Here's What Binge Drinking Does To Your Brain And Body

Forbes

07-07-2025

Binge drinking may start as fun—but it increases the risk of injury, blackouts and long-term health ... More problems.
From celebrity tequila brands to viral TikTok 'drunk girl' videos, social media glamorizes binge drinking as fun and carefree. But behind the curated posts and party culture lies a real issue — binge drinking can come with serious health risks.
Binge drinking is surprisingly common. According to data from the Centers for Disease Control and Prevention (CDC), 17% of U.S. adults report regularly binge drinking, with an average of four episodes per month — about once a weekend.
What Is Binge Drinking?
The CDC defines binge drinking as consuming five or more drinks for men, or four or more for women, within about two hours. A standard drink contains 14 grams (0.6 fluid ounces) of pure alcohol — equivalent to 12 ounces of beer (5% alcohol), 5 ounces of wine (12%) or 1.5 ounces of spirits (40%).
Women tend to reach higher blood alcohol concentrations (BAC) than men after consuming the same amount. This is due to their lower levels of alcohol dehydrogenase (the stomach enzyme that breaks down alcohol), less total body water and hormonal influences on alcohol metabolism.
From Buzz to Blackout: Progression From A Few Drinks To A Binge
A binge begins with a couple drinks. At one to two drinks, many feel relaxed or euphoric due to increased dopamine levels in the brain. However, even low doses begin to impair judgment and lower inhibitions. Alcohol depresses the central nervous system by enhancing the inhibitory neurotransmitter GABA and suppressing the excitatory neurotransmitter glutamate. Collectively these effects reduce motor coordination and mental clarity in a dose-dependent manner.
With three to four drinks, alcohol's effects become more pronounced as most surpass a BAC of 0.08%, the legal limit for driving. At this stage, speech slurs in some people. Motor skills have declined further, reaction times have slowed and decision-making has deteriorated. Emotional regulation also changes. Alcohol may amplify underlying moods including happiness. However, in some people anxiety, sadness or irritability may be increased. It may lead to outbursts of aggression.
The liver typically metabolizes about one drink per hour. Chronic drinkers may metabolize slightly faster due to increased activity of liver enzymes like CYP2E1. But the increase is modest. Alcohol is broken down into acetaldehyde, a toxic, carcinogenic compound, which is then converted to acetate and finally into water and carbon dioxide. The accumulation of acetaldehyde is responsible for many of alcohol's harmful effects.
Some individuals have a tolerance to alcohol. This means they may appear less intoxicated at the same BAC. Yet tolerance is a result of a brain adaptation to higher BACs and not faster metabolism. Therefore, a higher tolerance leads to increased consumption, raising the risk of alcohol-related health harms.
What Happens When Binge Drinking
Once alcohol consumption crosses the binge threshold — four drinks or more for women, five or more for men — both drunkenness increases and does the risk of acute health toxicity. Higher levels of alcohol depress the brainstem, which controls breathing as well as affecting heart rate and body temperature.
Very intoxicated individuals may experience vomiting, loss of consciousness or even dangerously slowed breathing. Vomiting can sometimes lead to aspiration. This is where stomach contents go into the lungs, sometimes leading to choking.
Blackouts are also a risk where the brain can't form new long-term memories despite the person being awake and active. Blackouts are more likely to occur when women drink more than 8 drinks and men more than 10 in an occasion. Blackouts are linked to increased risk of injury, poor decision-making as well as cognitive issues, like memory lapses and everyday thinking problems, even in young people.
The Health Risks of Binge Drinking
The most immediate consequence of a binge is the hangover, a collection of symptoms including headache, nausea, fatigue, muscle aches and irritability. These effects stem from dehydration, low blood sugar, immune system activation, inflammation, poor sleep quality and the toxic byproducts of alcohol metabolism.
But hangovers are only one risk. Serious binges can be immediately life-threatening. The Dubowski stages of alcohol influence defines 'stupor' as occurring at BACs of 0.30–0.40%. This is characterized by marked confusion, inability to stand or walk, vomiting and incontinence. At BACs above 0.40%, risks of coma and death increase, primarily due to respiratory depression and loss of airway protective reflexes.
Drinking markedly increases the risk of injury as motor coordination is diminished and risk taking behavior increases. Yet beyond injury, long-term, repeated binge drinking adversely affects nearly every major organ system. In the liver, it can cause fatty liver (steatosis), inflammation (alcoholic hepatitis), and permanent scarring (cirrhosis). The pancreas may also become inflamed, leading to painful and dangerous pancreatitis. The heart also is vulnerable. Binge drinking is linked to elevated blood pressure, arrhythmias, stroke and sudden cardiac death.
In the brain, repeated exposure to high alcohol levels can cause structural shrinkage in young adult brains, especially in areas responsible for memory and decision-making. Binge drinking is also linked with higher rates of anxiety, depression, and suicidal behavior. Over time, repeated binge drinking can progress to alcohol use disorder (AUD), a chronic relapsing condition marked by a loss of control over drinking and physical dependence.
Binge drinking also increases cancer risk. Alcohol and its byproduct acetaldehyde are both classified as Group 1 carcinogens by the World Health Organization (WHO). Binge drinking is linked to cancers of the breast, liver, colon, mouth, esophagus, and throat. According to the WHO, no level of alcohol consumption is considered safe, challenging long-held beliefs about the supposed benefits of moderate drinking.
These risks add up. A recent study in JAMA Network Open estimated that that there were over 140,000 deaths annually in the U.S. in people age 20 to 64 due to excessive alcohol use, accounting for 15% of deaths in men and 10% in women.
How to Reduce Risks Associated With Drinking
Of course, abstaining from alcohol eliminates the risks. Yet those who choose to drink can take steps to reduce harm. Eating a meal rich in fat and protein before drinking slows alcohol's absorption. Hydrating before, during and after alcohol use can mitigate dehydration and help reduce hangover severity.
Pacing alcohol consumption to ideally no more than one drink per hour allows the liver to keep up. Drinking earlier in the day to allow the body to completely metabolize the alcohol before sleep can help mitigate some alcohol-related sleep disruption.
Avoiding high-proof liquors and shots lowers the likelihood of rapid intoxication. Sticking to one type of alcoholic beverage may help reduce overconsumption, although research on this is mixed.
Additional protective strategies include setting a drink limit and planning transportation in advance. Avoid mixing alcohol with medications or other substances is also important, as combinations can increase overdose risks of overdose, blackouts or severe medical complications.
Finally, tracking alcohol use through a journal or app can help identify patterns. Taking regular breaks from alcohol — such as dry weeks or alcohol-free months — gives the body time to recover and can recalibrate tolerance. Some opt for a 'Dry January' as December tends to be the month with the highest alcohol consumption. Self-awareness and environmental control, such as avoiding high-risk settings or peer pressure, can also preventing binging.
Ultimately, binge drinking has become a socially accepted if not a central part of American culture, particularly in young people and on college campuses. But it is far from a harmless activity. It increases the risk of injury, cognitive decline, organ damage, cancer and death — even among those who only binge occasionally.
Understanding how alcohol affects the body can help inform choices. Whether through moderation or abstinence, reducing binge drinking is a step toward better long-term health.