Is alcohol a drug?

Yes, alcohol is a drug as defined by the Merriam-Webster and medical terminology. 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.

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

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:

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.

Is there a connection between alcohol and mental health issues?

Yes, the two are connected in multiple ways. Part of treating alcohol use disorder is looking at these connections in each patient and addressing how they affect one another.

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.

Alcohol and Mental Health Disorders

Is alcohol considered a drug on a drug test?

Standard drug tests typically do not look for the presence of alcohol. This is because they are meant to look for illegal substances that would be a barrier to employment, against the conditions of parole, or impact legal situations such as custody agreements.

Additionally, alcohol tends to clear the body faster than other substances. As a result, there is a smaller window for testing.

Is there a drug test for alcohol?

Labs can measure blood-alcohol levels with a blood test.

  • This test is often used in cases where drinking plays into a crime, such as driving while intoxicated.
  • This test is unlikely to be used in pre-employment screenings.
    • But, certain jobs may check whether an employee has been drinking if they have a reason to be suspicious or as part of a randomized safety program.

Sources

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: [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/

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