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Alcohol Facts

Depressant; Alcohol; GABA-A receptor positive allosteric modulator

Description

Alcohol (ethanol) — booze, liquor, spirits — is a depressant of the alcohol class. It amplifies the brain's main calming signal and blocks its main excitatory signal, broadly suppressing nervous system activity.[1][2]

Subjective effects include euphoria, loosened inhibition, enhanced sociability, anxiety relief, sedation, and impaired coordination. The experience follows a biphasic arc — rising blood alcohol brings warmth and social ease, while the descending phase brings heaviness, cognitive dulling, and emotional flatness.

Alcohol produces severe physical dependence, and withdrawal can include seizures and life-threatening delirium without medical management.[3] Chronic use damages the liver and brain, and acetaldehyde — alcohol's main breakdown product — is a confirmed carcinogen linked to cancers of the esophagus, liver, and breast.[4]

Dose and durationby route · individual sensitivity varies

Oral(g)
Threshold< 10 gLight10 – 20 gCommon20 – 30 gStrong30 – 40 gHeavy40+ g

Starts in 2 – 5 minLasts 1.5 – 5 hoursAfter-effects 6 – 48 hours

Body and dependence

Acute toxicity
Critical
Chronic toxicity
Critical
Physical dependence
High
Psychological dependence
High
Withdrawal
Life-threatening · fatal · medical supervision
Compulsive redosing
High

Tolerance

Builds
Moderate
Fully resets after
10.5 days
Carries over to
Benzodiazepines; Barbiturates; GHB; Other GABA-A positive allosteric modulators

Effectslikely at a common dose

Perception
Proprioceptive distortion; Spatial disorientation; Vestibular distortion; +17 possible, including Visual acuity suppression, Double vision
Body
Sedation; Muscle relaxation; Motor control impairment; Dehydration sensation; Increased urination; Dizziness; +25 possible, including Nausea, Headache, Temperature dysregulation
Thinking
Analysis suppression; Information processing suppression; Memory suppression; Thought deceleration; Cognitive impairment; Focus suppression; Decision impairment; +16 possible, including Language suppression, Thought disorganization, Confusion
Feeling
Anxiety suppression; Emotional enhancement; +8 possible, including Emotional lability, Anxiety, Depression
Self
Disinhibition; +8 possible, including Ego inflation, Communication suppression, Craving
Time
none likely · 2 possible, including Temporal disorientation
Awareness
none likely · 1 possible

Who shouldn't take it

Absolute
Concurrent opioid use; Concurrent benzodiazepine use; Concurrent GHB/GBL use; Hepatic cirrhosis / severe liver disease; Disulfiram therapy; Pregnancy (any amount); Operating vehicles or machinery
Relative
Seizure history / epilepsy; History of alcohol use disorder; Major depression, bipolar disorder, anxiety disorders; Hepatitis B or C co-infection; Concurrent acetaminophen in heavy drinkers; ALDH2*2 carriers (ALDH2 deficiency)

Combinations66 recorded

Lethal (9)
2-Fluorodeschloroketamine; Baclofen; Buprenorphine; GHB, GBL; Kratom; MAOIs; Methoxetamine; Opioids; Tramadol
Dangerous (34)
Anticholinergics; Antipsychotics; Atypical antipsychotics; Benzodiazepines; Buprenorphine, Kratom; Caffeine; Cannabis, THC; Clonidine, Guanfacine; Ephedrine, Pseudoephedrine; Gabapentin, Pregabalin; GHB, Baclofen; MDMA, Amphetamines; MDMA, MDA; Naltrexone; NDRIs (Wellbutrin); NSAIDs; Stimulants; THC; 5-HTP, Tryptophan; Alpha-2 adrenergic receptor antagonist; Antihistamines; Dopamine agonists; Ibogaine; Ketamine, DXM, PCP; and 10 more, see full page
Caution (18)
See full page: psychedex.org/substances/alcohol
Not graded (5)
Not listed never means safe.

Seek help immediately if

  • Extreme drowsiness — can't stay awake or be roused
  • Confusion, slurred speech, severe loss of coordination
  • Slow, shallow, or irregular breathing
  • Unconsciousness / unresponsive; limp, floppy body
  • Blue lips or fingertips
  • Vomiting while sedated (choking / aspiration risk)
  • Cold, clammy skin; weak pulse

What to do

  1. Try to wake them — shout, firm sternal rub
  2. If unresponsive or breathing is impaired, call emergency services
  3. Place them in the recovery position — critical, they can choke on vomit
  4. Monitor breathing continuously; be ready to give rescue breaths / CPR
  5. Never leave them alone to "sleep it off"
  6. Do not give other drugs, stimulants, or more depressants

Most depressant overdoses resolve with airway protection, breathing support, and monitoring. The danger is respiratory depression and choking on vomit — sharply worse when combined with opioids or alcohol. GHB/GBL overdoses often involve sudden deep unconsciousness and may self-resolve, but airway protection is essential.

988 Suicide & Crisis LifelineFireside Project: 62-FIRESIDE

Version r1 · Not medical advice

References

  1. [1]
    ^Morris TM, Henderson AS, Melton SM, et al. (2025) Attenuation of the discriminative stimulus and reinforcing effects of positive GABA-A modulators after Shisa7 knockdown in rats — Journal of Pharmacology and Experimental Therapeutics doi:10.1016/j.jpet.2025.103761
  2. [2]
    ^Lovinger DM, White G, Weight FF (1989) Ethanol inhibits NMDA-activated ion current in hippocampal neurons — Science PMID:2467382
  3. [3]
    ^Desai HR, Hyland JS, Paulos E, et al. (2024) Review of Attributes and Outcomes of Hospitalized Patients with Alcohol Withdrawal — Journal of community hospital internal medicine perspectives doi:10.55729/2000-9666.1420
  4. [4]
    ^Vijayraghavan S, Porcher L, Mieczkowski PA, Saini N (2022) Acetaldehyde makes a distinct mutation signature in single-stranded DNA — Nucleic acids research doi:10.1093/nar/gkac570
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