14 symptoms of brain damage by alcohol

Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.

Alcohol abuse can cause serious damage to the brain. According to a 2021 review article, between 50 and 80% of those struggling with alcohol abuse suffer from diminished cognitive abilities that manifest in a spectrum of cognitive and behavioral symptoms.

Impaired decision-making, reduced impulse control, and difficulties with attention and information processing are just the tip of the iceberg. As alcohol use disorder (AUD) progresses, the damage to cognitive function can escalate and lead to far more severe neurological impairments.

Ardu Recovery Center offers hope and healing for those struggling with alcohol dependence or addiction. Our alcohol rehab center provides compassionate, personalized care to help you overcome dependence and build a healthier future.

What is alcohol-related brain damage (ARBD)?

Alcohol-related brain damage (ARBD) is the result of prolonged and excessive alcohol consumption. It damages different parts of the brain, impairing cognitive functions, emotional regulation, and behavior.

ARBD encompasses a spectrum of disorders where the brain’s ability to function properly is compromised because of the toxic effects of alcohol and nutritional deficiencies associated with chronic alcohol use. While some effects of ARBD may be managed or improved with treatment and abstinence, the damage can sometimes lead to long-term challenges in mental and emotional health.

If you recognize any of the following 14 physical or behavioral symptoms of alcohol-related brain damage, reach out to us as soon as possible.

Physical symptoms of alcohol brain damage

Physical symptoms of alcohol brain damage manifest as changes in bodily functions and sensory perception that start to emerge after a prolonged period of binge drinking. These symptoms reflect the detrimental impact of alcohol on different brain regions responsible for controlling movement, coordination, and sensory processing.

Here are six physical symptoms of alcohol-induced brain damage:

Balance and coordination problems
Tremors and shaking
Decreased sensitivity to pain
Changes in vision or eye movement
Impaired quality of sleep
Seizures

Chronic alcohol use impairs balance and coordination

Impaired balance and loss of coordination are also common physical symptoms of alcohol abuse. They are signs of brain damage because alcohol impairs the cerebellum, the brain region responsible for motor control and balance. Chronic abuse leads to cerebellar atrophy, reducing its ability to coordinate movement and maintain equilibrium. This results in a stumbling gait, difficulty with fine motor tasks, and an increased risk of falls.

Eva, et. al. found that chronic drinking shrinks gray and white matter in brain areas responsible for memory, decision-making, and motor control and that effects can persist long after drinking stops.

Heavy drinking induces tremors and involuntary shaking

Chronic alcohol use disrupts brain neurotransmitter systems, particularly GABA and glutamate. Research shows that alcohol enhances GABA activity and inhibits glutamate to cause adaptive changes in receptor sensitivity. During withdrawal, this leads to hyperexcitability of the nervous system, which manifests as tremors.

Alcohol’s toxic effects on the cerebellum impair motor control and contribute to tremors and coordination issues. Chronic drinking also damages peripheral nerves. This may cause tremors and numbness in the extremities.

Make no mistake: alcohol is poisonous to your nervous system, so why not give your brain a chance and quit while you’re ahead?

Prolonged alcohol abuse decreases pain sensitivity

Alcohol’s impact on the central nervous system alters pain perception. It affects the thalamus and somatosensory cortex, regions involved in processing pain signals. This can lead to reduced sensitivity to pain, potentially masking injuries or health issues that normally prompt medical attention.

A 2019 study published in Neuropsychology explains that:

Alcohol reduces pain perception, especially at higher blood concentrations.
Chronic use harms pain-processing regions in the thalamus and somatosensory cortex.
Even during abstinence, alcohol-dependent individuals may show reduced pain sensitivity.
Long-term abuse can damage peripheral nerves, decreasing sensitivity in extremities.

Booze may numb the pain at first, but the more you drink, the more severe health consequences you’ll face.

Excessive alcohol consumption disrupts vision and eye movement

Alcohol damages parts of the brain controlling eye movement, such as the cerebellum and brain stem. This can cause involuntary eye movements (nystagmus) and impair the ability to focus.

Romano, et. al. posit that alcohol intoxication at 0.6‰ blood alcohol content consistently doubles the eye drift velocity across all gaze angles, which causes gaze instability similar to that seen in some cerebellar disorders. Long-term abuse may also damage the optic nerve, leading to decreased visual acuity or even partial vision loss.

Long-term alcohol misuse severely impacts sleep quality

Alcohol-related brain damage can seriously impair sleep. Brower, M.D. explains how:

Chronic alcohol use disrupts brain systems that regulate sleep, such as GABA, glutamate, and serotonin neurotransmitter systems. This makes it hard for drinkers to fall asleep or stay asleep and may lead to abnormal sleep patterns.
Alcohol damages the cerebral cortex and brainstem which control sleep-wake cycles.
Heavy drinking reduces slow-wave sleep and disrupts REM sleep.

Even after you stop drinking, these sleep problems often persist for months or years because they cause lasting neurological changes. Impaired sleep increases the risk of relapse and creates a vicious cycle of alcohol abuse and sleep disturbance.

We understand how persistent sleep issues can threaten your sobriety. Our specialized relapse prevention services address these challenges, so you can break the cycle of sleep disturbance and alcohol abuse to support your long-term recovery.

Persistent heavy drinking significantly increases seizure risk

Seizures are a less common but potentially life-threatening symptom of alcohol brain damage. Finnish researchers suggest that prolonged heavy drinking alters the brain’s electrical activity in the cortex and limbic system. It increases neuronal excitability while lowering seizure thresholds, which leaves your brain more prone to abnormal electrical discharges.

During alcohol withdrawal, hyperexcitability can trigger seizures because the brain struggles to readjust without alcohol’s dampening effects. Even in milder cases, the overall risk of seizures increases.

With abstinence, your brain may heal. Our Utah rehab center can guide you through safe alcohol detoxification and provide comprehensive treatment to help you overcome alcohol addiction and reduce your risk of life-threatening seizures.

Behavioral symptoms of alcohol brain damage

Alcohol’s impact on the brain goes beyond physical symptoms. Alterations in behavior are another key indicator of ARBD and they can often persist long after the person stops drinking.

Here are six common behavioral symptoms that may signal alcohol-related brain damage:

Memory impairment
Impaired decision-making abilities
Poor impulse control and judgment
Reduced attention span and focus
Mood swings and emotional instability
Personality changes

Alcohol erodes memory and recall

Long-term heavy drinking damages the brain’s memory systems, particularly the hippocampus. This region is responsible for forming new memories and can shrink as a result of heavy alcohol use. Researchers from the University of Sydney found that even in uncomplicated alcoholism, over 80% of drinkers show cognitive decline, particularly in executive functions and explicit memory.

Alcohol’s impact on memory goes beyond forgetting where you left your keys—it can mean difficulty retaining important conversations, work-related information, or personal experiences. Many heavy drinkers also experience “blackouts,” periods where they can’t recall what happened while drinking.

Drinking impairs decision-making skills

Chronic alcohol abuse damages the prefrontal cortex which regulates reasoning and executive functions. Smith, et. al. show that alcohol-related brain injury often results in cognitive deficits and brain atrophy in this brain region.

Postmortem research reveals structural and molecular changes in this area that affect astrocytes and oligodendrocytes. Astrocytes and oligodendrocytes are supportive brain cells that maintain neuronal health and function. Alterations in their levels impair judgment and make it hard to evaluate consequences.

Simply put, your brain can’t process information or make decisions as well as it should.

Alcohol lowers impulse control

Excessive alcohol consumption damages the brain’s inhibitory mechanisms in the frontal lobes. This area is responsible for self-control and regulating behavior. As it deteriorates, heavy drinkers find it increasingly difficult to resist urges or delay gratification.

Lowered impulse control can manifest in different ways: from increased aggression and risky sexual behavior to uncontrolled spending or substance abuse. Even when not drinking, people with ARBD may act without thinking.

The inability to control impulses can be particularly challenging in recovery because it makes resisting alcohol cravings more difficult. That’s why our alcohol detox program targets impulse control from the start. We’ll help rewire your brain’s reward system and give you a fighting chance against cravings long after you leave our care.

Chronic drinking reduces focus and attention span

Brain damage caused by heavy drinking damages brain regions responsible for executive function. This impairs attention span and concentration, as well as cognitive processes such as spatial reasoning, working memory, and executive function. A 2020 study found that heavy drinkers often find it difficult to focus on tasks, process information efficiently, or maintain attention for extended periods.

Alcohol destabilizes mood regulation

One of the most common effects of alcohol brain damage is the person’s inability to control emotions or regulate mood. Long-term alcohol abuse disrupts the balance of neurotransmitters (dopamine, serotonin, and endorphins) that regulate mood. It affects the limbic structures and causes mood swings ranging from euphoria to depression.

According to a 2023 study, the cognitive impairments caused by alcohol damage (especially to memory and executive function) result in frustration and emotional distress because patients struggle with daily tasks and social interactions. The isolation and loneliness that often follow these cognitive deficits can exacerbate emotional health problems.

Many people battling addiction also struggle with mental health issues. Ardu’s dual diagnosis program tackles both problems simultaneously.

Long-term abuse alters personality

Prolonged heavy drinking damages brain areas that control impulses, emotions, and social behavior. This leads to personality changes in many long-term alcoholics. A study of 86 alcohol abuse cases found personality changes in 12 patients, along with different mental disorders and physical damage.

Alcohol-induced brain alterations can manifest as increased irritability, aggression, apathy, or dramatic shifts in decision-making patterns. Some improvement is possible with therapy and abstinence from alcohol, but the complete restoration of pre-addiction personality traits may not always occur.

Ardu’s compassionate team of experts can help you reclaim the person you truly are with alcohol rehab services designed to heal both mind and body. Take the first step towards lasting change with our personalized therapy sessions and holistic detox programs tailored to your needs.

Is brain damage from alcohol permanent?

Brain damage caused by chronic and excessive alcohol consumption can be permanent. Based on everything we know about the effects of alcohol on the brain, here’s what you need to know:

As a neurotoxin, alcohol destroys brain cells, which over time can lead to a reduction in brain volume and disruption of normal brain function.
Alcohol abuse causes vitamin B1 (thiamine) deficiency. According to Oscar-Berman and Marinkovic, thiamine deficiency in alcoholics damages the hypothalamus, potentially leading to lasting or temporary cognitive problems and brain shrinkage.
Even moderate alcohol intake may contribute to brain shrinkage and a reduction in volume, particularly in areas such as the hippocampus.

Looking to quit drinking? Ardu’s residential treatment program offers personalized support from our dedicated healthcare team to help you achieve sobriety and stay on track for the long term.

Whether you’re seeking a safe environment to detox or ongoing care to maintain your recovery, we provide comprehensive services to guide you through every step of your journey to a healthier, alcohol-free life.

What happens to your brain when you quit drinking?

Your brain has an incredible capacity to heal and rewire itself once you stop drinking. It’s normal to encounter a range of physical and emotional challenges. Each person who quits drinking may experience mild or severe withdrawal symptoms.

Withdrawal symptoms: In the first weeks after quitting, your brain undergoes withdrawal as it adjusts to the lack of alcohol. This can cause headaches, anxiety, insomnia, irritability, and, in severe cases, hallucinations or seizures.
Structural brain changes return to normal: When drinking stops, the brain begins to repair the damaged hippocampus, restoring lost volume and cognitive function over time.
Cognitive functions restore: As the brain heals, memory, attention, and problem-solving improve. A 2009 study shows that alcohol-related memory and executive function impairments can improve in abstinent patients. Their cognitive performance returns to normal levels in approximately six months.
Neurotransmitters rebalance: After quitting, neurotransmitter levels in the brain gradually stabilize, which can improve mood and reduce cravings.
Emotional regulation improves: Alcohol abuse impairs emotional regulation, leading to mood swings and poor mental health. When alcohol use stops, the brain gradually regains control over emotions, contributing to better mental health and emotional stability.
Reduced risk of brain damage: Quitting reduces the risk of permanent brain damage and may lead to some recovery in brain volume and function.

Choose sobriety and allow your brain to restore its natural balance, sharpen your cognitive abilities, and rediscover emotional stability.

Do you need help getting sober?

The journey to sobriety is complex, but with the right support, you can achieve healing for your mind, body, and brain. Ardu provides a comprehensive array of therapies and services that support your brain’s recovery and teach you healthy coping skills for long-term sobriety.

Our multifaceted approach includes:

Medically-supervised detox for a safe withdrawal process
Cognitive behavioral therapy (CBT) to rewire thought patterns and behaviors and address decision-making impairments and impulse control issues
Mindfulness and meditation therapies to reduce stress and promote emotional regulation.
Nutritional therapy to restore essential nutrients and support brain health and repair
Sleep hygiene coaching to address alcohol-related sleep disturbances
Group therapy to enhance social cognition and mitigate personality changes and social isolation

Some of our patients prefer our holistic treatment methods. We help them delve into the underlying factors that contribute to their alcohol addiction. Practices such as meditation, yoga, and art therapy quiet stress pathways so new neurons can grow and reverse the damage caused by years of excessive drinking.

You don’t have to face this alone. We are here to support you every step of the way. If you’re ready to take the first step toward a healthier, alcohol-free life, reach out to us today and schedule a tour.

Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Alcohol brain damage FAQ

Does alcohol cause inflammation in the brain?

Alcohol can cause inflammation in the brain. When you consume large quantities or over long periods, alcohol’s metabolites such as acetaldehyde trigger an inflammatory response in the central nervous system. This neuroinflammation can lead to different neurological problems and contribute to alcohol-induced brain damage.

Alcohol activates the brain’s immune cells, called microglia, which release inflammatory molecules. This process damages or kills neurons which causes cognitive impairment, memory loss, problems with concentration, and other neurological issues. Chronic alcohol use also disrupts the blood-brain barrier to allow harmful substances to enter the brain more easily and further increase inflammation.

Alcohol-related lack of vitamin B1 (thiamine) can also exacerbate inflammation. Thiamine reduces inflammation and oxidative stress in the brain, but when you’re deficient in this vital nutrient, your brain becomes more susceptible to inflammation and brain impairment.

What is the brain disease caused by alcohol?

The primary brain disease caused by chronic alcohol abuse is known as alcohol-related brain damage (ARBD) or alcohol-related brain injury. This umbrella term encompasses several conditions, including Wernicke-Korsakoff syndrome, alcohol-induced dementia, and cerebellar atrophy.

Wernicke-Korsakoff syndrome is two separate but related conditions. Wernicke’s encephalopathy is an acute, life-threatening condition caused by severe vitamin B1 deficiency. It’s characterized by confusion, eye movement abnormalities, and poor balance. If left untreated, it can progress to Korsakoff’s syndrome, a chronic condition marked by severe memory problems, especially difficulty forming new memories.
Alcohol-induced dementia (alcoholic dementia) is another condition under the ARBD umbrella. This condition shares similarities with other types of dementia but is directly related to long-term, heavy alcohol use. It can cause problems with memory, learning, and other cognitive functions.
Cerebellar atrophy affects balance, coordination, and fine motor skills. This condition results from alcohol’s negative effects on the cerebellum, a part of the brain responsible for these functions.

What is early-stage alcoholic dementia?

Early-stage alcoholic dementia develops as a result of long-term, heavy alcohol use. It’s characterized by a decline in cognitive abilities that interferes with daily life. In the early stages, symptoms may be subtle and often mistaken for normal aging or stress.

Common early signs of alcoholic dementia include:

Memory problems, especially difficulty forming new memories
Trouble concentrating or paying attention
Difficulty with planning and organizing
Poor judgment and decision-making
Difficulty with balance and coordination
Mood changes, irritability, or depression

These symptoms are caused by alcohol’s toxic effects on the brain and the nutritional deficiencies that often accompany heavy drinking. Alcohol damages brain cells, disrupts neurotransmitters, and leads to brain shrinkage of areas responsible for memory and thinking.

Early-stage alcoholic dementia can be partially reversible if caught early and if the person stops drinking. Without intervention, it can progress to more severe forms of cognitive impairment.

What is considered heavy drinking?

Heavy drinking refers to a pattern of alcohol consumption that puts an individual at higher risk for alcohol-related health problems, including alcohol-related brain damage, cardiovascular problems, liver damage, and even cancer.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), heavy drinking is defined as:

More than 4 drinks on any day or more than 14 drinks per week for men
More than 3 drinks on any day or more than 7 drinks per week for women

A “standard drink” in the U.S. contains about 14 grams of pure alcohol. This is equivalent to:

12 ounces of regular beer (5% alcohol)
5 ounces of wine (12% alcohol)
1.5 ounces of distilled spirits (40% alcohol)

Binge drinking, a form of heavy drinking, is defined as consuming 5 or more drinks (for men) or 4 or more drinks (for women) within about 2 hours. Heavy drinking significantly increases the risk of developing alcohol-related brain injury, liver disease, and other health problems. If you’re concerned about your drinking habits, speak to your healthcare provider for personalized advice and support, or reach out to Ardu.

Can a brain MRI show alcohol use?

A brain MRI can’t directly show alcohol use, but it can reveal the damaging effects of chronic alcohol consumption on brain structure. Long-term alcohol misuse can lead to brain shrinkage in areas responsible for memory and cognitive function. An MRI might show reduced brain volume, enlarged ventricles, or changes in white matter integrity. These changes can indicate alcohol-related brain impairment, but they’re not exclusive to alcohol use.

Other conditions, including traumatic brain injury, can cause similar MRI findings. Healthcare providers typically consider MRI scans alongside a patient’s medical history, physical examination, and other tests to diagnose alcohol-related brain disorders.

What does 20 years of drinking do to your body?

Two decades of regular alcohol consumption can have far-reaching consequences on your health. Here are some examples:

Long-term alcohol use affects nearly every organ system, with the liver, brain, and cardiovascular system being particularly vulnerable.
Chronic alcohol misuse can lead to liver disease, ranging from fatty liver to cirrhosis.
It also increases the risk of high blood pressure and heart disease.
In the brain, prolonged drinking can cause alcohol-related dementia and a type of brain damage known as “wet brain” (Wernicke-Korsakoff syndrome).
Alcohol’s adverse effects on the digestive system lead to chronic inflammation and increase the risk of cancers.
20 years of heavy drinking can also weaken the immune system and make you more susceptible to infections.
Excessive consumption over time may cause hormonal imbalances. It affects fertility and sexual function in men and women.
The psychological toll of decades-long drinking is also significant. You face an increased risk of depression, anxiety, and other mental health issues.
Socially, long-term drinking often strains relationships and can impact work performance.

How long does it take for alcohol to leave your system?

The time it takes for alcohol to leave your system depends on the amount you consume, your body weight, metabolism, and liver function. On average, the liver can process about one standard drink (12 ounces of beer, 5 ounces of wine, or 1.5 ounces of spirits) per hour.

Blood alcohol concentration (BAC) typically peaks about 30–45 minutes after your last drink. From there, it decreases at a rate of about 0.015% per hour. So, if your BAC was 0.08%, it would take about 5.5 hours for the alcohol to be completely eliminated from your bloodstream.

Traces of alcohol can be detected in other ways for much longer. Breath tests can detect alcohol for 12–24 hours after your last drink. Urine tests can show alcohol use for up to 3–5 days, depending on the type of test. Hair follicle tests can detect alcohol for up to 90 days.

Even if you feel sober, your blood alcohol levels might still be elevated. The safest approach is to wait at least one hour per standard drink consumed before engaging in activities that require coordination and judgment, such as driving.

Resources

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