Street names: liquor, booze, juice, sauce

What is alcohol?

Alcohol is the substance in beer, wine and liquor that causes intoxication (“getting drunk”). It is also called ethanol. Alcohol is made by fermenting or distilling various fruits, vegetables or grains. It is a depressant, which means that it slows down the parts of the brain that affect thinking and behaviour, as well as breathing and heart rate.

The use of alcohol has been traced as far back as 7000 BC, and is common in many social, cultural and religious practices.
  

How much alcohol is in a drink?

Different types of drinks contain different amounts of alcohol. The amount of alcohol in fermented beverages such as beer and wine ranges from 4 to 15 per cent.

Distilled beverages, often called “hard liquor” or “spirits,” have more alcohol, typically over 25 per cent. Examples are rum, whisky and vodka.

Standard drink sizes help you know how much alcohol your drink contains. In Canada, a standard drink contains

17.05 millilitres or 13.45 grams of pure alcohol. This is equal to:

• one bottle of beer* (12 oz, 341 mL, 5% alcohol)
• one bottle of cider (12 oz, 341 mL, 5% alcohol)
• one glass of wine (5 oz, 142 mL, 12% alcohol)
• one shot glass of spirits (1.5 oz, 43 mL, 40% alcohol).
  • * Some regular beers have six or seven per cent alcohol or higher, making them stronger than a standard drink. “Light” beers have about four per cent alcohol.
       

What does alcohol look like?

Pure alcohol is a clear, colourless liquid. Alcoholic beverages get their distinctive colours from their ingredients and from the fermentation process.
   

Who uses alcohol?

Alcohol is the most commonly used drug in Canada. About 76 per cent of Canadians over age 15 have drunk alcohol in the past year.

Even though laws restrict alcohol use to people over age 18 or 19, many young people start drinking before it is legal. A 2023 survey in Ontario found that 36 per cent of students in grades 7 to 12 used alcohol in the last year, and 10 per cent reported binge drinking in the last month.

Traditionally, men have drunk more than women, but this gap is shrinking. The 2023 survey showed that, for the first time, girls in high school drank more than boys (39 vs 33 per cent).
  

How does alcohol make you feel?

The way alcohol affects you depends on many factors, including:

• how much and how often you drink
• how sensitive you are to alcohol
• your weight, age and sex
• what you ate recently and how much
• the environment you are in
• your mood
• your overall health
• whether you’ve taken other drugs (illegal, prescription, over-the-counter, herbal).

Many of these factors also determine how quickly you become intoxicated. How fast you drink also speeds up intoxication.

For many people, a single drink makes them feel more relaxed and social. Some people feel happy or excited, but others become sad or angry.

Alcohol also affects parts of the brain that control balance, memory and judgment, so it increases the chances of injury and harm. Excessive drinking can also lead to aggression, which is why alcohol often plays a role in violence and crime.

Females are generally more sensitive to the effects of alcohol than males, and all adults become increasingly sensitive to alcohol’s effects as they age. When some- one is more sensitive, it takes less alcohol to cause intoxication and more time for the body to get rid of the alcohol.
  

What is intoxication?

Intoxication is the buildup of alcohol in your body. Most alcohol is broken down and removed by the liver, but your liver can only break down about one drink per hour. If there is more alcohol than that in your body, the liver can’t process it and the alcohol stays in your bloodstream.

Early signs of alcohol intoxication include flushed skin, poor judgment and reduced inhibition. Continued drinking increases these effects and causes others, such as trouble focusing, slower reflexes, difficulty walking straight, slurred speech and blurry or doubled vision. With severe intoxication, the person may “black out” and not remember what they did while drinking. Other extreme effects include not being able to stand, vomiting, coma, even death.
  

How long does alcohol affect you?

How long the effects of alcohol last depends on your age, weight and genetics. How much you drink is also important. This means that if you drink a large amount of alcohol in an evening, you may still be intoxicated when you wake up in the morning and should avoid activities that require sobriety, such as driving.

Drinking too much can lead to a “hangover,” beginning eight to 12 hours after the last drink and lasting up to 24 hours or more. Hangovers are caused in part by acetaldehyde, a toxic chemical that is created as your

liver processes alcohol. Other causes include dehydration and changes in hormone levels. Symptoms include brain fog (having a hard time thinking), fatigue, headache, nausea, diarrhea, shakiness and vomiting.

Some people think that having a drink before bed helps them get to sleep. Alcohol does bring on sleep more quickly, but it often disrupts sleep patterns and causes wakefulness in the night.
  

Is alcohol dangerous?

Yes, alcohol can be dangerous in numerous ways.

The effect of alcohol on judgment, behaviour, attitude and reflexes can lead to embarrassment, risky sexual contact, violence, injury—even death. Alcohol is involved in more disruptive behaviour, crimes and automobile accidents than any other drug. Young people who are less experienced with alcohol might make impulsive or dangerous choices when they drink. Intoxication also increases the risk of suicide.

Extreme alcohol intoxication can be fatal. This can hap- pen when a person “passes out,” vomits, then chokes. If someone has been drinking heavily and passes out, lay them on their side and watch them closely. Signs of alcohol poisoning include clammy skin, low body temperature, slow or difficult breathing and loss of bladder control. If you see these signs, get emergency medical help.

Mixing alcohol with other drugs can be very dangerous. Alcohol can make other drugs less effective, or it can make their effects too strong. It is best never to mix alcohol with other drugs—whether that is medication or an illegal substance. If you are taking medication and want to drink, check first with your health care provider or pharmacist.

Drinking alcohol during pregnancy can lead to serious health issues for the baby, including behavioural prob- lems, growth delays, learning disabilities, facial deform- ities, joint and limb issues and heart defects. The risks increase with the amount of alcohol. The first trimester is especially critical, but there is no safe amount to drink at any stage of pregnancy. If you’re pregnant and need support, talk with your health care provider about resources that can help.
  

Is there a safe drinking level?

There is no “safe” level of drinking, but guidelines exist to help adults lower the risks:

• low risk: 2 drinks or fewer per week
• moderate risk: 3–6 drinks per week
• high risk: 7 drinks or more per week

Females who drink have a much higher risk of health problems than males, especially if they have more than six drinks per week. This is due to weight, metabolism and other biological differences.

In certain situations, it may be safest not to drink at all:

• if you use medication or other substances that interact with alcohol
• if you are involved in hazardous physical activities or will be driving or operating machinery
• if you are responsible for the safety of others
• if you are making significant decisions
• if you are pregnant or breastfeeding
• if you have certain medical conditions (e.g., liver disease, diabetes).
     

Is alcohol addictive?

It can be.

Heavy alcohol use can lead to alcohol use disorder, which used to be known as alcoholism. It is an addiction, where the person can’t stop drinking, even though it causes problems in their life.

This addiction involves tolerance and withdrawal, which means the person has to drink more to get the same effect and experiences withdrawal symptoms if they stop drinking. Symptoms include tremors, insomnia, vivid dreams, anxiety, nausea and seizures. They can last from two to seven days and range from mild to severe, depending on how long the person has used alcohol and how much they typically drink.

Some people experience severe alcohol withdrawal called delirium tremens, which starts two to five days after drinking stops. It features frightening hallucinations, extreme confusion, fever and a racing heart. It can be fatal if it isn’t treated.

Treatment for alcohol use disorder may begin by mana- ging withdrawal, but most people need additional help. Even after long periods of not drinking, a person may continue to crave alcohol and begin to drink again.

Treatment takes place in residential or community settings. It may include individual or group therapy, mutual help groups such as Alcoholics Anonymous and medications such as naltrexone or acamprosate. There is no single treatment that works best for everyone.
  

What are the long-term effects of drinking alcohol?

The long-term effects depend on how much and how often you drink. Three to six drinks per week increases the risk of breast and colon cancer. Seven or more drinks per week increases the risk of high blood pressure, stroke and heart problems.

Heavy alcohol use can cause difficulties getting and keeping an erection, menstrual irregularities, appetite loss, vitamin deficiencies and infections. Alcohol irritates the lining of the stomach and can cause inflammation and bleeding. Alcoholic liver disease is a major cause of death in North America.

Chronic use of alcohol can damage the brain, which can lead to dementia, difficulties with coordination and motor control, and loss of feeling or painful burning in the feet. It can also result in clinical depression. Suicide rates are much higher in people with alcohol use disorder.

Any reduction in alcohol use is beneficial. It is linked with improved liver function, healthier weight, better blood pressure and lower risk of cancer, stroke, diabetes, epilepsy, infectious diseases and liver failure.
  

What are the laws on alcohol?

Provincial and federal laws control the production, distribution, importation, advertising, possession and use of alcohol.

In Canada, the legal drinking age is 19, except for Quebec, Manitoba and Alberta, where it is age 18. In Ontario, it is illegal for anyone under age 19 to buy alcohol. It is also illegal to sell or give alcohol to anyone under that age. People under age 19 can drink alcohol only if it is given to them by their parent or legal guardian and drunk in their presence.

It is also illegal to sell alcohol to someone who appears intoxicated. If you sell or give alcohol to others, you can be held legally responsible if they hurt themselves or others while they are intoxicated. This includes guests in your home or patrons at a business.

Federal and provincial laws cover drinking and driving offences. For more information, see Do You Know… Alcohol, Other Drugs and Driving.

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Family members can contact the Family Resource Centre (FRC) in the RBC Patient and Family Learning Space (PFLS) for support. You can also visit the PFLS for resources and help connecting to services.

• PFE, FRC or PFLS: 1025 Queen St. W. (McCain Complex Care and Recovery Building)
• PFE and FRC: 416 535-8501, ext. 32028; pfe@camh.ca
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