======Pleasure zone======
Known as ''pleasure zone'', the positive exceeds the negative effects typically between '''0.030–0.059%''' blood ethanol concentration (BEC), but contrary at higher volumes like ] (0.08% as defined by NIAAA).

======BEC chart======
The data below apply '''specifically to ethanol''', not other '''alcohols''' found in alcoholic beverage.

{| class="wikitable"
|-
! Colspan="3" | Progressive effects of alcohol<ref>A hybridizing of effects as described at '''' from ] and (hosted on ''FlightPhysical.com'')</ref>
|-
! BAC (% by vol.)
! Behavior
! Impairment
|-
| style="text-align:center;"| 0.010–0.029
|
* Average individual appears<br />normal
|
* Subtle effects that can be<br />detected with special tests
|-
| style="text-align:center;"| 0.030–0.059
|
* Mild ]
* Relaxation
* Joyousness
* Talkativeness
* Decreased inhibition
|
* Concentration
|-
| style="text-align:center;"| 0.06–0.09
|
* Blunted feelings
* ]
* Extroversion
|
* Reasoning
* Depth perception
* Peripheral vision
* Glare recovery
|-
| style="text-align:center;"| 0.10–0.19
|
* Over-expression
* Emotional swings
* Anger or sadness
* Boisterousness
* Decreased libido
|
* Reflexes
* Reaction time
* Gross motor control
* Staggering
* Slurred speech
* Temporary erectile dysfunction
* Possibility of temporary alcohol poisoning
|-
| style="text-align:center;"| 0.20–0.29
|
* ]
* Loss of understanding
* Impaired sensations
* Possibility of falling unconscious
|
* Severe motor impairment
* Loss of consciousness
* ] blackout
|-
| style="text-align:center;"| 0.30–0.39
|
* Severe ]
* Unconsciousness
* Death is possible
|
* Bladder function
* ]
* ]
* ]
|-
| style="text-align:center;"| 0.40–0.50
|
* General lack of behavior
* Unconsciousness
|
* Breathing
* Heart rate
* ]
|-
| style="text-align:center;"| >0.50
|
* High risk of poisoning
* Possibility of death
|}

{| class="wikitable"
|-
! Colspan="6" | Standard drink chart (U.S.)<ref>Based on the ] standard of 0.6&nbsp;fl&nbsp;oz alcohol per drink. </ref>
|-
! Alcohol
! Amount (ml)
! Amount (fl&nbsp;oz)
! Serving size
! Alcohol (% by vol.)
! Alcohol
|-
| 80 proof liquor || 44 || 1.5 || One shot || 40 || {{convert|0.6|USoz|ml|abbr=on}}
|-
| Table wine || 148 || 5 || One glass || 12 || {{convert|0.6|USoz|ml|abbr=on}}
|-
| Beer || 355 || 12 || One can || 5 || {{convert|0.6|USoz|ml|abbr=on}}
|}

{| class="wikitable"
|-
! Male<br />Female !! Colspan="9"| Approximate blood alcohol percentage (by vol.)<ref> from ]</ref><br /><small>One drink has {{convert|0.5|USoz|ml|abbr=on}} alcohol by volume</small>
|-
! Rowspan="3"| Drinks !! Colspan="9"| Body weight
|-
! 40&nbsp;kg !! 45&nbsp;kg !! 55&nbsp;kg !! 64&nbsp;kg !! 73&nbsp;kg !! 82&nbsp;kg !! 91&nbsp;kg !! 100&nbsp;kg !! 109&nbsp;kg
|-
! 90&nbsp;lb !! 100&nbsp;lb !! 120&nbsp;lb !! 140&nbsp;lb !! 160&nbsp;lb !! 180&nbsp;lb !! 200&nbsp;lb !! 220&nbsp;lb !! 240&nbsp;lb
|- style="text-align:center;"
| 1 || –<br />0.05 || 0.04<br />0.05 || 0.03<br />0.04 || 0.03<br />0.03 || 0.02<br />0.03 || 0.02<br />0.03 || 0.02<br />0.02 || 0.02<br />0.02 || 0.02<br />0.02
|- style="text-align:center;"
| 2 || –<br />0.10 || 0.08<br />0.09 || 0.06<br />0.08 || 0.05<br />0.07 || 0.05<br />0.06 || 0.04<br />0.05 || 0.04<br />0.05 || 0.03<br />0.04 || 0.03<br />0.04
|- style="text-align:center;"
| 3 || –<br />0.15 || 0.11<br />0.14 || 0.09<br />0.11 || 0.08<br />0.10 || 0.07<br />0.09 || 0.06<br />0.08 || 0.06<br />0.07 || 0.05<br />0.06 || 0.05<br />0.06
|- style="text-align:center;"
| 4 || –<br />0.20 || 0.15<br />0.18 || 0.12<br />0.15 || 0.11<br />0.13 || 0.09<br />0.11 || 0.08<br />0.10 || 0.08<br />0.09 || 0.07<br />0.08 || 0.06<br />0.08
|- style="text-align:center;"
| 5 || –<br />0.25 || 0.19<br />0.23 || 0.16<br />0.19 || 0.13<br />0.16 || 0.12<br />0.14 || 0.11<br />0.13 || 0.09<br />0.11 || 0.09<br />0.10 || 0.08<br />0.09
|- style="text-align:center;"
| 6 || –<br />0.30 || 0.23<br />0.27 || 0.19<br />0.23 || 0.16<br />0.19 || 0.14<br />0.17 || 0.13<br />0.15 || 0.11<br />0.14 || 0.10<br />0.12 || 0.09<br />0.11
|- style="text-align:center;"
| 7 || –<br />0.35 || 0.26<br />0.32 || 0.22<br />0.27 || 0.19<br />0.23 || 0.16<br />0.20 || 0.15<br />0.18 || 0.13<br />0.16 || 0.12<br />0.14 || 0.11<br />0.13
|- style="text-align:center;"
| 8 || –<br />0.40 || 0.30<br />0.36 || 0.25<br />0.30 || 0.21<br />0.26 || 0.19<br />0.23 || 0.17<br />0.20 || 0.15<br />0.18 || 0.14<br />0.17 || 0.13<br />0.15
|- style="text-align:center;"
| 9 || –<br />0.45 || 0.34<br />0.41 || 0.28<br />0.34 || 0.24<br />0.29 || 0.21<br />0.26 || 0.19<br />0.23 || 0.17<br />0.20 || 0.15<br />0.19 || 0.14<br />0.17
|- style="text-align:center;"
|10 || –<br />0.51 || 0.38<br />0.45 || 0.31<br />0.38 || 0.27<br />0.32 || 0.23<br />0.28 || 0.21<br />0.25 || 0.19<br />0.23 || 0.17<br />0.21 || 0.16<br />0.19
|- style="text-align:center;"
| Colspan="10" | Subtract approximately 0.01 every 40 minutes after drinking.
|}

===Long-term effects of alcohol===
{{See also|Long-term effects of alcohol}}

====Adverse effects of binge drinking (0.08% BAC or higher)====
{{main|Binge drinking#Health effects}}

The ] (NIAAA) recently redefined the term "binge drinking" as any time one reaches a peak BAC of 0.08% or higher as opposed to some (arguably) arbitrary number of drinks in an evening.<ref name="cdc.gov"/>

=====Alcohol withdrawal syndrome=====
{{See also|Physical dependency}}

The severity of the ] can vary from mild symptoms such as mild sleep disturbances and mild anxiety to very severe and life threatening including ], particularly visual hallucinations in severe cases and convulsions (which may result in death).<ref name="eciawap">{{cite journal |author=Harada K |title=Emotional condition in alcohol withdrawal acute psychosis |journal=Seishin Shinkeigaku Zasshi |volume=95 |issue=7 |year=1993 |pages=523–9 |pmid=8234534}}</ref> This is sometimes referred to as alcohol-induced ]; Sedative hypnotic drugs such as alcohol, benzodiazepines, and barbiturates are the only commonly available substances that can be fatal in withdrawal due to their propensity to induce withdrawal convulsions.

=====High-functioning alcoholic (HFA)=====
{{see also|High-functioning alcoholic}}
A high-functioning alcoholic (HFA) is a form of ] where the alcoholic is able to maintain their outside life such as jobs, academics, relationships, etc.{{spaced ndash}}all while drinking alcoholically.<ref name="benton2009">{{cite book |title=Understanding the High-Functioning Alcoholic{{spaced ndash}}Professional Views and Personal Insights |last=Benton |first=Sarah Allen |year=2009 |publisher=] |isbn=978-0-313-35280-5 }}</ref>

Many HFAs are not viewed by society as alcoholics because they do not fit the common alcoholic ]. Unlike the stereotypical alcoholic, HFAs have either succeeded or ] through their lifetimes. This can lead to ] of alcoholism by both the HFA, co-workers, family members and friends. Functional alcoholics account for 19.5 percent of total U.S. alcoholics, with 50 percent being smokers and 33 percent having a multigenerational family history of alcoholism.<ref>{{cite web|title=Researchers Identify Alcoholic Subtypes|url=http://www.nih.gov/news/pr/jun2007/niaaa-28.htm|publisher=]{{spaced ndash}}] |accessdate= February 18, 2012|author= Press release | date =June 28, 2007}}</ref>

=====Alcoholism=====
{{Main|Alcoholism}}

Alcohol is the most available and widely abused substance; Beer alone is the world's most widely consumed<ref>{{cite web|title=Volume of World Beer Production|work=European Beer Guide|url=http://www.europeanbeerguide.net/eustats.htm#production|accessdate=17 October 2006| archiveurl= http://web.archive.org/web/20061028165040/http://www.europeanbeerguide.net/eustats.htm| archivedate= 28 October 2006 <!--DASHBot-->| deadurl= no}}</ref> ]; it is the third-most popular drink overall, after ] and ].<ref name="Nelson 2005">{{Cite book|url=http://books.google.com/?id=6xul0O_SI1MC&pg=PA1&dq=most+consumed+beverage|title=The Barbarian's Beverage: A History of Beer in Ancient Europe|year=2005|publisher=Routledge|location=Abingdon, Oxon|isbn=0-415-31121-7|page=1|accessdate=21 September 2010|last= Nelson|first=Max}}</ref> It is thought by some to be the oldest fermented beverage.<ref>{{cite book|title=The Alchemy of Culture: Intoxicants in Society|first=Richard|last=Rudgley|isbn=978-0-7141-1736-2|year=1993|pages=411|url=http://books.google.com/?id=5baAAAAAMAAJ&q=The+Alchemy+of+Culture&dq=The+Alchemy+of+Culture|publisher=British Museum Press|location=London|accessdate=13 January 2012}}</ref><ref>{{cite book|title=Origin and History of Beer and Brewing: From Prehistoric Times to the Beginning of Brewing Science and Technology|first=John P|last=Arnold|isbn=0-9662084-1-2|year=2005|pages=411|url=http://books.google.com/?id=O5CPAAAACAAJ&dq=Origin+and+History+of+Beer+and+Brewing|publisher=Reprint Edition by BeerBooks|location=Cleveland, Ohio|accessdate=13 January 2012}}</ref><ref>Joshua J. Mark (2011). . Ancient History Encyclopedia.</ref><ref>{{Cite book|url=http://books.google.com/?id=SHh-4M_QxEsC&pg=PA10&dq=oldest+beverage&q=oldest%20beverage |title=World's Best Beers: One Thousand |publisher=Google Books |accessdate=7 August 2010 |isbn=978-1-4027-6694-7 |date=6 October 2009 }}</ref>

Under the ]'s new definition of Alcoholism about 37 percent of college students may meet the criteria. Doctors are hoping that this new definition of the term will help catch severe cases of alcoholism early, instead of when the problem is full-blown.<ref name="dailyemerald1">{{cite web|url=http://dailyemerald.com/2012/05/22/redefining-alcoholic-what-this-means-for-students/ |title=About 37 percent of college students could now be considered alcoholics |publisher=Dailyemerald.com |date=2012-05-22 |accessdate=2013-02-05}}</ref>

Based on combined data from SAMHSA's 2004-2005 National Surveys on Drug Use & Health, the rate of past year alcohol dependence or abuse among persons aged 12 or older varied by level of alcohol use: 44.7% of past month heavy drinkers, 18.5% binge drinkers, 3.8% past month non-binge drinkers, and 1.3% of those who did not drink alcohol in the past month met the criteria for alcohol dependence or abuse in the past year. Males had higher rates than females for all measures of drinking in the past month: any alcohol use (57.5% vs. 45%), binge drinking (30.8% vs. 15.1%), and heavy alcohol use (10.5% vs. 3.3%), and males were twice as likely as females to have met the criteria for alcohol dependence or abuse in the past year (10.5% vs. 5.1%).<ref>“Gender differences in alcohol use and alcohol dependence or abuse: 2004 or 2005.” The NSDUH Report.Accessed June 22, 2012.</ref>

The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as the amount of alcohol leading to a blood alcohol content (BAC) of 0.08, which, for most adults, would be reached by consuming five drinks for men or four for women over a 2-hour period.

According to the National Institute on Alcohol Abuse and Alcoholism , men may be at risk for alcohol-related problems if their alcohol consumption exceeds 14 standard drinks per week or 4 drinks per day, and women may be at risk if they have more than 7 standard drinks per week or 3 drinks per day. A standard drink is defined as one 12-ounce bottle of beer, one 5-ounce glass of wine, or 1.5 ounces of distilled spirits.)<ref>http://pubs.niaaa.nih.gov/publications/aa68/aa68.htm</ref>

Alcoholism can lead to malnutrition because it can alter digestion and the metabolism of most nutrients. Severe ] deficiency is common in alcoholism due to deficiency of ], ], ], and ] ; this can lead to ]. ] is also associated with a type of dementia called ], which is caused by a deficiency in ] (vitamin B<sub>1</sub>).<ref name=Oscar-Berman2003>{{Cite journal|author=Oscar-Berman M, Marinkovic K |title=Alcoholism and the brain: an overview |journal=Alcohol Res Health |volume=27 |issue=2 |pages=125–33 |year=2003 |pmid=15303622 |doi= |url=}} .</ref> Muscle cramps, nausea, loss of appetite, nerve disorders, and depression are common symptoms of alcoholism. ] and bone fractures may occur due to deficiency of ].


=====Cancer=====
{{Main|Alcohol and cancer}}

Alcohol consumption has been linked with seven types of cancer: ], ], ], ], ], ] and ].<ref name="cancer1">{{cite web|title=Alcohol and cancer|url=http://info.cancerresearchuk.org/healthyliving/alcohol/|publisher=]}}</ref> Heavy drinkers are more likely to develop liver cancer due to ].<ref name="cancer1"/> The risk of developing cancer increases even with consumption of as little as three ] (one pint of lager or a large glass of wine) a day.<ref name="cancer1"/>

A global study found that 3.6% of all cancer cases worldwide are caused by drinking alcohol, resulting in 3.5% of all global cancer deaths.<ref name="abramson"/> A study in the ] found that alcohol causes about 6% of cancer deaths in the UK (9,000 deaths per year).<ref name="cancer1"/> A study in ] found that alcohol causes about 4.40% of all cancer deaths and 3.63% of all cancer incidences.<ref name="Liang 2010">{{cite journal | doi = 10.1186/1471-2458-10-730 | last1 = Liang | first1 = H. | last2 = Wang | year = 2010 | first2 = Jianbing | last3 = Xiao | first3 = Huijuan | last4 = Wang | first4 = Ding | last5 = Wei | first5 = Wenqiang | last6 = Qiao | first6 = Youlin | last7 = Boffetta | first7 = Paolo | title = Estimation of cancer incidence and mortality attributable to alcohol drinking in China | url = http://www.biomedcentral.com/1471-2458/10/730 | journal = BMC Public Health | volume = 10 | issue = 1| page = 730 }}</ref> For both men and women, the consumption of two or more drinks daily increases the risk of pancreatic cancer by 22%.<ref>{{Cite news|url=http://www.medicalnewstoday.com/articles/140882.php|title=Alcohol Consumption May Increase Pancreatic Cancer Risk|publisher=Medical News Today|date=2009-03-04}}</ref>

Women who regularly consume low to moderate amounts of alcohol have an increased risk of cancer of the upper digestive tract, rectum, liver, and breast.<ref>{{Cite news|url=http://professional.cancerconsultants.com/oncology_main_news.aspx?id=43299|title=Moderate Alcohol Consumption Increases Risk of Cancer in Women|date=2009-03-10}}</ref><ref>{{cite web|url=http://www.medicalnewstoday.com/articles/140882.php |title=Alcohol Consumption May Increase Pancreatic Cancer Risk |publisher=Medicalnewstoday.com |date= |accessdate=2010-02-11}}</ref>

Red wine contains ], which has some anti-cancer effect. However, based on studies done so far, there is no strong evidence that red wine protects against cancer in humans.<ref>{{cite web|url=http://info.cancerresearchuk.org/healthyliving/alcohol/benefits/|title=Can alcohol be good for you?|publisher=]}}</ref>

Recent studies indicate that Asian populations are particularly prone to carcinogenic effects of alcohol. It's been noted that ethanol's byproducts in metabolism results in ]. In non-Asian populations, an enzyme called ] that quickly converts acetaldehyde into ]. Asian populations have a variant form of alcohol dehydrogenase which prevents conversion of the acetaldehyde. This substance has been indicated to have strong interactions with DNA and thereby causing carcinogenic effects.<ref>http://www.kurzweilai.net/alcohol-may-boost-risk-of-cancer-for-asians</ref><ref>Silvia Balbo, Lei Meng, Robin L. Bliss, Joni A. Jensen, Dorothy K. Hatsukami, Stephen S. Hecht, Kinetics of DNA Adduct Formation in the Oral Cavity after Drinking Alcohol, Cancer Epidemiology, Biomarkers & Prevention, 2012, DOI: 10.1158/1055-9965.EPI-11-1175</ref>

=====Dementia=====
{{Main|Alcohol dementia}}
Excessive drinking has been linked to ]; it is estimated that 10% to 24% of dementia cases are caused by alcohol consumption, with women being at greater risk than men.<ref>{{cite web|url=http://www.nhs.uk/news/2009/05may/pages/alcoholmajordementiacause.aspx|title=Alcohol 'major cause of dementia'|publisher=]|date=2008-05-11}}</ref><ref>{{Cite news|url=http://www.guardian.co.uk/society/2009/may/10/alcohol-intake-dementia-memory-loss|publisher=The Guardian|title=Binge drinking 'increases risk' of dementia|date=2009-05-10 | location=London | first=Denis | last=Campbell | accessdate=2010-04-07}}</ref>

] is associated with a type of dementia called ], which is caused by a deficiency in ] (vitamin B<sub>1</sub>).<ref name="Oscar-Berman2003"/>

In people aged 55 or older, daily light-to-moderate drinking (one to three drinks) was associated with a 42% reduction in the probability of developing dementia and a 70% reduction in risk of ].<ref name="olddementia">{{Cite news|publisher=BBC News|url=http://news.bbc.co.uk/1/hi/health/1780130.stm|date=2002-01-25|title=Alcohol 'could reduce dementia risk'}}</ref> The researchers suggest that alcohol may stimulate the release of ] in the ] area of the brain.<ref name="olddementia"/>

=====Diabetes=====
If both parents have type 2 diabetes, this increases to a 45 percent chance.<ref>http://health.usnews.com/health-conditions/diabetes/type-2-diabetes</ref>

=====Hip fracture=====
An international study<ref>{{cite journal |author=Kanis JA |title=Alcohol intake as a risk factor for fracture |journal=Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA |volume=16 |issue=7 |pages=737–42 |year=2005 |month=July |pmid=15455194 |doi=10.1007/s00198-004-1734-y |url= |author-separator=, |author2=Johansson H |author3=Johnell O |display-authors=3 |last4=Oden |first4=Anders |last5=Laet |first5=Chris |last6=Eisman |first6=John A. |last7=Pols |first7=Huibert |last8=Tenenhouse |first8=Alan}}</ref> of almost 6,000 men and 11,000 women found that persons who reported that they drank more than 2 units of alcohol a day had an increased risk of fractures compared to non-drinkers. For example, those who drank over 3 units a day had nearly twice the risk of a hip fracture.

=====Obesity=====
Biological and environmental factors are thought to contribute to alcoholism and obesity.<ref name="Alcohol Studies 2003">UNC Bowles Center for Alcohol Studies. Alcoholism and Obesity: Overlapping Brain Pathways? Center Line. Vol 14, 2003.</ref> The physiologic commonalities between excessive eating and excessive alcohol drinking shed light on intervention strategies, such as pharmaceutical compounds that may help those who suffer from both.
Some of the brain signaling proteins that mediate excessive eating and weight gain also mediate uncontrolled alcohol consumption.<ref name="Alcohol Studies 2003"/> Some physiological substrates that underlie food intake and alcohol intake have been identified. Melanocortins, a group of signaling proteins, are found to be involved in both excessive food intake and alcohol intake.<ref>Thiele et al. Overlapping Peptide Control of Alcohol Self-Administration and Feeding. Alcohol Clin Exp Res, Vol 28, No 2, 2004: pp 288–294.</ref>

Alcohol may contribute to obesity. A study found frequent, light drinkers (three to seven drinking days per week, one drink per drinking day) had lower BMIs than infrequent, but heavier drinkers.<ref name="Breslow 2001">Breslow et al. Drinking Patterns and Body Mass Index in Never Smokers: National Health Interview Survey, 1997–2001. Am J Epidemiol 2005;161:368–376.</ref> Although calories in liquids containing ethanol may fail to trigger the physiologic mechanism that produces the feeling of fullness in the short term; long-term, frequent drinkers may compensate for energy derived from ethanol by eating less.<ref name="ReferenceA">Cordain et al. Influence of moderate daily wine consumption on body weight regulation and metabolism in healthy free-living males. J Am Coll Nutr 1997;16:134–9.</ref>

====Health effects of moderate drinking====
{{See also|Moderation}}

=====Longevity=====
A meta-analysis found with data from 477,200 individuals determined the dose-response relationships by sex and end point using lifetime abstainers as the reference group. The search revealed 20 cohort studies that met our inclusion criteria. A U-shaped relationship was found for both sexes. Compared with lifetime abstainers, the relative risk (RR) for type 2 diabetes among men was most protective when consuming 22 g/day alcohol (RR 0.87 ) and became deleterious at just over 60 g/day alcohol (1.01 ). Among women, consumption of 24 g/day alcohol was most protective (0.60 ) and became deleterious at about 50 g/day alcohol (1.02 ).<ref name="autogenerated2">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768203/</ref>

Interestingly, ethanol has been found to double the lifespans of worms feed 0.005% ethanol but does not markedly increase at higher concentrations. Supplementing starved cultures with ''n''-propanol and ''n''-butanol also extended lifespan.;<!--<ref name="plosone.org"/>--> ] (''n''-propanol) is thought to be similar to ethanol in its effects on human body, but 2-4 times more potent. However, this seems to be statistically significant for humans when compared to the previous study discusses; Human macronutrients in food consist mainly of water and the Dietary Reference Intake (DRI) for water is 3.7 litres (3700 mL x 0.005% EtOH = 18.5 mL EtOH) for 19-70 year old males, and 2.7 litres (2700 mL x 0.005% EtOH = 13.5 mL) for 19-70 year old women.

Because former drinkers may be inspired to abstain due to health concerns, they may actually be at increased risk of developing diabetes, known as the sick-quitter effect. Moreover, the balance of risk of alcohol consumption on other diseases and health outcomes, even at moderate levels of consumption, may outweigh the positive benefits with regard to diabetes.

Additionally, the way in which alcohol is consumed (i.e., with meals or bingeing on weekends) affects various health outcomes. Thus, it may be the case that the risk of diabetes associated with heavy alcohol consumption is due to consumption mainly on the weekend as opposed to the same amount spread over a week.<ref name="autogenerated2"/> In the United Kingdom "advice on weekly consumption is avoided".

In a 2010 long-term study of an older population, the beneficial effects of moderate drinking were confirmed, but abstainers and heavy drinkers showed an increase of about 50% in ] (even after controlling for confounding factors).<ref>{{cite journal |last1=Holahan |first1=Charles J. |last2=Schutte |first2=Kathleen K. |last3=Brennan |first3=Penny L. |last4=Holahan |first4=Carole K. |last5=Moos |first5=Bernice S. |last6=Moos |first6=Rudolf H. |title=Late-Life Alcohol Consumption and 20-Year Mortality |journal=Alcoholism: Clinical and Experimental Research |volume=34 |issue=11 |pages=1961–71 |year=2010 <!--|doi=10.1111/j.1530-0277.2010.01286.x--> |pmid=20735372}}</ref>

=====Diabetes=====
Daily consumption of a small amount of pure ] by older women may slow or prevent the onset of diabetes by lowering the level of ].<ref name="diabetes">{{Cite news|publisher=BBC News|url=http://news.bbc.co.uk/1/hi/health/1988884.stm|title=Alcohol may prevent diabetes|date=2002-05-15}}</ref> However, the researchers caution that the study used pure alcohol and that alcoholic beverages contain additives, including sugar, which would negate this effect.<ref name="diabetes"/>

People with diabetes should avoid sugary drinks such as ]s and ]s.<ref>{{cite web|url=http://www.netdoctor.co.uk/ate/diabetes/201565.html|publisher=Net Doctor|author=Dr Roger Henderson, GP|date=2006-01-17|title=Alcohol and diabetes}}</ref>

=====Heart disease=====
{{Main|Alcohol and cardiovascular disease}}

Alcohol consumption by the elderly results in increased ], which is almost entirely a result of lowered coronary heart disease.<ref name="klat"/> A British study found that consumption of two ] (one regular glass of wine) daily by doctors aged 48+ years increased longevity by reducing the risk of death by ] and ].<ref name="mortal">{{Cite journal |last1=Doll |first1=R. |last2=Peto |first2=R |last3=Boreham |first3=J |last4=Sutherland |first4=I |title=Mortality in relation to alcohol consumption: a prospective study among male British doctors |journal=International Journal of Epidemiology |volume=34 |issue=1 |pages=199–204 |year=2004 |pmid=15647313 |doi=10.1093/ije/dyh369}}</ref> Deaths for which alcohol consumption is known to increase risk accounted for only 5% of the total deaths, but this figure increased among those who drank more than two units of alcohol per day.<ref name="mortal"/>

One study found that men who drank moderate amounts of alcohol three or more times a week were up to 35% less likely to have a heart attack than non-drinkers, and men who increased their daily alcohol consumption by one drink over the 12 years of the study had a 22% lower risk of heart attack.<ref>{{Cite news|publisher=BBC News|url=http://news.bbc.co.uk/1/hi/health/2638399.stm|title=Frequent tipple cuts heart risk|date=2008-01-09}}</ref>

Daily intake of one or two ] (a half or full standard glass of wine) is associated with a lower risk of ] in men over 40, and in women who have been through menopause.<ref>{{cite web|url=http://www.bhf.org.uk/keeping_your_heart_healthy/healthy_eating/alcohol_advice.aspx|publisher=]|title=Alcohol and heart disease}}</ref> However, getting drunk one or more times per month put women at a significantly increased risk of heart attack, negating alcohol's potential protective effect.<ref>{{Cite news|url=http://www.sciencedaily.com/releases/2007/05/070523153047.htm|title=Moderate Drinking Lowers Women's Risk Of Heart Attack|publisher=Science Daily|date=2007-05-25}}</ref>

Increased ] due to alcohol consumption is almost entirely the result of a reduced rate of coronary heart disease.<ref name="klat">{{cite journal |last1=Klatsky |first1=A L |last2=Friedman |first2=G D |title=Alcohol and longevity |journal=American Journal of Public Health |volume=85 |issue=1 |pages=16–8 |year=1995 |pmid=7832254 |pmc=1615277 |doi=10.2105/AJPH.85.1.16}}</ref>

=====Neurotoxin=====
{{see also|Neurotoxin}}
]

As a neurotoxin, ethanol has been shown to induce nervous system damage and affect the body in a variety of ways. Among the known effects of ethanol exposure are both transient and lasting consequences. Some of the lasting effects include long-term reduced ] in the ],<ref>Taffe 2010</ref><ref>Morris 2009</ref> widespread brain atrophy,<ref>Bleich 2003</ref> and induced ] in the brain.<ref>Blanco 2005</ref> Of note, chronic ethanol ingestion has additionally been shown to induce reorganization of cellular membrane constituents, leading to a ] marked by increased membrane concentrations of ] and ].<ref name=Leonard1986>Leonard 1986</ref> This is important as neurotransmitter transport can be impaired through vesicular transport inhibition, resulting in diminished neural network function. One significant example of reduced inter-neuron communication is the ability for ethanol to inhibit ] in the hippocampus, resulting in reduced ] and memory acquisition.<ref name=Lovinger1989>Lovinger 1989</ref> NMDA has been shown to play an important role in long-term potentiation (LTP) and consequently memory formation.<ref>Davis 1992</ref> With chronic ethanol intake, however, the susceptibility of these NMDA receptors to induce LTP increases in the ] in an ] (IP3) dependent manner.<ref>Bernier 2011</ref> This reorganization may lead to neuronal cytotoxicity both through hyperactivation of postsynaptic neurons and through induced addiction to continuous ethanol consumption. It has, additionally, been shown that ethanol directly reduces intracellular calcium ion accumulation through inhibited NMDA receptor activity, and thus reduces the capacity for the occurrence of LTP.<ref name=Takadera1990>Takadera 1990</ref>

In addition to the neurotoxic effects of ethanol in mature organisms, chronic ingestion is capable of inducing severe developmental defects. Evidence was first shown in 1973 of a connection between chronic ethanol intake by mothers and defects in their offspring.<ref>Jones 1973</ref> This work was responsible for creating the classification of ]; a disease characterized by common ] aberrations such as defects in ] formation, limb development, and ] formation. The magnitude of ethanol neurotoxicity in ]es leading to fetal alcohol syndrome has been shown to be dependent on antioxidant levels in the brain such as ].<ref>Mitchell 1999</ref> As the fetal brain is relatively fragile and susceptible to induced stresses, severe deleterious effects of alcohol exposure can be seen in important areas such as the hippocampus and ]. The severity of these effects is directly dependent upon the amount and frequency of ethanol consumption by the mother, and the stage in development of the fetus.<ref>Gil-Mohapel 2010</ref> It is known that ethanol exposure results in reduced antioxidant levels, mitochondrial dysfunction (Chu 2007), and subsequent neuronal death, seemingly as a result of increased generation of ] (ROS).<ref name=Brocardo2011>Brocardo 2011</ref> This is a plausible mechanism, as there is a reduced presence in the fetal brain of antioxidant enzymes such as ] and ].<ref>Bergamini 2004</ref> In support of this mechanism, administration of high levels of ] vitamin E results in reduced or eliminated ethanol-induced neurotoxic effects in fetuses.<ref name=Heaton2000>Heaton 2000</ref>

=====Self-medication=====
Alcohol and sedative/hypnotic drugs, such as barbiturates and benzodiazepines, are central nervous system (CNS) depressants, which produce feelings of relaxation, and sedation, while relieving feelings of depression and anxiety. Alcohol also lowers inhibitions, while benzodiazepines are anxiolytic. Though they are generally ineffective antidepressants, as most are short-acting, the rapid onset of alcohol and sedative/hypnotics softens rigid defenses and, in low to moderate doses, provides the illusion of relief from depressive affect and anxiety. As alcohol also lowers inhibitions, alcohol is also hypothesized to be used by those who normally constrain emotions by attenuating intense emotions in high or obliterating doses, which allows them to express feelings of affection, aggression, and closeness.

{{see also|Self-medication|}}
;Anxiolytics/Antidepressant
] and ]/] drugs, such as ] and ], are ] (CNS) ] that lower inhibitions via ]. Depressants produce feelings of relaxation and sedation, while relieving feelings of depression and anxiety. Though they are generally ineffective antidepressants, as most are short-acting, the rapid onset of alcohol and sedative/hypnotics softens rigid defenses and, in low to moderate doses, provides relief from depressive affect and anxiety.<ref name=Khantzian1997>Khantzian, E.J. (1997). The self-medication hypothesis of drug use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4, 231-244.</ref><ref name=Khantzian2003>Khantzian, E.J. (2003). The self-medication hypothesis revisited: The dually diagnosed patient. Primary Psychiatry, 10, 47-48, 53-54.</ref> As alcohol also lowers inhibitions, alcohol is also hypothesized to be used by those who normally constrain emotions by attenuating intense emotions in high or obliterating doses, which allows them to express feelings of affection, aggression and closeness.<ref name=Khantzian2003/><ref name=Khantzian1999 >Khantzian, E.J. (1999). Treating addiction as a human process. Northvale, NJ: Jason Aronson.</ref> People with ] commonly use these drugs to overcome their highly set inhibitions.<ref>Sarah W. Book, M.D., and Carrie L. Randall, Ph.D. . Alcohol Research and Health, 2002.</ref>

Self medicating excessively for prolonged periods of time with benzodiazepines or alcohol often makes the symptoms of anxiety or depression worse. This is believed to occur as a result of the changes in brain chemistry from long-term use.<ref>{{cite journal |author=Professor C Heather Ashton |url=http://www.benzo.org.uk/ashbzoc.htm |year=1987 |title= Benzodiazepine Withdrawal: Outcome in 50 Patients |journal=British Journal of Addiction |volume=82 |pages=655–671}}</ref><ref>{{cite journal |author=Michelini S |coauthors=Cassano GB, Frare F, Perugi G |year=1996 |month=July |title=Long-term use of benzodiazepines: tolerance, dependence and clinical problems in anxiety and mood disorders |journal= Pharmacopsychiatry |volume=29 |issue=4 |pages=127–34 |pmid=8858711 |doi=10.1055/s-2007-979558}}</ref><ref>{{cite journal |author=Wetterling T |coauthors=Junghanns K |year=2000 |month=Dec |title=Psychopathology of alcoholics during withdrawal and early abstinence |journal=Eur Psychiatry |volume=15 |issue=8 |pages=483–8 |pmid=11175926 |doi=10.1016/S0924-9338(00)00519-8}}</ref><ref>{{cite journal |author=Cowley DS |date=Jan 1, 1992 |title=Alcohol abuse, substance abuse, and panic disorder |journal=Am J Med |volume=92 |issue=1A |pages=41S–8S |pmid=1346485 |doi=10.1016/0002-9343(92)90136-Y}}</ref><ref>{{cite journal |author=Cosci F |coauthors=Schruers KR, Abrams K, Griez EJ |year=2007 |month=Jun |title=Alcohol use disorders and panic disorder: a review of the evidence of a direct relationship |journal=J Clin Psychiatry |volume=68 |issue=6 |pages=874–80 |pmid=17592911 |doi=10.4088/JCP.v68n0608}}</ref> Of those who seek help from mental health services for conditions including ] such as ] or ], approximately half have alcohol or ] issues.<ref name=pmid7769598/>

Sometimes anxiety precedes alcohol or benzodiazepine dependence but the alcohol or benzodiazepine dependence acts to keep the anxiety disorders going, often progressively making them worse. However, some people addicted to alcohol or benzodiazepines, when it is explained to them that they have a choice between ongoing poor mental health or quitting and recovering from their symptoms, decide on quitting alcohol or benzodiazepines or both. It has been noted that every individual has an individual sensitivity level to alcohol or sedative hypnotic drugs, and what one person can tolerate without ill health, may cause another to suffer very ill health, and even moderate drinking can cause rebound anxiety syndrome and sleep disorders. A person suffering the toxic effects of alcohol will not benefit from other therapies or medications, as these do not address the root cause of the symptoms.<ref name=pmid7769598>{{cite journal |author=Cohen SI |title=Alcohol and benzodiazepines generate anxiety, panic and phobias |journal=J R Soc Med |volume=88 |issue=2 |pages=73–7 |year= 1995 |month=February |pmid=7769598 |pmc=1295099 }}</ref>

;Insomnia
{{see also|Insomnia#Alcohol}}
Alcohol is often used as a form of self-treatment of insomnia to induce sleep. However, alcohol use to induce sleep can be a cause of insomnia. ] is associated with a decrease in ] stage 3 and 4 sleep as well as suppression of ] and REM sleep fragmentation. Frequent moving between sleep stages occurs, with awakenings due to headaches, ], ], and ]. Glutamine rebound also plays a role as when someone is drinking; alcohol inhibits glutamine, one of the body's natural stimulants. When the person stops drinking, the body tries to make up for lost time by producing more glutamine than it needs.
The increase in glutamine levels stimulates the brain while the drinker is trying to sleep, keeping him/her from reaching the deepest levels of sleep.<ref>Perry, Lacy. (2004-10-12) . Health.howstuffworks.com. Retrieved on 2011-11-20.</ref> Stopping chronic alcohol use can also lead to severe insomnia with vivid dreams. During withdrawal REM sleep is typically exaggerated as part of a ].<ref name="sleep_medicine_a04">{{Cite book| last1 = Lee-chiong | first1 = Teofilo | title = Sleep Medicine: Essentials and Review | date = 24 April 2008 | publisher = Oxford University Press, USA | url = http://books.google.com/?id=s1F_DEbRNMcC&pg=PT105 | isbn = 0-19-530659-7 | page = 105 }}</ref>

=====Stroke=====
A study found that lifelong abstainers were 2.36 times more likely to suffer a ] than those who regularly drank a moderate amount of alcohol beverages. Heavy drinkers were 2.88 times more likely to suffer a stroke than moderate drinkers.<ref>{{cite journal |last1=Rodgers |first1=H |last2=Aitken |first2=PD |last3=French |first3=JM |last4=Curless |first4=RH |last5=Bates |first5=D |last6=James |first6=OF |title=Alcohol and stroke. A case-control study of drinking habits past and present. |url=http://stroke.ahajournals.org/cgi/pmidlookup?view=long&pmid=8378949 |journal=Stroke; a journal of cerebral circulation |volume=24 |issue=10 |pages=1473–7 |year=1993 |pmid=8378949}}</ref>


==Alcohol laws== ==Alcohol laws==

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This article is about ethyl alcoholic beverages. For consumable alcohols, see Pharmacology of alcohols.
These flaming cocktails illustrate that a distilled beverage may be ignited. The term ethanol is derived from ether from aithein "to burn, shine".

An alcoholic beverage is a drink containing ethyl alcohol (ethanol) and often small quantities of other consumable alcohols. Alcoholic beverages are divided into three general classes for taxation and regulation of production: beers, wines, and spirits (or distilled beverage). They are legally consumed in most countries, and over 100 countries have laws regulating their production, sale, and consumption. In particular, such laws specify the minimum age at which a person may legally buy or drink them. This minimum age varies between 16 and 25 years, depending upon the country and the type of drink. Most nations set the age at 18 years.

The production and consumption of alcohol occurs in most cultures of the world, from hunter-gatherer peoples to nation-states. Alcoholic beverages are often an important part of social events in these cultures.


Alcoholic beverages

Distilled beverage

See also: Distilled beverage
An old whiskey still.

A distilled beverage, spirit, or liquor is an alcoholic beverage produced by distilling (i.e., concentrating by distillation) ethanol produced by means of fermenting grain, fruit, or vegetables. The term hard liquor is used in North America to distinguish distilled beverages from undistilled ones (implicitly weaker).

Freeze distillation concentrates methanol and fusel alcohols (fermentation by-products partially removed by distillation) in applejack to unhealthy levels. As a result, many countries prohibit such applejack as a health measure. However, reducing methanol with the absorption of 4A molecular sieve is a practical method for production.

Vodka, gin, baijiu, tequila, whisky, brandy, and soju are examples of distilled beverages. Undistilled fermented beverages include beer, wine, and cider.

Rectified spirit

See also: Rectified spirit
Rectified spirit made by Polmos.

A rectified spirit, rectified alcohol, or neutral spirit is highly concentrated ethanol which has been purified by means of repeated distillation, a process that is called rectification. It typically contains 95% alcohol by volume (ABV). Rectified spirits are used in mixed drinks, in the production of liqueurs, for medicinal purposes, and as a household solvent. In chemistry, a tincture is a solution that has alcohol as its solvent.

Neutral grain spirit

See also: Neutral grain spirit

Neutral grain spirit (also called pure grain alcohol (PGA) or grain neutral spirit (GNS)) is a clear, colorless, flammable liquid that has been distilled from a grain-based mash to a very high level of ethanol content. The term neutral refers to the spirit's lacking the flavor that would have been present if the mash ingredients were distilled to a lower level of alcoholic purity, and also lacking any flavoring added to it after distillation (as is done, for example, with gin). Other kinds of spirits, such as whisky, are distilled to a lower alcohol percentage in order to preserve the flavor of the mash.

Fermented beverages

See also: List of alcoholic beverages
The interior of a liquor store in the United States that sells alcoholic beverages

Beer and wine are produced by fermentation of sugar- or starch-containing plant material. Beverages produced by fermentation followed by distillation have a higher alcohol content and are known as liquor or spirits.

Chemical composition

Alcohols
Main article: Alcohol

Alcohol is a general term for any organic compound in which a hydroxyl group (-O H) is bound to a carbon atom, which in turn may be bound to other carbon atoms and further hydrogens. Alcohols other than ethanol are found in trace quantities in alcoholic beverages. Ethanol is the active ingredient in alcoholic beverages and is produced by fermentation.

Congeners
See also: congener (alcohol) and hangover

Congeners are biologically active chemicals (chemicals which exert an effect on the body or brain) found in fermenation ethanol in trace quantities. Bourbon has a higher congener concentration than vodka. It has been suggested that some of these substances contribute to the symptoms of a hangover. Congeners include:

Furfural

Furfural is a congener that inhibits yeast metabolism. It may be added to alcoholic beverages during the fermentation stage. Although it occurs in many foods and flavorants, furfural is toxic with an LD50 of 65 mg/kg (oral, rat).

Tannins

Tannins are congeners found in wine. Tannins contain powerful antioxidants such as polyphenols.

Fusel alcohol
Main article: Fusel alcohol

Fusel alcohols, also sometimes called fusel oils, or potato oil in Europe, are a mixture of several alcohols (chiefly 2-methyl-1-butanol) produced as a by-product of ethanol fermentation.

The term fusel is German for "bad liquor".

Fusel alcohols may contain up to 50 different components, where the chief constituents are isobutanol (2-methyl-1-propanol), propanol, and above all, the pair of isoamylalkohols: 2-methyl-1-butanol and 3-methyl-1-butanol. Occurrence of flavor compounds and some other compounds in alcoholic beverages for beer, wine, and spirits, are listed in hundreds in a document. Methanol is a toxic alcohol also found in trace quantities.

Excessive concentrations of these fractions may cause off-flavors, sometimes described as "spicy", "hot", or "solvent-like". Some beverages, such as rum, whisky (especially Bourbon), incompletely rectified vodka (eg Siwucha), and traditional ales and ciders, are expected to have relatively high concentrations of fusel alcohols as part of their flavor profile. In other beverages, such as Korn, vodka, and lagers, the presence of fusel alcohols is considered a fault.

Beverages by fermentation ingredients

The names of some alcoholic beverages are determined by their base material. In general, a beverage fermented from a grain mash will be called a beer. If the fermented mash is distilled, then the beverage is a spirit.

Wine and brandy are usually made from grapes but when they are made from another kind of fruit, they are distinguished as fruit wine or fruit brandy. The kind of fruit must be specified, such as "cherry brandy" or "plum wine."

Beer is made from barley or a blend of several grains.

Whiskey (or whisky) is made from grain or a blend of several grains. The type of whiskey (scotch, rye, bourbon, or corn) is determined by the primary grain.

Vodka is distilled from fermented grain. It is highly distilled so that it will contain less of the flavor of its base material. Gin is a similar distillate but it is flavored by juniper berries and sometimes by other herbs as well.

In the United States and Canada, cider often means unfermented apple juice (sometimes called sweet cider), and fermented apple juice is called hard cider. In the United Kingdom and Australia, cider refers to the alcoholic beverage.

Applejack is sometimes made by means of freeze distillation.

Grains
Source Name of fermented beverage Name of distilled beverage
barley beer, ale, barley wine Scotch whisky, Irish whiskey, shōchū (mugijōchū) (Japan)
rye rye beer, kvass rye whiskey, vodka (Poland), Korn (Germany)
corn chicha, corn beer, tesguino Bourbon whiskey; and vodka (rarely)
sorghum burukutu (Nigeria), pito (Ghana), merisa (southern Sudan), bilibili (Chad, Central African Republic, Cameroon) maotai, gaoliang, certain other types of baijiu (China).
wheat wheat beer horilka (Ukraine), vodka, wheat whisky, weizenkorn (Germany)
rice beer, brem (Bali), huangjiu and choujiu (China), Ruou gao (Vietnam), sake (Japan), sonti (India), makgeolli (Korea), tuak (Borneo Island), thwon (Nepal) aila (Nepal), rice baijiu (China), shōchū (komejōchū) and awamori (Japan), soju (Korea)
millet millet beer (Sub-Saharan Africa), tongba (Nepal, Tibet), boza (the Balkans, Turkey)
buckwheat shōchū (sobajōchū) (Japan)
Fruit juice
Source Name of fermented beverage Name of distilled beverage
juice of grapes, wine brandy, Cognac (France), Vermouth, Armagnac (France), Branntwein (Germany), pisco (Peru, Chile), (Grozdova) Rakia (The Balkans, Turkey), singani (Bolivia), Arak (Syria, Lebanon, Jordan), törkölypálinka (Hungary)
juice of apples cider (U.S.: "hard cider"), Apfelwein applejack (or apple brandy), calvados, cider
juice of pears perry, or pear cider; poiré (France) Poire Williams, pear brandy, Eau-de-vie (France), pálinka (Hungary), Krushova rakia / Krushevitsa (Bulgaria)
juice of plums plum wine slivovitz, țuică, umeshu, pálinka, Slivova rakia / Slivovitsa (Bulgaria)
juice of apricots Kaisieva rakia (Bulgaria)
juice of pineapples tepache (Mexico)
junipers borovička (Slovakia)
bananas or plantains Chuoi hot (Vietnam), urgwagwa (Uganda, Rwanda), mbege (with millet malt; Tanzania), kasikisi (with sorghum malt; Democratic Republic of the Congo)
gouqi gouqi jiu (China) gouqi jiu (China)
coconut Toddy (Sri Lanka, India) arrack, lambanog (Sri Lanka, India, Philippines)
ginger with sugar, ginger with raisins ginger ale, ginger beer, ginger wine
Myrica rubra yangmei jiu (China) yangmei jiu (China)
pomace pomace wine Raki/Ouzo/Pastis/Sambuca (Turkey/Greece/France/Italy), tsipouro/tsikoudia (Greece), grappa (Italy), Trester (Germany), marc (France), orujo (Spain), zivania (Cyprus), aguardente (Portugal), tescovină (Romania), Arak (Iraq)
Vegetables
Source Name of fermented beverage Name of distilled beverage
juice of ginger root ginger beer (Botswana)
potato potato beer horilka (Ukraine), vodka (Poland and Germany), akvavit (Scandinavia), poitín (poteen) (Ireland)
sweet potato shōchū (imojōchū) (Japan), soju (Korea)
cassava/manioc/yuca nihamanchi (South America), kasiri (Sub-Saharan Africa), chicha (Ecuador)
juice of sugarcane, or molasses basi, betsa-betsa (regional) rum (Caribbean), pinga or cachaça (Brasil), aguardiente, guaro
juice of agave pulque tequila, mezcal, raicilla
Other ingredients
Source Name of fermented beverage Name of distilled beverage
sap of palm coyol wine (Central America), tembo (Sub-Saharan Africa), toddy (Indian subcontinent)
sap of Arenga pinnata, Coconut, Borassus flabellifer Tuak (Indonesia) Arrack
honey mead, horilka (Ukraine), tej (Ethiopia) distilled mead (mead brandy or honey brandy)
milk kumis, kefir, blaand arkhi (Mongolia)
sugar kilju and mead or sima (Finland) shōchū (kokutō shōchū): made from brown sugar (Japan)
Flavoring

Alcohol is a moderately good solvent for many fatty substances and essential oils. This attribute facilitates the use of flavoring and coloring compounds in alcoholic beverages, especially distilled beverages. Flavors may be naturally present in the beverage’s base material. Beer and wine may be flavored before fermentation. Spirits may be flavored before, during, or after distillation.

Sometimes flavor is obtained by allowing the beverage to stand for months or years in oak barrels, usually American or French oak.

A few brands of spirits have fruit or herbs inserted into the bottle at the time of bottling.

Tax regulated classes

Beer
Main article: Beer

Beer is one of the world's oldest and most widely consumed alcoholic beverages, and the third most popular drink overall after water and tea. It is produced by the brewing and fermentation of starches which are mainly derived from cereal grains — most commonly malted barley although wheat, maize (corn), and rice are also used.

Alcoholic beverages that are distilled after fermentation, or are fermented from non-cereal sources (such as grapes or honey), or are fermented from unmalted cereal grain are not classified as beer.

The two main types of beer are lager and ale. Ale is further classified into varieties such as pale ale, stout, and brown ale, whereas different types of lager include black lager, pilsener, and bock.

Most beer is flavored with hops, which add bitterness and act as a natural preservative. Other flavorings, such as fruits or herbs, may also be used.

The alcoholic strength of beer is usually 4–6% alcohol by volume (ABV), but it may be less than 2% or greater than 25%. Beers having an ABV of 60% (120 proof) have been produced by freezing brewed beer and removing water in the form of ice, a process referred to as "ice distilling".

Beer is part of the drinking culture of various nations and has acquired social traditions such as beer festivals, pub games, and pub crawling (sometimes known as bar hopping).

The basics of brewing beer are shared across national and cultural boundaries. The beer-brewing industry is global in scope, consisting of several dominant multinational companies and thousands of smaller producers, which range from regional breweries to microbreweries.

Wine
Main article: Wine

Wine is produced from grapes, and from fruits such as plums, cherries, or apples. Wine involves a longer fermentation process than beer and also a long aging process (months or years), resulting in an alcohol content of 9–16% ABV. Sparkling wine can be made by means of a secondary fermentation.

Fortified wine is wine (such as port or sherry), to which a distilled beverage (usually brandy) has been added.

Spirits
Main article: Distilled beverage

Unsweetened, distilled, alcoholic beverages that have an alcohol content of at least 20% ABV are called spirits. Spirits are produced by the distillation of a fermented base product. Distilling concentrates the alcohol and eliminates some of the congeners. For the most common distilled beverages, such as whiskey and vodka, the alcohol content is around 40%.

Spirits can be added to wines to create fortified wines, such as port and sherry.

Distilled alcoholic beverages were first recorded in Europe in the mid-12th century. By the early 14th century, they had spread throughout the European continent. They also spread eastward from Europe, mainly due to the Mongols, and began to be seen in China no later than the 14th century.

Paracelsus gave alcohol its modern name, which is derived from an Arabic word that means “finely divided” (a reference to distillation).

Fortified beverages

Fortified wine

See also: Fortified wine
A glass of port, a fortified wine.

Fortified wine is wine with an added distilled beverage (usually brandy). Fortified wine is distinguished from spirits made from wine in that spirits are produced by means of distillation, while fortified wine is simply wine that has had a spirit added to it. Many different styles of fortified wine have been developed, including Port, Sherry, Madeira, Marsala, Commandaria wine and the aromatized wine Vermouth.

Mixed drinks

See also: Mixed drinks

Mixed drinks include alcoholic mixed drinks (cocktails, beer cocktails, flaming beverages, fortified wines, mixed drink shooters and drink shots, wine cocktails) and non-alcoholic mixed drinks (including punches).

Blending and caffeinated alcoholic drinks may also be called mixed drinks.

Ready to drink

See also: Ready to drink

Standards

Alcohol concentration

Main articles: Alcohol by volume and alcohol proof

The concentration of alcohol in a beverage is usually stated as the percentage of alcohol by volume (ABV) or as proof. In the United States, proof is twice the percentage of alcohol by volume at 60 degrees Fahrenheit (e.g. 80 proof = 40% ABV). Degrees proof were formerly used in the United Kingdom, where 100 degrees proof was equivalent to 57.1% ABV. Historically, this was the most dilute spirit that would sustain the combustion of gunpowder.

Ordinary distillation cannot produce alcohol of more than 95.6% ABV (191.2 proof) because at that point alcohol is an azeotrope with water. A spirit which contains a very high level of alcohol and does not contain any added flavoring is commonly called a neutral spirit. Generally, any distilled alcoholic beverage of 170 proof or higher is considered to be a neutral spirit.

Most yeasts cannot reproduce when the concentration of alcohol is higher than about 18%, so that is the practical limit for the strength of fermented beverages such as wine, beer, and sake. However, some strains of yeast have been developed that can reproduce in solutions of up to 25% ABV.

Alcohol-free definition controversy

The term alcohol-free (eg alcohol-free beer) is often used to describe a product that contains 0% ABV; As such, it is permitted by Islam, and they are also popular in countries that enforce alcohol prohibition, such as Saudi Arabia, Kuwait and Iran.

However, alcohol is legal in most countries of the world where alcohol culture also is prevalent. Laws vary in countries when beverages must indicate the strength but also what they define as alcohol-free; Experts calling the label “misleading” and a threat to recovering alcoholics.

In the EU the labeling of beverages containing more than 1.2% by volume of alcohol must indicate the actual alcoholic strength by volume, i.e. showing the word "alcohol" or the abbreviation "alc." followed by the symbol "% vol."

Most of the alcohol-free drinks sold in Sweden’s state-run liquor store monopoly Systembolaget actually contain alcohol, with experts calling the label “misleading” and a threat to recovering alcoholics. Systembolaget define alcohol-free as a drink that contains a maximum of 0.5 percent alcohol by volume. Interestingly, the drug policy of Sweden is based on zero tolerance.

Standard drinks

Main articles: Standard drink § Pure alcohol measure, Alcohol equivalence, and Unit of alcohol
A "standard drink" does not necessarily reflect a typical serving size, such as seen here

A standard drink is a notional drink that contains a specified amount of pure alcohol. The standard drink is used in many countries to quantify alcohol intake. It is usually expressed as a measure of beer, wine, or spirits. One standard drink always contains the same amount of alcohol regardless of serving size or the type of alcoholic beverage.

The standard drink varies significantly from country to country. For example, it is 7.62 ml (6 grams) of alcohol in Austria, but in Japan it is 25 ml (19.75 grams).

In the United Kingdom, there is a system of units of alcohol which serves as a guideline for alcohol consumption. A single unit of alcohol is defined as 10 ml. The number of units present in a typical drink is printed on bottles. The system is intended as an aid to people who are regulating the amount of alcohol they drink; it is not used to determine serving sizes.

In the United States, the standard drink contains 0.6 US fluid ounces (18 ml) of alcohol. This is approximately the amount of alcohol in a 12-US-fluid-ounce (350 ml) glass of beer, a 5-US-fluid-ounce (150 ml) glass of wine, or a 1.5-US-fluid-ounce (44 ml) glass of a 40% ABV (80 proof) spirit.

Serving sizes

See also: Shot glass § Sizes

In the United Kingdom, serving size in licensed premises is regulated under the Weights and Measures Act (1985). Spirits (gin, whisky, rum, and vodka) are sold in 25 ml or 35 ml quantities or multiples thereof. Beer is typically served in pints (568 ml), but is also served in half-pints or third-pints.

In Ireland, the serving size of spirits is 35.5 ml or 71 ml. Beer is usually served in pints or half-pints ("glasses"). In the Netherlands and Belgium, standard servings are 250 and 500 ml for pilsner; 300 and 330 ml for ales.

The shape of a glass can have a significant effect on how much one pours. A Cornell University study of students and bartenders' pouring showed both groups pour more into short, wide glasses than into tall, slender glasses. Aiming to pour one shot of alcohol (1.5 ounces or 44.3 ml), students on average poured 45.5 ml & 59.6 ml (30% more) respectively into the tall and short glasses. The bartenders scored similarly, on average pouring 20.5% more into the short glasses. More experienced bartenders were more accurate, pouring 10.3% less alcohol than less experienced bartenders. Practice reduced the tendency of both groups to over pour for tall, slender glasses but not for short, wide glasses. These misperceptions are attributed to two perceptual biases: (1) Estimating that tall, slender glasses have more volume than shorter, wider glasses; and (2) Over focusing on the height of the liquid and disregarding the width.

Alcohol consumption

History

Main articles: History of alcoholic beverages and drinking culture

Alcoholic beverages have been drunk by people around the world since ancient times. Reasons that have been proposed for drinking them include:

Archaeological record

Chemical analysis of traces absorbed and preserved in pottery jars from the neolithic village of Jiahu in Henan province in northern China has revealed that a mixed fermented beverage made from rice, honey, and fruit was being produced as early as 9,000 years ago. This is approximately the time when barley beer and grape wine were beginning to be made in the Middle East.

Recipes have been found on clay tablets and art in Mesopotamia that show people using straws to drink beer from large vats and pots.

The Hindu ayurvedic texts describe both the beneficial effects of alcoholic beverages and the consequences of intoxication and alcoholic diseases.

The medicinal use of alcohol was mentioned in Sumerian and Egyptian texts dating from about 2100 BC. The Hebrew Bible recommends giving alcoholic drinks to those who are dying or depressed, so that they can forget their misery (Proverbs 31:6-7).

Wine was consumed in Classical Greece at breakfast or at symposia, and in the 1st century BC it was part of the diet of most Roman citizens. Both the Greeks and the Romans generally drank diluted wine (the strength varying from 1 part wine and 1 part water, to 1 part wine and 4 parts water).

In Europe during the Middle Ages, beer, often of very low strength, was an everyday drink for all classes and ages of people. A document from that time mentions nuns having an allowance of six pints of ale each day. Cider and pomace wine were also widely available; grape wine was the prerogative of the higher classes.

By the time the Europeans reached the Americas in the 15th century, several native civilizations had developed alcoholic beverages. According to a post-conquest Aztec document, consumption of the local "wine" (pulque) was generally restricted to religious ceremonies but was freely allowed to those who were older than 70 years.

The natives of South America produced a beer-like beverage from cassava or maize, which had to be chewed before fermentation in order to turn the starch into sugar. (Beverages of this kind are known today as cauim or chicha.) This chewing technique was also used in ancient Japan to make sake from rice and other starchy crops.

Alcohol in American history

In the early 19th century, Americans had inherited a hearty drinking tradition. Many types of alcohol were consumed. One reason for this heavy drinking was attributed to an overabundance of corn on the western frontier, which encouraged the widespread production of cheap whiskey. It was at this time that alcohol became an important part of the American diet. In the 1820s, Americans drank seven gallons of alcohol per person annually.

During the 19th century, Americans drank alcohol in two distinctive ways. One way was to drink small amounts daily and regularly, usually at home or alone. The other way consisted of communal binges. Groups of people would gather in a public place for elections, court sessions, militia musters, holiday celebrations, or neighborly festivities. Participants would typically drink until they became intoxicated.

Routes of administration

Inhalation

Although this method is rare, it is becoming more and more common.

Nebulizer

A nebulizer device that vaporizes liquor (distilled spirits) and mixes it with oxygen into small aerosol droplets so that it can be more easily inhaled into the lungs.

Oral

Drinking is the usual way of administer alcoholic beverages but distilled beverages have been used by other routes as well.

Molecular encapsulation
Main article: Alcohol powder

Alcohol powder is molecular encapsulated alcohol. The powder will produce an alcoholic drink when mixed with water. Alcohol powder can simply be made by molecular encapsulation in cyclodextrin, a sugar which can absorb an estimated 60% of its own weight.

Gelatin capsules

Distilled beverages can be placed into gelatin capsules as a liquid or cyclodextrin complexed powder to avoid an unpleasant taste. To date, a company called Alcogel have patented ethanol in softgel. This capsule will directly put 190 proof alcohol into the stomach by swallowing it whole. 12 capsules provides as much alcohol as there is in a 33 cL (12.5 oz) beer. However, in the future, Alcogel plans to work with the medical field to change the way alcohol is currently prescribed and find better ways for alcohol detoxification.

Intravenous

  • Recreational
    • Distilled ethanol beverages are sometimes used by intravenous drug users, occasionally when they are cut of supply of other drugs and there are to little ethanol to get intoxicated orally. However, another alcohol, ethchlorvynol, is not compatible with intravenous injection and serious injury or death can occur when it is used in this manner
  • Medical
    • Ethylene glycol poisoning: Doctors saved a poisoned tourist using vodka drip. Pharmaceutical grade ethanol is usually given intravenously as a 5 or 10% solution in 5% dextrose, but it is also sometimes given orally in the form of a strong spirit such as whisky, vodka, or gin.
    • Methanol poisoning: A 10% ethanol solution administered intravenously is a safe and effective antidote for severe methanol poisoning.

Applications

In many countries, people drink alcoholic beverages at lunch and dinner. Studies have found that when food is eaten before drinking alcohol, alcohol absorption is reduced and the rate at which alcohol is eliminated from the blood is increased. The mechanism for the faster alcohol elimination appears to be unrelated to the type of food. The likely mechanism is food-induced increases in alcohol-metabolizing enzymes and liver blood flow.

At times and places of poor public sanitation (such as Medieval Europe), the consumption of alcoholic drinks was a way of avoiding water-borne diseases such as cholera. Small beer and faux wine, in particular, were used for this purpose. Although alcohol kills bacteria, its low concentration in these beverages would have had only a limited effect. More important was that the boiling of water (required for the brewing of beer) and the growth of yeast (required for fermentation of beer and wine) would tend to kill dangerous microorganisms. The alcohol content of these beverages allowed them to be stored for months or years in simple wood or clay containers without spoiling. For this reason, they were commonly kept aboard sailing vessels as an important (or even the sole) source of hydration for the crew, especially during the long voyages of the early modern period.

In cold climates, potent alcoholic beverages such as vodka are popularly seen as a way to “warm up” the body, possibly because alcohol is a quickly absorbed source of food energy and because it dilates peripheral blood vessels (peripherovascular dilation). This is a misconception because the “warmth” is actually caused by a transfer of heat from the body’s core to its extremities, where it is quickly lost to the environment. However, the perception alone may be welcomed when only comfort, rather than hypothermia, is a concern.

Alcohol consumption by country

Main article: List of countries by alcohol consumption
2004 data of alcohol consumption per capita (age 15 or older), per year, by country, in liters of pure alcohol.


Accessibility

A row of alcoholic beverages – in this case, spirits – in a bar

Alcohol laws

Main article: Alcohol laws

Alcohol laws are laws in relation to the manufacture, use, influence and sale of ethanol (ethyl alcohol, EtOH) or alcoholic beverages that contains ethanol.

Alcohol laws often seek to reduce the availability of alcoholic beverages, often with the stated purpose of reducing the health and social side effect of their consumption. This can take the form of age limits for alcohol consumption, and distribution only in licensed stores or in monopoly stores. Often, this is combined with some form of alcohol taxation.

Alcohol and religion

Main articles: Religion and alcohol, Christianity and alcohol, Islam and alcohol, and Alcohol in the Bible

The current Arabic name for alcohol in The Qur'an, in verse 37:47, uses the word الغول al-ġawl —properly meaning "spirit" or "demon"—with the sense "the thing that gives the wine its headiness." The term ethanol was invented 1838, modeled on German äthyl (Liebig), from Greek aither (see ether) + hyle "stuff.". Ether in late 14c. meant "upper regions of space," from Old French ether and directly from Latin aether "the upper pure, bright air," from Greek aither "upper air; bright, purer air; the sky," from aithein "to burn, shine," from PIE root *aidh- "to burn" (see edifice).

Monastic beer production

Main articles: Trappist beer and abbey beers

Trappist beer is brewed by Trappist breweries. Eight monasteries — six in Belgium, one in the Netherlands and one in Austria — currently brew beer and sell it as Authentic Trappist Product.

The designation "abbey beers" (Bières d'Abbaye or Abdijbier) was originally used for any monastic or monastic-style beer. After the introduction of an official Trappist beer designation by the International Trappist Association in 1997, it came to mean products similar in style or presentation to monastic beers.

Some abbeys have a lighter, less alcoholic versions of the beers for the internal consumption (Petite Orval or Chimay Dorée) called patersbier.

Consumption

Some alcoholic beverages have been invested with religious significance, as in the ancient Greco-Roman religion, such as in the ecstatic rituals of Dionysus (also called Bacchus). Some have postulated that pagan religions actively promoted alcohol and drunkenness as a means of fostering fertility. Alcohol was believed to increase sexual desire and to make it easier to approach another person for sex. For example, Norse paganism considered alcohol to be the sap of Yggdrasil. Drunkenness was an important fertility rite in this religion.

Many Christian denominations use wine in the Eucharist or Communion and permit alcohol in moderation. Other denominations use unfermented grape juice in Communion and either abstain from alcohol by choice or prohibit it outright.

Judaism uses wine on Shabbat for Kiddush as well as in the Passover ceremony, Purim, and other religious ceremonies. The drinking of alcohol is allowed. Some Jewish texts, e.g. the Talmud, encourage moderate drinking on holidays (such as Purim) in order to make the occasion more joyous.

Prohibition

Some religions forbid, discourage, or restrict the drinking of alcoholic beverages for various reasons. These include Islam, Jainism, the Bahá'í Faith, The Church of Jesus Christ of Latter-day Saints, the Seventh-day Adventist Church, the Church of Christ, Scientist, the United Pentecostal Church International, Theravada, most Mahayana schools of Buddhism, some Protestant denominations of Christianity, some sects of Taoism (Five Precepts (Taoism) and Ten Precepts (Taoism)), and Hinduism.

The Pali Canon, the scripture of Theravada Buddhism, depicts refraining from alcohol as essential to moral conduct because alcohol causes a loss of mindfulness. The fifth of the Five Precepts states, "Surā-meraya-majja-pamādaṭṭhānā veramaṇī sikkhāpadaṃ samādiyāmi." The English translation is, "I undertake to refrain from fermented drink that causes heedlessness." Technically this prohibition does not cover drugs other than alcohol. But its purport is not that alcohol is an evil but that the carelessness it produces creates bad karma. Therefore any substance (beyond tea or mild coffee) that affects one's mindfulness is considered to be covered by this prohibition.

See also

References

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