Chapter 3

How Alcohol Makes You Drunk

Pop the cap off a Budweiser, and take a long, slow drink. The ice-cold, refreshing beer flows into your mouth and down your throat, along with alcohol, the two-carbon chemical sought after by nearly every culture on the globe. Before it even reaches your stomach, it enters your bloodstream as you feel the very first signs of a warm mellowness that you have grown to love. Alcohol is unusual in that it is absorbed right through the mucosa (the lining of your mouth, esophagus, and stomach). It is such a small molecule that it doesn’t have to be broken down by any digestive enzymes, so it passes directly through the wall of any portion of the gut. This is in distinct contrast to most foods containing the three major energy sources: carbohydrates, proteins, and fats. Most of these are large, complex molecules that must be broken down into smaller molecular fragments by stomach acid or digestive enzymes in the mouth or small intestine to be absorbed. Absorption of alcohol begins immediately after the first swallow and continues until the last fragment is absorbed in the small intestine. Unlike many foods and most medications, alcohol is 100 percent absorbed into the bloodstream, and it is quickly and evenly distributed to all organs, muscles, fat, and, of course, the brain.

Because alcohol is so chemically simple, the body assimilates it very quickly. Its small size and simple structure allows it to pass readily through the membrane of every cell in the body. Alcohol functions as a two-carbon sugar, so it is considered to be in the carbohydrate family. It is metabolized preferentially over glucose in the liver and converted to a chemical called acetaldehyde at a fixed rate of one ounce per hour. Acetaldehyde is a toxic, cancer-causing chemical, and that toxicity is responsible for a large portion of the damage alcohol does to the body. The higher the blood alcohol level is, the higher the acetaldehyde concentration also is. Alcohol is a cell poison. At high concentrations, it interferes with normal cell metabolism, and it is toxic to many cells in the body, including the liver, heart, and nervous system.

Although the temporary effect of alcohol may be pleasurable, it has many damaging effects on your body. The ounceand-a-half of alcohol in a Budweiser will be well traveled before it passes into your urine or is breathed out in an exhalation. It’s illuminating to see where it has been in the interim.