S/He Can Drink Me Under the Table and Never Get Drunk! — the Truth About Tolerance
Posted Aug 27 2010 6:23am
by Lisa Frederiksen
Many of us have known or seen people who seem to be able to drink far more than others without ever seeming to get drunk. Some people even aspire to being able to drink a lot without getting drunk — in other words, building up their tolerance. But the bottom line is that the impacts on a person’s brain occur whether they appear/feel drunk or not. This is because it still takes their bodies approximately one hour to metabolize one drink.
As you may recall reading other posts on this site, alcohol is metabolized by the liver. Alcohol enters the bloodstream through the walls of the small intestine. Because alcohol dissolves in water, the bloodstream carries it throughout the body (which is 60-70% water) where it is absorbed in body tissue in proportion to the body tissue’s water content. Contrary to popular belief, we cannot rid our bodies of the alcohol we drink by peeing or sweating or vomiting it out. It’s our liver that rids our bodies of the alcohol we consume.
“So, what does that have to do with being able to drink a lot and not appear drunk?” you might ask. The brain is mostly water and highly vascularized (lots of blood vessels). When a person drinks more alcohol than their liver can metabolize, the excess alcohol stays in their bloodstream and suppresses certain brain functions — especially those related to judgment, learning, memory, pleasure, motivation and emotion.
Additionally, “too much to drink” is relative. The impact of alcohol on the brain and body depends on a number of factors beyond this very general rule of thumb that it takes the liver about one hour to process one standard drink. Weight, stress, gender, medications, tolerance, stage of brain development, lack of sleep, amount of food eaten and how quickly the alcohol is consumed are a few of the factors. Additionally, some people have lower amounts of the enzyme ADH in their livers, so their liver doesn’t process the alcohol the same way as someone with normal levels, and thus the alcohol remains in their system longer. Some people have genetic differences, such as a genetic predisposition as a result of having a parent or sibling with the disease of alcoholism. [Alcoholism is one of the diseases of addiction. Addiction is a chronic, often relapsing brain disease.] Other people have brain changes caused by early use of alcohol and/or having experienced one or more of the other risk factors for developing alcohol misuse problems.
But specifically to the issue of tolerance — the ability to drink a lot without seemingly having any consequence — is a problem. It is not good. In fact, tolerance can contribute to a person developing the disease of alcoholism and/or problems related to alcohol misuse. Please find the following links for more information on tolerance and alcohol.