Alcohol related brain impairment (2023)

Brain and nerves


Read the full fact sheet
  • Alcohol has a toxic effect on the central nervous system and can cause significant brain impairment.
  • ARBI is more likely in people who drink heavily over a long period of time, but excessive binge drinkers are also at risk.
  • The symptoms depend on which part of the brain has been damaged, but can include problems with memory, thinking abilities and physical coordination.
(Video) Alcohol Related Brain Injury | Martin Jackson | Ausmed Lectures

On this page

  • Alcohol and brain injury
  • Alcohol consumption and ARBI
  • Guidelines to reduce health risks from alcohol
  • Disorders linked with ARBI
  • Behaviours linked with ARBI
  • Dealing with behaviours of concern
  • Treatment for ARBI
  • Where to get help
  • Things to remember

Alcohol is one of the many causes of acquired brain injury. The problems caused by alcohol misuse are together called alcohol related brain impairment (ARBI). A person with ARBI might experience problems with memory, thinking-related abilities and physical coordination.

More than 2,500 Australians are treated for ARBI every year, with approximately 200,000 Australians currently undiagnosed. Around two million Australians are potentially at risk of developing ARBI due to their drinking habits.

Just how much damage is done depends on a number of factors, which can include your age, gender, nutrition and your overall alcohol consumption. A younger person has a better chance of improvement because of their greater powers of recovery. However, the effects of ARBI can be permanent for many people.

Alcohol and brain injury

Brain injury can be caused by alcohol because it:

  • has a toxic effect on the central nervous system (CNS)
  • results in changes to metabolism, heart functioning and blood supply
  • interferes with the absorption of vitamin B1 (thiamine), which is an important brain nutrient
  • may be associated with poor nutrition
  • can lead to falls and accidents that injure the brain.

Alcohol consumption and ARBI

Alcohol is one of the most popular drugs in Australia. Around 40 per cent of Australian adults drink alcohol on a weekly basis and 10 per cent drink every day. Alcohol consumption ranges from light (social drinkers) to heavy consumption.

Alcohol related brain impairment is more likely to occur if a person drinks heavily on a regular basis over many years. A decline in thinking-related abilities is gradual and depends on how much alcohol is consumed and for how long. It is also possible to develop ARBI over a short period of time, if the drinking is excessive enough. This is known as ‘binge drinking’ or ‘heavy episodic drinking’ and is a short-term, high-risk way of drinking alcohol.

Men and women who consume more than four standard drinks on any single occasion are at risk. Mixing alcohol and other drugs – either illegal drugs or some prescription drugs – can cause serious health problems.

Guidelines to reduce health risks from alcohol

In 2009, the National Health and Medical Research Council (NHMRC) released guidelines to reduce the health risks from alcohol consumption. To avoid these health risks, the guidelines recommend:

  • for men and women – a maximum of two standard alcoholic drinks a day
  • children and young people – for children and young people under the age of 18 not drinking alcohol is the safest option. Children under 15 are at greatest risk of harm from drinking and so not drinking alcohol is most important for this group. Delaying the age at which drinking begins is strongly recommended for young people between the age of 15 and 17.
  • pregnant and breastfeeding women – the safest choice is not to drink alcohol while breastfeeding, pregnant or if you are planning a pregnancy.

Disorders linked with ARBI

ARBI is associated with changes in cognition (memory and thinking abilities), difficulties with balance and coordination, and a range of medical and neurological disorders. Some alcohol-related disorders include:

(Video) USW Research | Alcohol Related Brain Damage - Addictions Research Group

  • Cerebellar atrophy – the cerebellum is the part of the brain responsible for muscle coordination. Damage results in difficulties with balance and walking, which is called ‘ataxia’.
  • Frontal lobe dysfunction – the brain’s frontal lobes are involved in abstract thinking, planning, problem solving and emotion. Damage results in cognitive (thought) difficulties.
  • Hepatic encephalopathy – many people with alcohol-related liver disease develop particular psychiatric symptoms, such as mood changes, confusion and hallucinations.
  • Wernicke’s encephalopathy – this is a disorder caused by a severe deficiency of vitamin B1. Some of the symptoms include ataxia, confusion and problems with vision.
  • Korsakoff’s amnesic syndrome – this includes a loss of short-term memory, an inability to acquire new information and ‘confabulation’ (the person fills in gaps in their memory with fabrications that they believe to be true).
  • Peripheral neuropathy – the body’s extremities are affected by numbness, pain, and pins and needles.

Behaviours linked with ARBI

Those people close to someone with ARBI may face a range of behaviours that cause problems. There are a number of possible causes or reasons for these types of behaviour, including medical problems, memory and thinking problems, physical discomfort, the side effects of medication or fatigue from lack of sleep. Alternatively, behaviours of concern may be a reaction to stress, anxiety, or a change or upset to daily routine.

Some common behaviours include:

  • aggressive and angry outbursts
  • moodiness
  • confusion
  • withdrawal
  • lack of motivation
  • untidiness and poor hygiene habits
  • sexually inappropriate behaviour
  • poor control of emotions.

Dealing with behaviours of concern

Helpful strategies include:

  • Be prepared to listen – people with ARBI need to feel listened to and understood.
  • Reassure the person that you are there to help them.
  • Speak in a calm, soothing tone.
  • Give praise when the person regains their composure after an outburst.
  • Set clear and firm limits, and repeat them as often as possible.
  • Reinforce and reward appropriate behaviour
  • Ignore the behaviour if it is appropriate to do so and there is no risk of harm to the individual or others.

There are some responses you should try to avoid when dealing with behaviours of concern, including:

  • Avoid arguing or reacting to any provocation.
  • Avoid using a bossy tone or ordering the person around.
  • Ignore negative, critical or aggressive comments.
  • Do not take the behaviour personally.
  • Avoid adopting defensive postures such as standing with your arms crossed.

Treatment for ARBI

A person with a suspected ARBI should have their health assessed by a doctor. They may benefit from referral for a more specialist assessment by a neuropsychologist or neurologist.

Treatment depends on the person and the type of brain damage sustained. Good nutrition is really important. Sometimes, doctors will prescribe multivitamins (especially thiamine) to reduce the risk of further severe brain injury. Alcohol and other drug (AOD) treatments may need to be modified for a person with an ARBI.

Where to get help

  • Your doctor
  • A neuropsychologist, neurologist or AOD treatment service
  • arbias – specialist services for people with acquired brain injury including alcohol and substance related brain impairment Tel. (03) 8388 1222
  • Family Drug Help – for information and support for people concerned about a relative or friend using drugs Tel. 1300 660 068

Things to remember

  • Alcohol has a toxic effect on the central nervous system and can cause significant brain impairment.
  • ARBI is more likely in people who drink heavily over a long period of time, but excessive binge drinkers are also at risk.
  • The symptoms depend on which part of the brain has been damaged, but can include problems with memory, thinking abilities and physical coordination.

  • Australian guidelines to reduce health risks from drinking alcohol, 2009, National Health and Medical Research Council. More information here.
  • Looking Forward – Acquired Brain Injury (4th Edition), 2011, arbias. More information here.
  • Fortune N, Wen X, The definition, incidence and prevalence of Acquired Brain Injury in Australia, AIHW Publications, Australian Institute of Health and Welfare, Canberra.

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Alcohol related brain impairment (2)

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Related information

  • Acquired brain injury The long-term effects of brain injury will be different for each person and can range from mild to profound.
  • Alcohol related brain impairment - memory loss If a person with alcohol related brain impairment is aware of their memory limits, they can learn how to deal with them.
  • Alcohol related brain impairment - support People with alcohol related brain impairment benefit when their life is organised and follows a good structure.
  • Amnesia Loss of memory can be temporary or permanent, but 'amnesia' usually refers to the temporary variety.
  • Epilepsy and Young People - Diagnosis (video) Epilepsy is the world's most common serious brain disorder and is characterised by a tendency to have recurrent seizures. Most seizures are spontaneous and brief yet self-limiting and can involve loss of consciousness, a range of unusual movements, odd feelings and sensations or changed behaviour.

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How do you know if you have brain damage from alcohol? ›

dementia-like symptoms, such as difficulties forming new memories. changes in mood or behavior. increased risk of developing Alzheimer's disease and Parkinson's disease. changes in blood flow patterns in the brain.

Does alcohol cause brain impairment? ›

People who have been drinking large amounts of alcohol for long periods of time run the risk of developing serious and persistent changes in the brain. Damage may be a result of the direct effects of alcohol on the brain or may result indirectly, from a poor general health status or from severe liver disease.

What are 4 impacts of alcohol on the brain? ›

Alcohol makes it harder for the brain areas controlling balance, memory, speech, and judgment to do their jobs, resulting in a higher likelihood of injuries and other negative outcomes. Long-term, heavy drinking causes alterations in the neurons, such as reductions in their size.

How long can someone live with Wernicke Korsakoff syndrome? ›

Korsakoff's syndrome dementia affects not just the brain, but also the cardiovascular and central nervous system. Once a person has been diagnosed with end stage alcoholism, life expectancy can be as limited as six months.

Does the brain repair itself after alcoholism? ›

Alcohol related brain damage and recovery. Studies into the effects of alcohol on the brain have shown that the brain is able to repair itself remarkably quickly after stopping drinking.

Is alcoholic dementia reversible? ›

At an early stage of the disease, problems may be reduced or reversed if the person abstains from alcohol, improves their diet and replace vitamins especially thiamine and vitamin B1. Thiamine is important to limit some of the toxic effects of alcohol, and is an important supplement for heavy drinkers.

What is the first thing that alcohol effects in the brain? ›

What is the First Brain Function Affected by Alcohol? The first area compromised is the Cerebral Cortex, which causes confusion and lowers inhibitions. For example, jokes start to seem funnier, and a user may be less afraid to talk to new people or do something outside of their comfort zone.

What is alcohol related dementia called? ›

While Wernicke-Korsakoff syndrome is sometimes referred to as alcoholic dementia or alcohol related dementia, it is caused by thiamine deficiency, rather than being a direct result of alcohol abuse. Wernicke's encephalopathy affects eye movement and vision, balance and coordination, and causes confusion.

What are Korsakoff symptoms? ›

Symptoms include mental confusion, vision problems, coma, hypothermia, low blood pressure, and lack of muscle coordination (ataxia). Korsakoff syndrome (also called Korsakoff's amnesic syndrome) is a memory disorder that results from vitamin B1 deficiency and is associated with alcoholism.

What is considered heavy drinking? ›

What do you mean by heavy drinking? For men, heavy drinking is typically defined as consuming 15 drinks or more per week. For women, heavy drinking is typically defined as consuming 8 drinks or more per week.

What happens if you drink alcohol everyday for a year? ›

Long-Term Health Risks. Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems including: High blood pressure, heart disease, stroke, liver disease, and digestive problems. Cancer of the breast, mouth, throat, esophagus, voice box, liver, colon, and rectum.

Does alcohol affect long term memory? ›

Alcohol primarily disrupts the ability to form new long–term memories; it causes less disruption of recall of previously established long–term memories or of the ability to keep new information active in short–term memory for a few seconds or more.

What is the first stage of Wernicke-Korsakoff syndrome? ›

Wernicke–Korsakoff syndrome has two separate stages. First there will be a brief time when a person has intense inflammation (swelling) of their brain. This is known as 'Wernicke's encephalopathy'. If this condition isn't treated quickly, the person may develop a more long-term condition called 'Korsakoff's syndrome'.

How much do you have to drink to get Korsakoff's? ›

A “significant” alcohol history, which includes an average of 35 drinks per week for men (28 for women), typically for 5 to 10 years or more. In order to obtain a reasonable diagnosis, 30 to 60 days should have transpired since the last exposure to alcohol.

Can a person fully recover from Korsakoff syndrome? ›

Available data suggest that about 25 percent of those who develop Korsakoff syndrome eventually recover, about half improve but don't recover completely, and about 25 percent remain unchanged. Some research suggests that those who recover from an episode may have a normal life expectancy if they abstain from alcohol.

What is the life expectancy of a recovered alcoholic? ›

The conclusion of the study was that people who have to be hospitalized because of the negative health effects of their alcoholism typically have an average life expectancy of 47 to 53 years for men and 50 to 58 years for women.

How long does it take for brain chemistry to return to normal after alcohol? ›

It takes at least two weeks for the brain to return to normal after drinking. Therefore, this is when the alcohol recovery timeline begins. It is less able to suppress a desire to drink until the brain has recovered. The reason for this is that alcohol has harmed the brain's cognitive function.

Is damage from drinking reversible? ›

Reversible Effects from Alcohol Abuse

Maintaining sobriety for 5-7 years is the peak time where reversible changes can occur. However, most change usually takes place in the first year. Any further damage due to alcohol abuse is retracted if one stops drinking. Still, many brain changes can't be eliminated.

What is the life expectancy of someone with alcohol dementia? ›

Alcoholic Dementia Life Expectancy

While there are no specific life expectancy projections for alcohol-related dementia in general, a study shows that the life expectancy for someone with Wernicke-Korsakoff Syndrome is eight years for 50% of people who have this form of alcohol-related brain damage.

What percentage of alcoholics get dementia? ›

Among those drinking >14 units/week, a 7 unit increase in alcohol consumption was associated with a 17% (95% confidence interval 4% to 32%) increase in risk of dementia.

How long does it take to get alcoholic dementia? ›

A clinical diagnosis of dementia at least 60 days after the last exposure to alcohol. Significant alcohol use as defined by a minimum average of 35 standard drinks per week for men (28 for women) for greater than a period of five years.

What part of the brain is affected most quickly by alcohol? ›

Alcohol then affects the frontal lobe and parietal lobe, slowing your reaction time to sensory information. The cerebellum controls your balance and coordination.

What 3 parts of the brain are affected by alcohol? ›

Areas of the brain that are especially vulnerable to alcoholism–related damage are the cerebral cortex and subcortical areas such as the limbic system (important for feeling and expressing emotions), the thalamus (important for communication within the brain), the hypothalamus (which releases hormones in response to ...

How many drinks per week is considered an alcoholic? ›

For men, consuming more than 4 drinks on any day or more than 14 drinks per week. For women, consuming more than 3 drinks on any day or more than 7 drinks per week.

What are the three clinical features of alcohol related dementia? ›

The person may have memory loss and difficulty thinking things through. They may have problems with more complex tasks, such as managing their finances. The symptoms may cause problems with daily life. For example, the person may no longer be able to cook a meal.

What is the usual age range of onset for Korsakoff syndrome? ›

Like more common types of dementia, it may be underdiagnosed. The disorder affects slightly more males than females, and is evenly distributed between ages 30 and 70.

How long does it take to develop Wernicke-Korsakoff syndrome? ›

Affected individuals may not display all three symptoms. Confusion and disorientation associated with Wernicke syndrome develops over a few days or weeks and is the main problem associated with the disorder. It is an acute syndrome precipitated by thiamine deficiency.

Does Korsakoff show on MRI? ›

Findings on magnetic resonance imaging of the brain (Figure) were consistent with previously undiagnosed Korsakoff syndrome.

What is the difference between Wernicke and Korsakoff? ›

Wernicke encephalopathy causes brain damage in lower parts of the brain called the thalamus and hypothalamus. Korsakoff psychosis results from permanent damage to areas of the brain involved with memory.

How do you reverse Korsakoff syndrome? ›

Korsakoff syndrome typically can't be reversed. In serious cases, it can cause brain damage and lead to problems with memory and your walk that don't go away.

Is a bottle of wine a day too much? ›

Drinking a bottle of wine per day is not considered healthy by most standards. However, when does it morph from a regular, innocent occurrence into alcohol use disorder (AUD) or alcoholism? First, it's important to note that building tolerance in order to drink an entire bottle of wine is a definitive red flag.

Can you be a heavy drinker and not an alcoholic? ›

Nine in 10 adults who drink too much alcohol are not alcoholics or alcohol dependent, according to a new study released by the Centers for Disease Control and Prevention in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA).

What is the healthiest alcohol? ›

However, if you are going to drink, having red wine in moderation is a healthier choice than other alcoholic drinks. This is due to its high levels of antioxidants called polyphenols, which have been linked to better heart and gut health.

What alcohol does to your body after 40? ›

Drinking too much alcohol over a long time can: Lead to some kinds of cancer, liver damage, immune system disorders, and brain damage. Worsen some health conditions such as osteoporosis, diabetes, high blood pressure, stroke, ulcers, memory loss, and mood disorders.

How much do alcoholics drink a day? ›

Alcoholics generally drink excessively, often much more than four drinks per day and in a manner they can't control.

Is it normal to drink every night? ›

"While there are a number of variables, typically having a drink every night does not necessarily equate to alcohol use disorder, but it can increase the risk of developing alcohol-related health problems," Lawrence Weinstein, MD, Chief Medical Officer at American Addiction Centers tells WebMD Connect to Care.

Why can't I remember things after drinking? ›

Alcohol-related blackouts are gaps in a person's memory for events that occurred while they were intoxicated. These gaps happen when a person drinks enough alcohol to temporarily block the transfer of memories from short-term to long-term storage—known as memory consolidation—in a brain area called the hippocampus.

Can alcohol cause permanent memory loss? ›

How Alcohol Is Linked to Memory Loss. Whether it's over one night or several years, heavy alcohol use can lead to lapses in memory. This may include difficulty recalling recent events or even an entire night. It can also lead to permanent memory loss, described as dementia.

Do alcoholics lose their memory? ›

Chronic alcohol use can lead to permanent brain damage and memory impairments. Alcohol-related dementia is a condition caused by long-term heavy alcohol use. People with this condition experience memory loss and difficulty forming new memories.

What is the life expectancy for Wernicke Korsakoff? ›

Korsakoff's syndrome dementia affects not just the brain, but also the cardiovascular and central nervous system. Once a person has been diagnosed with end stage alcoholism, life expectancy can be as limited as six months.

Who is most likely to get Wernicke-Korsakoff syndrome? ›

Wernicke-Korsakoff syndrome affects more men than women, usually between ages 30 and 70 years. Most alcohol-related cases of WKS involve men and those over age 40. Women and people who are younger are more likely to develop the syndrome due to other causes (aside from alcohol).

What is the mortality rate for Wernicke-Korsakoff syndrome? ›

Mortality usually occurs secondary to infections and hepatic failure, but some deaths are attributable to defects of prolonged thiamine deficiency. The mortality rate is 10% to 15% in severe cases. Prognosis depends on the stage of disease at presentation and time of treatment.

What does wet brain feel like? ›

The first component of WKS is Wernicke's encephalopathy (WE), which is a short-term neurological disorder. The three hallmark signs of WE include mental confusion and apathy, loss of muscular coordination while standing or walking, and eye movement dysfunction and vision disturbances.

What signs indicate that someone has had too much to drink? ›

7 Signs That Someone Has Had Too Much to Drink
  • Flushed Face. ...
  • Over Exaggerated Emotions. ...
  • Acting Strangely. ...
  • Aggression. ...
  • Lack of Safety. ...
  • Lack of Body Control. ...
  • Throwing Up. ...
  • For help regarding alcoholism.
24 Oct 2016

What is the most common cause of Korsakoff syndrome? ›

Korsakoff's syndrome is a disorder that primarily affects the memory system in the brain. It usually results from a deficiency of thiamine (vitamin B1), which may be caused by alcohol abuse, dietary deficiencies, prolonged vomiting, eating disorders, or the effects of chemotherapy.

What type of memory loss goes along with Korsakoff's syndrome? ›

A profound anterograde memory deficit for information, regardless of the nature of the material, is the hallmark of Korsakoff syndrome, an amnesic condition resulting from severe thiamine (vitamin B1) deficiency.

How does Korsakoff progress? ›

Korsakoff's syndrome

It usually develops gradually. Brain damage occurs in areas of the brain important for short-term memory. The main symptom is memory loss – particularly of events occurring after the onset of the condition. Sometimes, memories of the more distant past can also be affected.

How much do you have to drink to damage your brain? ›

Those who had the equivalent of four or more drinks a day had almost six times the risk of hippocampal shrinkage as did nondrinkers, while moderate drinkers had three times the risk.

How long after drinking does your brain heal? ›

It takes at least two weeks for the brain to return to normal after drinking. Therefore, this is when the alcohol recovery timeline begins. It is less able to suppress a desire to drink until the brain has recovered. The reason for this is that alcohol has harmed the brain's cognitive function.

How much does your IQ drop when drunk? ›

Nevertheless, alcohol-related disorders were associated with a decline in IQ test scores between −4 IQ points (self-reported treatment for alcohol problems) and −5 IQ points (alcohol-related hospital diagnoses), corresponding to between ¼ and ⅓ of the standard deviation of 15, which underlines the importance of our ...


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