Alcohol-Related Brain Damage (ARBD): Causes, Symptoms & Treatment

Anyone who has ever felt even a little bit tipsy has experienced the power alcohol has over the brain. You might feel less inhibited after one or two drinks, with slower reaction times, slurred speech and coordination problems increasing as you consume more alcohol. Although it’s easy to wave these effects off as minor, temporary side effects, they also indicate the potential link between alcohol and brain damage.

Your central nervous system, which includes your brain, spinal cord and the network of neurons that carry information to other parts of your body (like your muscles and limbs), is sensitive to the effects of alcohol. Over time, it can change things on a cellular level, ultimately altering your behavior and leading to alcohol brain damage. The effects can be devastating, but there’s hope for recovery. With abstinence, your brain may be able to heal and reduce some of the effects.

Alcohol-related brain damage (ARBD) is a medical term but does not technically refer to a specific condition. Rather, it is an umbrella term that refers to any brain damage caused by alcohol use. This can include nerve damage caused by alcohol, vitamin deficiencies that occur with alcohol use and lead to brain damage and even physical trauma to the brain due to being drunk. 

Can Alcohol Cause Brain Damage?

Yes. In fact, research published by NIAAA suggests that approximately 50% of people with alcohol use disorder in the U.S. have some level of neuropsychological problems. 

Brain damage caused by alcohol should be a serious concern for anyone who drinks — casual and heavy drinkers alike. The brain is easily affected by alcohol, and alcohol can have many different impacts on the brain. As the National Institute on Alcohol Abuse and Alcoholism (NIAAA) notes, brain impairment is noticeable after one or two drinks, although those effects are typically short-term.

Risk Factors for Developing Alcohol and Brain Damage

Alcohol-related brain damage typically develops over time and is influenced by several key factors:

• Age and Health Status: The impact of excessive drinking may be more pronounced in older adults or those with co-occurring disorders. Additionally, people with compromised liver function or other chronic illnesses may experience a faster progression of alcohol-related brain damage.
• Quantity and Frequency of Alcohol Use: The total amount of alcohol consumed and how often it is consumed play a central role in ARBD. While heavy, sustained drinking poses the greatest risk, binge drinking episodes can also contribute to detrimental effects on the brain.
• Duration of Use: The longer someone misuses alcohol, the greater their risk of developing brain damage. Years or decades of heavy drinking can progressively weaken neural structures and deplete essential nutrients needed for healthy brain function.
• Nutritional Deficiencies: Chronic alcohol misuse is often associated with poor dietary habits. Nutritional deficiencies can arise from both decreased intake of essential nutrients and impaired absorption in the gastrointestinal tract. This is especially critical regarding thiamine (vitamin B1), which is crucial for brain health. Thiamine deficiency is a common contributor to certain types of ARBD.
• Genetic and Biological Factors: Some people may be more vulnerable to the neurotoxic effects of alcohol based on their genetic makeup or underlying health conditions. Family history of alcoholism, mental health conditions, or metabolic disorders may compound the risk for ARBD.

How Does Alcohol Cause Brain Damage?

Alcohol can damage your brain in many ways:

• Wet brain: This condition, known as Wernicke-Korsakoff syndrome, comes from heavy alcohol use. It’s due to a thiamine (vitamin B1) deficiency created by alcohol, causing mental confusion, balance issues and severe memory problems. This condition can be reversed if treated early but will eventually become permanent.
• Traumatic brain injury: Drinking alcohol can cause you to lose balance and coordination while impairing judgment. This increases the risk of falls and accidents, resulting in traumatic brain injuries. These injuries can lead to long-term physical and cognitive problems that may be permanent.
• Stroke: Drinking too much alcohol can cause high blood pressure and irregular heartbeats, known risk factors for stroke. A stroke happens when your brain doesn’t get enough blood, starving your brain cells of the oxygen and nutrients they need to survive, potentially causing severe and irreversible brain damage.
• Lack of oxygen: Drinking a large amount of alcohol in a short time can lead to alcohol poisoning. This can make you unconscious or put you in a coma, causing your breathing to become irregular or even stop. This lack of oxygen can cause serious brain damage or even death.
• Fetal alcohol syndrome: This condition occurs when a woman consumes alcohol during pregnancy. The alcohol can cross the placenta and harm the developing fetus’s brain, leading to physical, behavioral and cognitive abnormalities. The brain damage caused by fetal alcohol syndrome is irreversible and can permanently impact an individual’s life.

How Much Alcohol Does It Take To Cause Brain Damage?

For people who choose to drink, the Centers for Disease Control recommends consuming no more than one drink (an alcoholic beverage containing 14 grams of alcohol) daily for women and two drinks daily or fewer for men. The more you consume, the greater the risk of adverse effects. Brain damage caused by alcohol abuse results from the long-term effects of heavy consumption on your central nervous system.

Studies suggest that heavy drinking over the years can shrink brain volume, cause faster age-related memory loss and increase your tolerance, which typically leads to higher consumption levels and increased brain damage.

Can One Night of Drinking Cause Brain Damage? 

Yes, a single night of drinking can cause brain damage. While it might not cause some conditions, like wet brain or a stroke, a single night of drinking can lead to impairment that causes a traumatic brain injury caused by alcohol. A single drink by someone pregnant can cause fetal alcohol syndrome, leading to permanent brain damage for a developing child. No amount of alcohol can be safely used without risking some form of brain damage, which can result from a single night of drinking.

Types of Alcohol-Related Brain Damage

Alcohol can have a profound impact on the brain, leading to a range of disorders with varying symptoms. These disorders include Wernicke-Korsakoff Syndrome, fetal alcohol syndrome, hepatic encephalopathy, peripheral neuropathy and cerebellar atrophy.

Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff Syndrome (WKS) is a severe form of alcohol-related brain damage. It is caused by a lack of vitamin B1 (thiamine) in the body, which is a result of long-term heavy drinking. WKS is made up of two separate elements: Wernicke’s encephalopathy and Korsakoff’s psychosis.

Symptoms of Wernicke’s encephalopathy include:

• Confusion and disorientation
• Numbness in the hands and feet
• Rapid random eye movements (sometimes called ‘dancing eyes’)
• Blurred vision
• Poor balance and unsteady walking

Symptoms of Korsakoff’s psychosis include:

• Memory loss
• Apathy
• Confusion about where they are and about the passage of time

Fetal Alcohol Syndrome

Fetal alcohol syndrome (FAS) is a condition that occurs in a child whose mother drank alcohol during pregnancy. This can cause brain damage and growth problems in the child.

Symptoms of FAS include:

• Learning disabilities
• Behavioral problems
• Physical abnormalities such as a smaller head, shorter-than-average height and low body weight

Hepatic Encephalopathy

Hepatic encephalopathy is a decline in brain function that occurs as a result of severe liver disease. In this condition, your liver can’t adequately remove toxins from your blood, causing them to build up in your bloodstream and eventually your brain.

Symptoms of hepatic encephalopathy include:

• Confusion or disorientation
• Shortened attention span
• Personality changes or mood swings
• Poor judgment
• Difficulty with coordination, including handwriting

Peripheral Neuropathy

Peripheral neuropathy is a result of damage to your peripheral nerves, often causing weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body.

Symptoms of peripheral neuropathy include:

• Gradual onset of numbness, prickling or tingling in your feet or hands
• Sharp, jabbing, throbbing, freezing or burning pain
• Extreme sensitivity to touch
• Lack of coordination and falling

Cerebellar Atrophy

Cerebellar atrophy, or cerebellar degeneration, is a condition characterized by the wasting away of cells in the cerebellum, the part of the brain that controls muscle coordination. This can be caused by chronic alcohol abuse.

Symptoms of cerebellar atrophy include:

• Difficulty with movement and coordination, including walking and picking up objects
• Unsteady and uncoordinated movements
• Speech difficulties
• Involuntary back-and-forth eye movements
• Difficulty swallowing

Remember, these symptoms can vary from mild to severe, and most people with alcohol-related brain damage will experience some rather than all of them. Many of these symptoms can improve or even disappear over time with proper care and treatment.

Does Alcohol Cause Permanent Brain Damage?

Yes, but not necessarily for everyone. The permanency of brain damage caused by alcohol depends on the type of brain damage that alcohol caused. Some types, like fetal alcohol syndrome, will be permanent no matter what. Others, like Wernicke-Korsakoff syndrome, can be reversed if treated early. Strokes and traumatic brain injuries will generally be permanent to some extent, but a degree of recovery can certainly occur. 

How Is Alcohol-Related Brain Damage Diagnosed?

Diagnosis of alcohol-related brain damage typically involves a combination of clinical evaluations, imaging studies, and laboratory tests. While each case may present differently, several common steps are used to confirm an ARBD diagnosis:

• Neuropsychological Testing: These specialized assessments measure memory, attention, decision-making, and other cognitive domains. They can help pinpoint areas of dysfunction attributable to alcohol misuse.
• Medical and Psychiatric History: A thorough review of a patient’s alcohol consumption patterns, nutritional habits, and personal or family history of mental illness or neurological disorders is often the first step.
• Physical Examination and Neurological Assessment: Doctors examine motor skills, balance, coordination, and reflexes. They may also test a patient’s memory, problem-solving abilities, and overall cognitive function.
• Imaging Studies: Magnetic resonance imaging (MRI) or computed tomography (CT) scans can reveal changes in brain structure, such as shrinkage in the frontal cortex or cerebellum. These scans may also help rule out other possible causes of cognitive dysfunction, such as tumors or strokes.
• Laboratory Tests: Blood tests can assess nutritional deficiencies (e.g., thiamine levels) and liver function. Elevated liver enzymes, for instance, may indicate chronic alcohol use and liver damage that can indirectly impact the brain.

Treating Alcohol-Related Brain Damage

Treating alcohol-related brain damage is multifaceted, often requiring medical, nutritional, and psychosocial interventions. While some forms of ARBD may be partially reversible, the extent of recovery largely depends on how early the condition is detected and the person’s commitment to healthy lifestyle changes. Key treatment approaches include:

• Holistic Approaches: Activities that reduce stress and promote mental clarity—such as mindfulness, yoga, meditation, and exercise—can be beneficial supplements to more traditional treatment interventions. These can help stabilize mood, improve sleep quality, and enhance cognitive function over time.
• Alcohol Cessation and Rehabilitation: The cornerstone of ARBD treatment is achieving and maintaining sobriety. For many people, this may involve detoxification in a clinical setting, followed by an inpatient or outpatient rehabilitation program. Such programs typically include counseling, therapy, and support groups that equip individuals with the skills needed to avoid relapse.
• Nutritional Support and Thiamine Supplementation: Because poor diet and malabsorption contribute significantly to ARBD, correcting nutritional deficiencies is crucial. Thiamine supplementation (often administered intravenously or orally in high doses) is essential for anyone showing signs of Wernicke-Korsakoff syndrome or other forms of ARBD. A balanced diet rich in vitamins and minerals supports overall brain health and can bolster recovery.
• Medications: In some cases, doctors may prescribe medications to support cognitive function or alleviate symptoms of depression, anxiety, and other co-occurring mental health conditions. Medications that help reduce alcohol cravings may also be part of a comprehensive treatment plan.
• Psychological and Behavioral Therapies: Cognitive behavioral therapy (CBT) and other evidence-based modalities can aid in rebuilding cognitive skills and addressing negative thought patterns. Therapy can also help individuals develop healthier coping strategies and prevent relapse during stressful situations.
• Occupational and Physical Therapy: When coordination, balance, or fine motor skills are impaired, occupational and physical therapists can help individuals relearn motor functions and adapt to limitations. These therapies focus on improving daily functioning and enhancing quality of life.
• Support Groups and Continuing Care: Peer-support groups, such as Alcoholics Anonymous (AA), provide a structured environment in which people can share experiences, learn from others, and maintain accountability. After formal treatment ends, ongoing support is a key factor in preventing relapse and managing any lingering cognitive deficits.

If you or someone you love is struggling with alcohol addiction, Orlando Recovery Center is here to help. We’ll create a comprehensive treatment program to address the addiction and any co-occurring mental health disorders. Call today to start taking control of your recovery.