Writer: Kiana Danesh Manesh
Editor: Isabella Io
“Do you wanna do shots?” may be a common phrase if you’re a teenager going through high school, and you may have even given in to escape from the immense peer pressure you felt during the moment. You don't want to ‘ruin’ the vibe, do you? Although underage drinking is steadily declining year by year, in America, over 12 million men and women aged 12-20 still partake in underage drinking. Worldwide, the WHO (World Health Organization) concluded England has the highest rates of underage drinking. [10]
Taking data from each country in Europe, Central Asia, and Canada, children were asked about their cigarette, drinking, vaping, and drug habits. England had a shocking result, with over a quarter of boys and a third of the girls reporting they had been drunk by the age of 15. [13] Alcohol affects each lobe of the brain, causing blurred vision, slurred speech, poor memory, and other symptoms impairing cognitive function [9]. But how many drinks does one have to consume before the brain’s cognitive function is stunted forever? Does it even matter in the long run? Was the law made to be broken?
How does alcohol work?
If we want to understand how alcohol affects cognitive development, we first must understand its mechanisms of action, and how these feelings of uncontrollable excitement, happiness, and sadness come about. Alcohol (or ethanol C2H5OH), is a widely used psychoactive substance that is absorbed through the stomach and/or small intestine, where it is then distributed throughout the water in the body. This distribution allows the brain, heart, and muscles to have the same amount of alcohol concentration as the blood, the liver is an exception to this rule, as it receives higher amounts of ethanol due to the blood being taken directly from the stomach. [12] As the ethanol travels from the stomach and intestine to the bloodstream, the liver begins breaking it down to eliminate it. This process is important, as it determines the amount of alcohol that reaches the brain. The liver begins to metabolize the ethanol and uses two enzymes to do so, alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). The majority of the Ethanol is broken down into a carcinogen called acetaldehyde (CH3CHO) by ADH, a toxic compound that poses the potential to cause harm - despite only remaining in the body for a short amount of time. It is broken down into an acute toxic compound, acetate, by ALDH. [11] The alcohol then reaches your brain in just 5 minutes, where it then inhibits your GABA and glutamate receptors. [15] These two receptors are opposites and work together as an “on” and “off” switch in your brain. GABA (gamma-aminobutyric acid) is the head inhibitory neurotransmitter in the brain, blocking chemical messages being passed on from one nerve cell to another. Glutamate, being the exact opposite, is the main excitatory neurotransmitter in the brain. Which allows messages to be passed on from nerve cell to nerve cell. [3] When these two receptors are meddled, the communication pathways in the brain are disturbed and slowed, causing a loss of control over your balance, speech, memory, and judgment. Which increases the risk of injury and death. Ethanol then targets and stimulates receptors that release dopamine, which is why feelings of euphoria and pleasure come about, and why individuals get hooked. [9]
So, what happens when alcohol enters the mind of a carefree adolescent looking to have fun? Let's find out.
Alcohol's Impact
Your teenage years are one of the most integral moments for brain development as the prefrontal cortex and the limbic system are still developing and maturing. The prefrontal cortex is responsible for your decision-making and cognitive control, such as regulating your emotions, thoughts, and behavior. The prefrontal cortex continues to mature and develop up until early adulthood, which explains why teenagers tend to have poor judgment and lack of impulse control. [8] The limbic system, more specifically the amygdala, and hypothalamus, are in charge of our emotions and emotional responses. The amygdala is extremely vital to processing your emotions, helping link your emotions with things such as memory, learning, and senses. It is also responsible for triggering your ‘flight or fight’ response. [5] The hypothalamus, while regulating your emotions, deals with your sex drive, body temperature, hormone release, and blood pressure. [2] During your adolescent years, the limbic system matures and increases in sensitivity. For example, your limbic system will be extremely sensitive and responsive to social rejection and peer pressure, which may be a great fear when you’re at a party and refuse to drink. You’re terrified you will be shunned, so you are more likely to give in. When these two are paired in a social setting such as parties, it explains why teenagers seem to be impulsive, rebellious, and risk-taking. It is all a result of your brain development which is vital for adulthood.
Teenagers are at a higher risk of substance abuse, and many turn to heavy drinking without realizing it due to early onset alcohol use. Alcohol affects not only your neuropsychological performance but also your brain structure. [9] In a study by Brown et al, 33 alcohol-dependent teenagers in treatment who ranged from 15 to 16 years old, were put to the test against a control group of teenagers who had never had alcohol. The researchers tested their memory, attention, visuospatial skills (how you understand visual things around you), abstract reasoning, and planning. After 3 weeks of sobriety, both groups underwent neuropsychological testing. The results showed that the control group performed better on verbal and nonverbal memory and that alcohol withdrawal impacted their ability to perform well on visuospatial tests. Concluding that alcohol misuse and dependence harms brain function in early to middle adolescence. [1] Another concerning consequence is grey matter reduction and stunted white matter growth. Chronic misuse of the drug, during vital stages of your brain development, leads to a rapid loss of brain tissue and neurons. In addition to also affecting information being passed around in the brain. This is a negative change in brain structure, which affects brain development. Grey and white matter reduction is worrying, as their function in the brain is crucial, grey matter indicates a large concentration of neurons playing a role in our cognitive processing and emotional regulation. When grey matter is reduced, nerve cells die, which in turn causes cognitive impairment that cannot be reversed. [4] White matter refers to a large concentration of axons that helps information travel in the brain. When the white matter is damaged, communication between neuron cells is disrupted. [7]
Conclusion
In summary, we've learned that over 12 million boys and girls in the U.S. have reported participating in underage drinking, and England is leading in teenagers and pre-teens drinking in the world according to the WHO. We understood that these young care-free teens get their risk-taking and rebellious behavior from their brain development, with their prefrontal cortex still developing up until their young adult years, and their limbic system which continues to mature. When a teen does decide to take a few shots, the alcohol makes its way to the brain where it then binds and inhibits your GABA and glutamate receptors, causing the communication in your brain to be disrupted. While it all may be ‘harmless’ fun at the moment, teenagers pose a higher risk of substance abuse, and there is a possibility that you may become addicted to the feeling, which would cause you to become a chronic user. Individuals who partake in such heavy drinking at a young age, have been shown to perform worse during neuropsychological tests, indicating a negative impact on brain function. What is even more concerning is that grey and white matter is reduced, showcasing a loss of neuron cells. So, before you decide to pour yourself another drink at a party - think again (for the sake of your brain cells).
Sources & Works Cited
[1] Brown, S. A., Tapert, S. F., Granholm, E., & Delis, D. C. (2000). Neurocognitive functioning of adolescents: effects of protracted alcohol use. Alcoholism, Clinical and Experimental Research, 24(2), 164–171. https://pubmed.ncbi.nlm.nih.gov/10698367/
[2] Cleveland Clinic. (2022a, March 16). Hypothalamus: What It Is, Function, Conditions & Disorders. Cleveland Clinic. https://my.clevelandclinic.org/health/body/22566-hypothalamus
[3] Cleveland Clinic. (2022b, April 25). Gamma-Aminobutyric acid (GABA). Cleveland Clinic. https://my.clevelandclinic.org/health/articles/22857-gamma-aminobutyric-acid-gaba
[4] Cleveland Clinic. (2023a, March 19). Grey matter. Cleveland Clinic. https://my.clevelandclinic.org/health/body/24831-grey-matter
[5] Cleveland Clinic. (2023b, April 11). The amygdala: A small part of your brain’s biggest abilities. Cleveland Clinic. https://my.clevelandclinic.org/health/body/24894-amygdala
[6] Heikkinen, N., Niskanen, E., Könönen, M., Tolmunen, T., Kekkonen, V., Kivimäki, P., Tanila, H., Laukkanen, E., & Vanninen, R. (2017). Alcohol consumption during adolescence is associated with reduced grey matter volumes. Addiction, 112(4), 604–613. https://doi.org/10.1111/add.13697
[7] Hydrochephalus Association. (2022, January 15). Grey Matter Brain Damage | White vs. Grey Matter Injury. Www.hydroassoc.org. https://www.hydroassoc.org/grey-matter-brain-damage/
[8] Lumen Learning. (n.d.). Brain Development During Adolescence | Lifespan Development. Courses.lumenlearning.com. https://courses.lumenlearning.com/wm-lifespandevelopment/chapter/brain-development-during-adolescence/#:~:text=During%20adolescence%2C%20myelination%20and%20synaptic
[9] National Institute on Alcohol Abuse and Alcoholism. (2022). Alcohol and the Brain: An Overview | National Institute on Alcohol Abuse and Alcoholism (NIAAA). Www.niaaa.nih.gov. https://www.niaaa.nih.gov/publications/alcohol-and-brain-overview#:~:text=Alcohol%20interferes%20with%20the%20brain%27s
[10] National Institute on Alcohol Abuse and Alcoholism. (2023). Underage Drinking in the United States (ages 12 to 20) | National Institute on Alcohol Abuse and Alcoholism (NIAAA). Www.niaaa.nih.gov. https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/alcohol-facts-and-statistics/underage-drinking-united-states-ages-12-20
[11] National institute on Alcohol Abuse and Alcoholism. (2022, May). Alcohol Metabolism | National Institute on Alcohol Abuse and Alcoholism (NIAAA). Www.niaaa.nih.gov. https://www.niaaa.nih.gov/publications/alcohol-metabolism#:~:text=The%20Chemical%20Breakdown%20of%20Alcohol
[12] Paton, A. (2005). Alcohol in the Body. BMJ, 330(7482), 85–87. https://doi.org/10.1136/bmj.330.7482.85
[13] Roxby, P., & Bailey, E. (2024, April 25). England child alcohol use tops global chart, finds WHO report. https://www.bbc.com/news/health-68884005
[14] Tapert, S. F., Caldwell, L., & Burke, C. (2004). Alcohol and the Adolescent Brain. Alcohol Research & Health, 28(4), 205–212. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6601673/
[15] The Scripps research institute . (2019). The Effects of Alcohol on the Brain. Scripps.edu. https://www.scripps.edu/newsandviews/e_20020225/koob2.html
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