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Is alcohol a drug?

Answered by Dr. David Zoeller M.D. 0

Yes, alcohol is a drug as defined by the Merriam-Webster dictionary and in medical terminology. (EtOH is the medical abbreviation). It is not, however, a controlled substance according to the FDA.

While it’s not illegal for those who are of age, alcohol can cause dependence and addiction, habituation, and its use has a clear impact on brain health.

Page Topics
Why is alcohol a drug? | Is alcohol a psychoactive drug? | Is alcohol a gateway drug? | | Does alcohol affect mental health? | Does alcohol show on a drug test?

Why is alcohol considered a drug?

Alcohol is considered a drug because it meets the following criteria:

  • It causes changes in consciousness when consumed
  • It can lead to addiction
  • Frequent use causes tolerance

Our culture is much more accepting of alcohol compared to other substances, but that doesn’t mean that it is any safer or less addictive.

Is alcohol a psychoactive drug?

Yes. Psychoactive drugs are substances that act on the brain and produce changes in mood, awareness, thoughts, feelings, or behavior. Alcohol can impact all five.

  • Mood: Because alcohol is a depressant with temporary stimulant effects, it can cause mood swings.
  • Awareness: When alcohol interacts with the brain, it changes consciousness and how aware someone is of their surroundings.
  • Thoughts: Since alcohol can lower inhibitions and produce depressant effects, people that drink often have thoughts they otherwise would not have, including suicidal ideations.
  • Feelings: Alcohol can cause mood swings or feelings of extreme highs and lows.
  • Behavior: Alcohol lowers inhibitions and can cause out-of-character behavior.

Alcohol affects several brain regions:

(See addiction and the brain and wet brain syndrome articles).

Is alcohol a gateway drug?

Alcohol can be a gateway to other substances. This doesn’t mean that everyone who drinks will develop an addiction to harder substances, nor does it mean that everyone who drinks becomes an alcoholic. But the fact is, many people who have other addictions started with alcohol.

The evidence isn’t just anecdotal. Research shows that alcohol is a gateway drug.

Some risk factors of developing alcoholism increase the risk of alcohol as a gateway drug include:

  • Aggressive behavior, especially in early childhood
  • Lack of support at home and amongst friends
  • A family history of substance abuse
  • Easy access to drugs
  • Lack of resources

Does alcohol affect mental health?

Absolutely. Many people drink to take the edge off, but alcohol makes anxiety and depression symptoms worse in the long-term. More severe and more damaging effects tend to happen after years of frequent and heavy use.

Alcohol-related mental health conditions include:

  • Major depression
  • Panic disorder
  • Schizophrenia
  • Bipolar disorder
  • Post-traumatic stress disorder

People who have mental health disorders as pre-existing conditions tend to get worse while drinking.

(For more on how alcohol impacts physical health, see does alcohol raise blood pressure and signs of liver damage from alcohol questions).

Which happens first: mental health issues or alcohol abuse?

Pre-existing mental health issues can fuel alcohol abuse. Many people with mental health struggles will self-medicate with alcohol. Over time, this turns to dependence and then addiction.

It also works the other way. Abusing alcohol makes people depressed and anxious, which can cause mental health issues to develop. Most of the time these symptoms will get better after the individual stops drinking, but some people will need further treatment.

Part of the treatment for alcoholism is looking at these connections in each patient and addressing how they affect one another.

Alcohol and Mental Health Disorders

Is alcohol considered a drug on a drug test?

Standard drug tests do not look for alcohol because they are meant to look for illegal substances. However, alcohol can be added on.

When Alcohol is Included on a Drug Test

  • Employment screenings of jobs like machine operators, pilots or those in healthcare, (especially those working in alcohol addiction treatment).
  • Employment screenings if alcohol if suspected or as part of a randomized safety program.
  • Many probation tests, especially for alcohol-related offenses like D.U.I.
  • Alcohol addiction recovery programs like sober living or IOP.
  • When drinking plays into a crime, such as driving while intoxicated (usually a blood test is used instead of the standard urine tests).

Alcohol use is not typically a barrier to employment, against the conditions of parole or a factor in custody agreements.

Plus, alcohol clears the body quickly and can only be detected for 2-3 days.

Being worried about your drinking being “caught” is a sign of addiction.

If you need help with alcohol, learn more about the top two alcohol rehabs in the country > Tennessee alcohol rehab and Kentucky alcohol rehab. (National ratings published here).

JourneyPure.com doctors follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, count records, academic organizations, highly regarded nonprofit organizations, government reports and their own expertise with decades in the fields and their own personal recovery.

  • Crum, R. M., Mojtabai, R., Lazareck, S., Bolton, J. M., Robinson, J., Sareen, J., Green, K. M., Stuart, E. A., La Flair, L., Alvanzo, A. A., & Storr, C. L. (2013). A prospective assessment of reports of drinking to self-medicate mood symptoms with the incidence and persistence of alcohol dependence. JAMA psychiatry, 70(7), 718–726. https://doi.org/10.1001/jamapsychiatry.2013.1098

    Kirby, T., & Barry, A. E. (2012). Alcohol as a gateway drug: a study of US 12th graders. The Journal of school health, 82(8), 371–379. https://doi.org/10.1111/j.1746-1561.2012.00712.x

    NIAAA. (2004). Alcohol Alert. Alcohol Alert, (63). Retrieved February 4, 2021, from https://pubs.niaaa.nih.gov/publications/aa63/aa63.htm#:~:text=Difficulty walking, blurred vision, slurred,quickly resolve when drinking stops

    Niaaa.nih.gov. 2020. Alcohol Facts and Statistics | National Institute on Alcohol Abuse and Alcoholism (NIAAA). [online] Available at: <https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics> [Accessed 4 February 2021].

    NIDA. 2020, May 25. What are risk factors and protective factors?. Retrieved from https://www.drugabuse.gov/publications/preventing-drug-use-among-children-adolescents/chapter-1-risk-factors-protective-factors/what-are-risk-factors on 2021, February 4

    Parsons O.A. (1975) Brain Damage in Alcoholics: Altered States of Unconsciousness. In: Gross M.M. (eds) Alcohol Intoxication and Withdrawal. Advances in Experimental Medicine and Biology, vol 59. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-0632-1_40

    Rosenbloom, M., Sullivan, E. V., & Pfefferbaum, A. (2004). Using Magnetic Resonance Imaging and Diffusion Tensor Imaging to Assess Brain Damage in Alcoholics. National Institute on Alcohol Abuse and Alcoholism. Retrieved from https://pubs.niaaa.nih.gov/publications/arh27-2/146-152.htm

    Sayette M. A. (2017). The effects of alcohol on emotion in social drinkers. Behaviour research and therapy, 88, 76–89. https://doi.org/10.1016/j.brat.2016.06.005

    Shivani, R., MD, Goldsmith, J., MD, & Anthenelli, R. M., MD. (2002). Alcoholism and Psychiatric Disorders. Retrieved February 4, 2021, from https://www.niaaa.nih.gov/

Disclaimer

All content is for informational purposes only. No material on this site, whether from our doctors or the community, is a substitute for seeking personalized professional medical advice, diagnosis or treatment. Never disregard advice from a qualified healthcare professional or delay seeking advice because of something you read on this website.

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Written By

Dr. David Zoeller M.D.

Medical Director

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Dr. Zoeller has been practicing internal medicine for more than 30 years with a special interest in brain and addiction science. He is a Diplomate of the American Board of Pain Medicine and certified in addiction medicine by the American Board of Preventive Medicine. After starting his career as a Chemical Engineer at IBM, Dr. Zoeller graduated from the Louisville School of Medicine. He currently serves as an associate professor at the University of Kentucky, the University of Louisville and Vanderbilt University.

  • Medical executive at JourneyPure, a nationally-recognized drug & alcohol treatment center with locations across the country
  • 30 years as a medical doctor
  • Certified in addiction medicine by the American Board of Preventive Medicine
  • Diplomate of the American Board of Pain Medicine
  • Associate professor at the University of Kentucky, the University of Louisville and Vanderbilt University
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