How Alcohol Affects Your Body and Brain

We tend to think of alcohol in social terms – something celebratory, casual and commonplace. It’s marketed as a way to unwind, loosen up or connect with others. But what’s rarely discussed is what’s happening underneath the surface, inside your cells, organs and neural networks, every time you drink.

Understanding what alcohol actually does to your body and brain isn’t about fear tactics or judgement. Whether you drink occasionally or often, understanding the physical and psychological toll of alcohol can help you make choices that align with how you want to feel, live and function long term.

The effects of alcohol are often cumulative. What feels fine today may lead to symptoms tomorrow – or years down the line. This article unpacks the science behind those changes in a clear, honest, and human way, so you can assess whether alcohol is still serving you or silently taking something away.

What Happens to Your Body When You Drink Alcohol?

Alcohol begins working on your body within minutes of the first sip. The process is rapid and can be very intense. 

Immediate absorption and distribution

Once consumed, alcohol passes through the stomach lining and small intestine into your bloodstream. Unlike food, which takes time to digest, alcohol bypasses several filters, reaching your brain, liver, heart and lungs quickly.

The liver’s workload

Your liver processes more than 90% of the alcohol you consume, breaking it down into less harmful substances using two enzymes: alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). This is a slow process (about one unit per hour) and any excess alcohol remains in the bloodstream, affecting other organs and brain chemistry.

Neurological changes

Alcohol increases the effects of GABA (an inhibitory neurotransmitter), leading to sedation and lowered inhibition. Simultaneously, it decreases glutamate (an excitatory neurotransmitter), which contributes to slowed thinking and reaction time. Dopamine, the brain’s pleasure chemical, also surges, initially fuelling that temporary “buzz.”

But once the alcohol wears off, your brain enters a rebound state, often marked by anxiety, low mood, fatigue, or irritability. This is a key reason many people experience “hangxiety” the day after drinking.

Related reading: Alcohol and Mental Health: What You Need to Know

Short-Term Effects of Alcohol: What You Might Notice Now

Even a single episode of drinking can create noticeable changes in how you feel and think. These short-term effects are often dismissed as “just part of the night,” but they signal underlying strain on multiple bodily systems. 

Cognitive and behavioural changes

• Lowered inhibition: May lead to risk-taking or impulsive choices
• Slowed reaction time: Increased risk of accidents or injury
• Memory disruption: Especially during heavy drinking, short-term memory can become patchy or even blacked out
• Mood swings: Alcohol lowers emotional regulation, increasing the likelihood of agitation or sudden sadness.

Physical effects

• Dehydration: Alcohol is a diuretic, pulling water from your cells and leaving you feeling dry, sluggish, and foggy
• Increased heart rate: The cardiovascular system compensates for fluctuating blood pressure
• Digestive disruption: Alcohol irritates the stomach lining, can trigger nausea, and impairs nutrient absorption
• Sleep disturbance: While alcohol may help you fall asleep, it suppresses REM cycles – leaving you groggy or unrefreshed.

Impact on coordination and safety

Alcohol impairs the cerebellum, the area of your brain responsible for balance and motor control. Even small amounts can affect:

• Walking and spatial awareness
• Speech and reaction time
• Driving ability (even under the legal limit).

These changes, although temporary, are often the first warning signs that your body is struggling to process what seems like a normal amount of alcohol.

Long-Term Effects of Alcohol on the Body

For many people, the more damaging effects of alcohol aren’t felt immediately. They unfold slowly – over months or years – becoming part of a subtle but steady decline in health. It’s not just heavy drinkers who are at risk. Even “moderate” daily drinking can quietly strain the body’s organs, systems, and defences over time.

These long-term effects are often misattributed to age, stress, or unrelated conditions. But a closer look often reveals alcohol as a significant contributor—if not the root cause.

The Liver: First Line of Defense – and First to Be Damaged

Your liver is the primary organ responsible for metabolising alcohol. Over time, this responsibility becomes a burden.

Progressive stages of liver damage include:

Fatty Liver (Steatosis)

• Fat begins to accumulate in liver cells
• Often symptomless but reversible with abstinence.

Alcoholic Hepatitis

• Inflammation of the liver tissue
• Symptoms include jaundice, abdominal pain, and nausea
• Can be mild or life-threatening.

Cirrhosis of the Liver

• Irreversible scarring of liver tissue
• This can lead to liver failure, internal bleeding, and death
• Associated with a high risk of liver cancer.

Even without obvious symptoms, liver function may be impaired – affecting digestion, hormone regulation, and detoxification.

The Heart and Circulatory System: Silent Strain

Alcohol affects blood pressure, cholesterol levels, and the heart’s rhythm. While a single drink might relax blood vessels temporarily, chronic exposure has the opposite effect.

Long-term cardiovascular effects:

• Hypertension (high blood pressure) – a major risk factor for stroke and heart attack
• Cardiomyopathy – weakening of the heart muscle, reducing its ability to pump blood
• Arrhythmias – irregular heartbeat, including atrial fibrillation
• Increased risk of ischemic and haemorrhagic stroke

These conditions often progress without pain or visible symptoms, making them easy to miss until a major cardiac event occurs.

The Immune System: Weakened Defences

Alcohol suppresses immune function in both the short and long term. The body becomes more vulnerable to infections, viruses, and inflammatory responses.

Key immune impacts include:

• Reduced white blood cell production
• Impaired healing from wounds or illness
• Greater susceptibility to respiratory infections (including pneumonia and tuberculosis)
• Increased autoimmune responses and chronic inflammation.

A weakened immune system doesn’t just mean “getting sick more often” – it affects everything from gut health to recovery after surgery or trauma.

The Digestive System and Nutrient Absorption

Alcohol disrupts the gastrointestinal system from mouth to colon. It reduces the stomach’s ability to produce acid and enzymes, interferes with nutrient absorption in the small intestine, and irritates the bowel lining.

Common effects include:

• Chronic acid reflux and gastritis
• Diarrhoea, bloating, or constipation
• Malabsorption of essential nutrients – especially B vitamins, folate, and magnesium
• Increased risk of ulcers and gastrointestinal bleeding

Many people with long-term alcohol use show signs of nutritional deficiency, even when their diet appears adequate.

Cancer Risk: The Invisible Threat

Alcohol is classified as a Group 1 carcinogen by the World Health Organization. This means it’s definitively linked to cancer in humans. The risk rises with the quantity and frequency of alcohol consumed—but there is no safe threshold when it comes to cancer risk.

Cancers linked to alcohol include:

• Oral cavity (mouth, tongue, throat)
• Larynx and oesophagus
• Liver
• Colorectal
• Breast cancer – even light drinking increases risk

One reason alcohol increases cancer risk is that it’s metabolised into acetaldehyde, a toxic substance that can damage DNA and prevent cells from repairing themselves.

Hormonal and Reproductive Health

Alcohol disrupts hormonal systems in both men and women, with wide-reaching consequences.

In men:

• Decreased testosterone levels
• Lower sperm count and motility
• Erectile dysfunction
• Breast enlargement (gynecomastia).

In women:

• Menstrual irregularities
• Fertility challenges
• Early onset of menopause
• Increased oestrogen levels (linked to breast cancer).

Chronic alcohol use can also worsen symptoms of hormonal conditions such as PCOS, thyroid dysfunction, and adrenal fatigue.

Metabolism and Weight Gain

Alcohol is calorie-dense, providing seven calories per gram, second only to fat. Unlike other calories, alcohol is metabolised first, pushing fat and sugar storage to the side. This leads to fat accumulation, especially around the midsection.

Metabolic effects:

• Increased fat storage, especially visceral fat
• Insulin resistance
• Blood sugar instability and hypoglycaemia
• Increased risk of type 2 diabetes.

Alcohol also disrupts leptin and ghrelin – hormones that regulate hunger and fullness – making it harder to sense when you’re truly hungry or satisfied.

Skin, Hair, and Ageing

The effects of alcohol on the skin are often some of the most visible – and the most ignored.

• Dehydration leads to dull, flaky skin
• Blood vessel dilation causes redness and broken capillaries
• Inflammatory responses worsen conditions like acne and rosacea
• Impaired collagen production accelerates fine lines and sagging
• Brittle nails and hair thinning are common with long-term use.

These cosmetic effects are often the body’s way of signalling that something deeper is off balance.

Musculoskeletal and Joint Health

Alcohol interferes with the body’s ability to maintain strong bones and flexible joints.

• Reduces bone density meaning higher risk of fractures and osteoporosis
• Depletes vitamin D and calcium absorption
• Weakens muscle tone and recovery
• Contributes to inflammation and joint pain

In older adults, these changes increase the risk of falls, injuries, and reduced mobility.

Endocrine and Nervous System Decline

Perhaps most concerning is alcohol’s impact on the brain and nervous system over time. It doesn’t just affect memory – it changes how the brain processes emotion, movement, and basic functions.

Neurological symptoms include:

• Slowed cognitive processing
• Emotional dysregulation
• Reduced balance and coordination
• Nerve pain or tingling (especially in hands and feet)
• Risk of permanent alcohol-related brain damage (e.g. Wernicke–Korsakoff syndrome).

These changes are rarely sudden; they happen slowly and quietly, often mistaken for age-related decline or burnout. But the root may be alcohol. 

How Alcohol Reshapes the Brain Itself

The brain is one of the most complex and sensitive organs in the human body and also one of the most affected by long-term alcohol use. While alcohol’s short-term effects on mood and coordination are well known, its deeper structural and functional impact is often underestimated.

Alcohol doesn’t just influence how you feel for a night – it gradually rewires the systems responsible for memory, learning, focus, and even physical coordination. These changes happen slowly, but they are measurable, significant, and, in some cases, irreversible.

Brain Structure and Neuroplasticity

Every time you drink, your brain’s internal messaging system—comprised of neurons and synapses—must adapt. In small doses, this adaptability is manageable. But with repeated exposure, alcohol begins to interfere with neuroplasticity—the brain’s natural ability to heal, grow, and rewire itself.

Long-term effects on brain structure include:

• Shrinkage of grey matter, particularly in the prefrontal cortex (responsible for decision-making, planning, and impulse control)
• Hippocampal atrophy, affecting memory formation and spatial awareness
• Deterioration of white matter, which disrupts communication between different brain regions
• Reduction in neurogenesis, limiting the creation of new neurons.

These changes contribute to what many people describe as brain fog, poor concentration, or a growing sense of mental fatigue. While subtle at first, they tend to accumulate over time.

Cognitive Impairment and Slowed Processing

Heavy and long-term alcohol use is linked to a measurable decline in cognitive performance – even in people who do not meet the criteria for alcohol dependence. This often appears as difficulty concentrating, recalling information, or multitasking.

Common symptoms of cognitive impairment include:

• Short-term memory issues, such as forgetting names or repeating questions
• Reduced mental processing speed, leading to hesitation or confusion in conversation
• Increased effort required for problem-solving or organisation
• Frequent word-finding difficulties (also known as tip-of-the-tongue moments).

What’s important to understand is that these effects don’t require extreme drinking. Even low-to-moderate daily alcohol use has been associated with decreased brain volume in population studies.

Impact on Balance, Motor Control and Reaction Time

The cerebellum, located at the back of the brain, controls movement, balance, and motor precision. Alcohol depresses activity in this region, which is why coordination is one of the first things affected when drinking.

Over time, this leads to:

• Slower reaction times (dangerous while driving or operating machinery)
• Shaky hands or unsteady gait, even when sober
• Difficulties with fine motor skills – like writing, using tools, or buttoning a shirt
• Increased risk of falls or injury, especially in older adults.

These motor changes are often mistaken for ageing, but they may be partially reversible if alcohol use is reduced before the damage becomes permanent.

Dopaminergic System and Motivation

Alcohol directly influences the brain’s dopaminergic system – the network that controls reward, motivation and goal-oriented behaviour. In the early stages of alcohol use, dopamine surges create feelings of pleasure or relief. But the brain compensates by reducing natural dopamine production and sensitivity.

The long-term result is:

• Reduced motivation for non-alcohol rewards, like hobbies, relationships, or career goals
• Flat or apathetic emotional states on non-drinking days
• Compulsive seeking of alcohol as a shortcut to stimulation
• Gradual disinterest in formerly enjoyable activities.

This blunted response isn’t a personality shift – it’s a sign of a chemical imbalance within the brain’s reward system, created and reinforced by alcohol over time.

Wernicke – Korsakoff Syndrome (WKS): Alcohol-Related Brain Damage

One of the most serious and underdiagnosed neurological consequences of chronic alcohol use is Wernicke-Korsakoff Syndrome (WKS). This condition stems from a severe deficiency of thiamine (vitamin B1), often due to poor nutrition and alcohol’s interference with vitamin absorption.

WKS is actually a spectrum comprising two stages:

1. Wernicke’s Encephalopathy

• Confusion and disorientation
• Loss of muscle coordination (ataxia)
• Abnormal eye movements or vision issues
• Risk of coma or death if untreated.

2. Korsakoff’s Psychosis

• Persistent memory gaps (especially for recent events)
• Confabulation (filling in memory blanks with fabricated stories)
• Inability to form new memories
• Difficulty learning or adapting to new information.

Although early WKS may be partially reversible with immediate medical treatment and high-dose thiamine, advanced stages often result in permanent cognitive damage.

The Nervous System and Alcohol-Related Neuropathy

Beyond the brain, alcohol has profound effects on the peripheral nervous system, which transmits signals between your brain and the rest of your body. Prolonged exposure to alcohol can damage the protective sheath around nerves, impairing their ability to communicate.

Symptoms of alcohol-related neuropathy:

• Numbness or tingling in hands and feet (peripheral neuropathy)
• Burning or stabbing sensations
• Muscle weakness or cramps
• Loss of coordination in limbs
• Increased sensitivity to pain or touch.

These symptoms often begin subtly but progress if alcohol consumption continues. In some cases, the damage becomes permanent and leads to disability.

Subtle Signs Alcohol Is Affecting Your Body and Brain

Not everyone who drinks heavily shows dramatic or obvious signs of damage. Often, the earliest indicators are so subtle they’re dismissed or misunderstood. Recognising these early warnings can prevent deeper, more lasting damage later.

Physical and cognitive signs to watch for:

• Difficulty concentrating or following conversations
• Fatigue or sluggishness that persists even with rest
• Forgetfulness or reliance on reminders for basic tasks
• Delayed reaction times, clumsiness, or frequent stumbles
• Diminished interest in exercise, socialising, or hobbies
• Relying on alcohol for sleep, energy, or emotional stability.

Many of these symptoms are mistakenly attributed to work stress, burnout, hormonal changes, or general ageing. But in some cases, the common factor is alcohol – even at levels most people wouldn’t consider extreme.

If these signs are familiar, now would be a good time to consider quitting alcohol before symptoms worsen.

Rebuilding Brain and Body Health After Alcohol Use

Healing from the neurological and physiological impact of alcohol isn’t just possible—it’s often more achievable than people think. While some forms of damage, particularly in advanced stages of alcohol-related disease, may be irreversible, many systems begin to repair themselves surprisingly quickly once alcohol is removed.

What the body and brain need isn’t just sobriety—it’s active restoration. Recovery is a biological process, not just a behavioural choice.

Neuroplasticity: The Brain’s Natural Repair System

The human brain is incredibly adaptive. Through a process called neuroplasticity, it constantly reshapes its own structure and function in response to experience. When alcohol is removed, and healthier habits are introduced, the brain begins to:

• Form new neural pathways
• Strengthen cognitive processing and memory retrieval
• Restore neurotransmitter balance
• Increase production of brain-derived neurotrophic factor (BDNF), a key protein in neural growth and healing

The speed and extent of recovery vary based on age, duration of alcohol use, and other health factors—but measurable improvements can begin in just weeks.

Nutritional Repair: Replenishing What Alcohol Depletes

Alcohol disrupts digestion, damages the gut lining, and impairs nutrient absorption—especially of water-soluble vitamins like B1, B6, B12, folate and minerals such as magnesium and zinc.

Key nutritional priorities in recovery:

For many people, working with a nutritionist experienced in recovery can help tailor these strategies to individual needs, especially where long-term deficiencies have developed.

Physical Activity: Rebuilding Strength, Balance and Mood

Exercise supports nearly every system affected by alcohol. Movement stimulates circulation, regulates stress hormones, increases neuroplasticity, and accelerates detoxification.

You don’t need intense workouts to start. In fact, many recovery experts recommend gentle, consistent movement in the early stages:

• Brisk walking
• Stretching or yoga
• Swimming or cycling
• Bodyweight strength training
• Tai chi or guided mobility exercises.

Over time, physical activity can help rebuild lost coordination, reduce inflammation, and stabilise sleep and energy rhythms disrupted by long-term alcohol use.

Sleep Recovery: Reclaiming Restorative Rhythms

Alcohol disrupts sleep cycles – especially REM sleep, which is crucial for memory consolidation and emotional regulation. Even though it makes you feel drowsy, alcohol reduces sleep quality and increases overnight awakenings.

As the body rebalances, natural sleep may feel elusive at first. But improvements come with:

• Consistency – like going to bed and waking up at the same time daily
• Reducing screen time in the hour before bed
• Creating a dark, cool, quiet sleep environment
• Supplementing with magnesium glycinate or herbal aids (with professional guidance).

With time, deep, restorative sleep can return and with it, better cognitive clarity and resilience.

Nervous System Regulation: Calming the Recovery Process

After alcohol is removed, the nervous system may feel overactive, raw, or hypersensitive. This is especially common if alcohol is used to regulate stress or emotion.

To soothe the system:

• Use vagus nerve stimulation techniques – like deep breathing, humming, or cold exposure
• Practice somatic grounding, such as placing your feet on the floor and noticing physical sensations
• Try guided body scans, progressive muscle relaxation, or slow rhythmic movement
• Engage with safe, low-stimulation environments during early recovery.

These techniques help restore the body’s ability to self-regulate without relying on external substances. At Abbington House, we integrate these holistic practices into our daily programme alongside psychological support. If clients become familiar with these techniques, they are more likely to utilise them once they leave us. 

Timeframes of Healing: What to Expect

Healing timelines vary from person to person, but common physiological recovery benchmarks include:

Note: These are general averages. Some effects – like neuropathy or Wernicke – Korsakoff symptoms – require clinical support and may be only partially reversible.

Healing from the effects of alcohol isn’t about giving something up. It’s about getting something back.

• Mental clarity
• Physical vitality
• Emotional stability
• Motivation and creativity
• Confidence in your body and your mind.

Even if you’ve been drinking daily for years, or you don’t feel ready to stop entirely, it’s never too late to explore what recovery looks like. Even small changes can spark profound shifts in energy, focus, and resilience.

If you’re thinking about starting your recovery journey, contact us today. Our team are here to answer any questions you have about treatment and take you through your options. 

Want to explore your next step? Learn more about alcohol withdrawal symptoms or early signs of alcohol addiction