What is alcohol?
Alcohol (Ethanol) is a liquid substance, which is an ingredient in alcoholic drinks in varying concentrations
The alcohol-level of a drink is indicated by percent by volume (Vol.-%). For example, if a bottle says it has a 12% alcohol percentage it means that per 100 milliliters, there’s 12 milliliters of pure ethanol. If you want to calculate the level of alcohol in grams, you need to know the density of ethanol in it. At room temperature, this is around 0,8 grams per milliliter. You multiply that times the amount of milliliter. In the 12% example this would mean: 12*0,8= 9,6 grams of alcohol.
Alcohol consumption is common in many parts of the world, it’s culturally integrated and is a vital part of many parties. Alcohol usually is (usually) a legal substance for adults and relatively easy to get your hands on. Alcohol being a neurotoxic substance – especially its metabolite acetaldehyd – can cause physical and psychological damage upon consumption. Alcohol dependence can develop unnoticed over time.
How is alcohol used?
In most cases, alcohol is drunk. Alcohol levels of alcoholic drinks vary vastly.
There are four different categories of alcohol, differentiated by the manufacturing process.
- Beer (2 – 5 Vol.-%) – bock beer can have up to 12% of alcohol
- Wine (including (semi-)sparkling wine) (7-17 Vol.-%)
- Spirits (minimum of 15 Vol.-%, maximum 80)
- Alcopops (alcoholic sodas) (1,2 – 10 Vol.-%)
Make sure you know how high the alcohol percentage in your drink is and adapt accordingly. For orientation: A so-called “standard drink” contains 10 – 12 grams of pure ethanol. Therefor a standard drink is:
- 250 – 300 milliliters of beer,
- 125 milliliter of wine
- 100 milliliters of sparkling wine
- or 40 milliliters of a spirit (0,4 cl = a double shot)
A relativley low-risk consumption of alcohol means one standard drink per day for women, two for men. You should not consume alcohol every day.
It can take up to 60 minutes to feel the effects. Alcohol goes through the mucosa into the bloodstream.
Alcohol can also be consumed rectally (“butt chugging”), which has a way faster and more intense effect. IMPORTANT: doses need to be less compared to oral consumption, spirits should not be consumed rectally. Overdosing is common with butt chugging, because the alcohol is absorbed directly through the mucosa, and not disassembled in the stomach prior. Butt chugging can be painful and irritate the intestinal mucosa.
How does alcohol feel?
Every substance has a different effect on different people. How alcohol affects you depends on a few factors like: bodyweight, if you’re used to drinking alcohol, the kind of drink, amounts consumed, empty or full stomach. An important role is played by your environment, and by your mental and physical condition.
Alcohol, if dosed moderately, can have a relaxing and (sexually) liberating effect. Your mood can improve, your sociableness can increase while your awareness for risk estimating and your perception of pain can decrease.
Side effects and long-term impact
With higher consumption, alcohol makes you feel numb and subdued. It can lead to imbalance, a bad temper and aggressive behavior. Motoric skills (such as speaking, hearing, seeing and balance) will be impaired. While coming down you might experience a loss of memory and a hangover the day after. Hangovers can include headaches, nausea, vomiting, anxiety, tiredness, etc.
Regular and high consumption of alcohol over long periods of time can lead to liver problems such as a cirrhosis of the liver. High and regular consumption has been linked to a higher risk of getting cancer. Consuming alcohol can also enhance or intensify moodiness and depressive episodes.
Alcohol related secondary damages can affect every organ and tissue. There are 200 known diseases directly linked to extensive alcohol consumption.
Overdose
xcessive consumption of alcohol or “binge drinking” (a lot of alcohol in a short period of time) can lead to alcohol poisoning. Overdosing is common with butt chugging, because the alcohol is absorbed directly through the mucosa, and not disassembled in the stomach prior. Besides extreme nausea and vomiting overdosing can lead to seizures and a comatose state (reflexes such as breathing, proper blood circulation and body temperature control may stop).
If you feel an ongoing state of discomfort, get medical help. If you encounter a passed out person, check their breathing, provide first aid and call an ambulance (112).
You can find more information about drug emergencies here.
Drug combinations
Generally speaking: Consuming more than one substance at a time puts your body and your mental state under more pressure. Certain effects may be intensified, weakened or delayed by the interactions. The probability of an overdose or side effects is not calculable.
- Alcohol + Nicotine: Alcohol increases the effects of nicotine. It leads to higher blood pressure and increases the risk of cancer.
- Alcohol + Cannabis: Cannabis increases the effects of alcohol, the circulation is impacted. Can lead to nausea, limited reactivity and unconsciousness.
- Alcohol + GHB/GBL, heroin or benzos: risk of life threatening respiratory paralysis and cardiac arrest.
- Alcohol + ketamine: nausea and vomiting possible. Risk of respiratory paralysis.
- Alcohol + crystal, speed, MDMA or cocaine: The effects of alcohol can no longer be perceived – alcohol poisoning is possible! Liver and kidneys are put under high pressure. The combination dries out the body, can lead to overheating.
- Alcohol + medications: Alcohol can increase and prolong the effects of your medications, and vice versa. The breakdown of both substances can be slowed down. Combining painkillers and psychoactive pills is risky. Combining alcohol with beta blockers, anti allergic pills and diabetes pills can lead to unwanted effects and a feeling of discomfort.
Addiction potential and withdrawal
- Alcohol & HIV
- If you regularly drink a lot of alcohol your risk of developing physical or mental dependency increases. The transition from indulgence to habituation to dependency is gradual. Taking breaks from drinking can help: for example if you have 2 – 3 alcohol free days per week.
- With continuous consumption, your body gets used to the alcohol and the potency gradually decreases. This means that you have to drink more to achieve the same effect (tolerance development).
- If you quit longlasting, consistend drinking, you might get withdrawal symptoms. These can last from 3 to 7 days and include: shaking, nausea, headaches, sweating, problems sleeping, seizures and depressive episodes, anxiety, aggressive behavior and moodiness.
- Quitting cold turkey (no medical supervision) can be life threatening. Inform yourself about hospitals in your area which offer supervised rehab and get help.
Safer Use
- Decide for yourself, if, when and how much you want to drink.
- You should plan in grams of pure ethanol and calculate the amount of possible drinks based on that.
- If you occasionally drink too much, ask yourself how that happens. What impacts your drinking behavior?
- Drink with people you trust and feel comfortable with. Ideally you’re with a person who stays sober and can help, if needed.
- It’s never okay to give people alcohol without them knowing or giving consent. You’re putting their life at risk and committing a crime. If you witness such a situation, get help and protect the person being spiked.
- Your tolerance can vary from day to day. Test small amounts and see what effects they have on you.
- Taking breaks while drinking can help stabilize your system.
- Stay hydrated! Drink enough non-alcoholic beverages, ideally water.
- Eat before and during! This helps your stomach and the effects of alcohol are not as intense.
- Mixing substances influences the effects and can lead to unpredictable effects.
- Mixing GHB/GBL with alcohol increases the chances of overdosing a lot. It can lead to life threatening situations.
- “Don’t drink and drive” – little amounts (significantly less than one standard drink) have negative effects on your perception of reality and reactivity, and therefore your driving skills. You’re putting yourself and others at risk.
- Sober periods or alcohol free days/weeks help not getting used to alcohol.
Safer Sex
- Mutual consent – don’t let someone talk you into something you don’t want. Talk about what you (don’t) want when having sex. You can always say no.
- Only sleep with people who can communicate boundaries and consent! If a person is so drunk that they can’t communicate anymore, they also can no longer give consent. Under no circumstances may sexual acts be (further) performed on them. This is true even if mutual intentions were previously discussed while conscious. It is a criminal offense.
- Before having sex, make sure to have enough safer sex utensils.
- The numbing effect of alcohol can make erections and orgasms more difficult.
- Heavy drinking can make it difficult to get/keep an erection. Sexual enhancers put more stress on your body.
- Alcohol influences your judgment. It’s possible safer sex might not be a priority anymore when under the influence. Abstaining from safer sex increases the chances of transmitting HIV, Hepatitis and other STIs.
- Alcohol influences your perception of pain. When engaging in practices such as fisting or S/M the chances of injury are increased when under the influence.
- Butt chugging increases chances of getting infected with STIs/HIV since the mucosa is irritated.
- Some medicine combined with alcohol leads to more stress on the liver. Medical personnel or health centers will inform you about interdependence of substances and specific medicine.
- Get tested for HIV and STI’s once per year and make sure your Hepatitis A & B shots are up to date.
Interactions with HIV treatment
- Alcohol puts extra stress on the liver. Your liver might be damaged in the process.
- Combining Sustiva or Atripla with alcohol increases the chances of psychological side-effects.
- Take drugs and HIV medication at different times. This might decrease the chance of side-effects. If you’re planning on partying for a long time, make sure to bring enough medicine – and if you do end up drinking and taking your medicine at the same time, make sure to dose the alcohol less
- Talk to your doctor about the interaction of your HIV medications with intoxicants.
- Information on interdependence of substances and HIV-medicine can be found here.
Counseling
Would you like to talk to somebody about your substance use? Do you have questions or are you looking for support? Do you want to share or reflect on any experiences? Do you feel that you might be using too much? Are you worried about friends or acquaintances and would like advice or tips on how to handle the situation? Counseling centers in Berlin are there for you!
24/7 counseling hotline by Drogennotdienst Berlin: 030 19237