- Alcohol, also known as ethanol or ethyl alcohol, is a highly addictive, dependence-producing, and toxic substance.
- It is a part of many social cultures, and in these circumstances, it may not be easy to see the innumerable health and social problems caused by excessive drinking.
- Alcohol use accounts for 3.1 million deaths every year and causes many health-related issues.
Alcohol, also known as ethanol or ethyl alcohol, is a highly addictive, dependence-producing, and toxic substance. It is a part of many social cultures, and in these circumstances, it may not be easy to see the innumerable health and social problems caused by excessive drinking. Alcohol use accounts for 3.1 million deaths every year and causes many health-related issues. About 5% of the disease burden in the world is due to alcohol-related health problems.
Alcohol can affect different people differently. According to the center for Disease Control, moderate drinking is described as one or fewer drinks per day for females and two or fewer drinks for men. Initially, alcohol dulls anxiety, producing a sense of relaxation. However, with more consumption, patients start feeling agitated or aggressive. Social disinhibition may occur. Some common symptoms of alcohol consumption are:
- Loss of social inhibition
- Incoordination or ataxic gait
- Slurring of speech
- Reduced reaction time
- Impaired judgment
- Euphoria
- Aggression
Chronic use may lead to loss of neurons or brain cells and produce degeneration of the cerebellum, nerve damage, and memory problems. It may lead to a syndrome called Wernicke-Korsakoff syndrome, which produces irreversible changes in the brain.
People who habitually consume alcohol for an extended period of time may experience withdrawal symptoms if they discontinue alcohol immediately. Some of these symptoms include
- Nausea
- Shaking
- Anxiety
- Tremors
- Seizures
- Hallucinations
- Extreme agitation
- Fever
If you experience any of these symptoms, please seek professional help and consult a physician at once.
Chronic heavy consumption of alcohol increases the risk of health problems. These range from a spectrum of alcoholic hepatitis to cirrhosis of the liver. It also increases the chances of liver,
stomach, pancreas, and esophagus cancer. Some people are liable to be at a greater risk of developing these complications. It is believed that the way the body metabolizes alcohol can vary from individual to individual, and this way accounts for the difference in risks between different people. However, the body can utilize a set amount of alcohol per hour. According to studies, after consuming one alcoholic drink on an empty stomach, the blood alcohol levels return to zero after 2 hours, and this value increases to 7 hours after 4 to 5 drinks. It clearly illustrates that the body can break down or metabolize a fixed amount of alcohol per hour. (source: WHO, 2024)
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Once alcohol is ingested, it is quickly absorbed in the bloodstream and is distributed to all body tissues. It can even cross the placenta in pregnant women and can affect the fetus. Thus women who drink heavily during pregnancy may deliver babies with fetal alcohol syndrome. It is mainly metabolized by the liver through the action of enzymes. Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are the two significant enzymes that break down the alcohol molecule into acetaldehyde. Acetaldehyde is potentially carcinogenic and is responsible for causing liver and other tumors. It is quickly converted into acetate and is removed from the body. Small amounts are eliminated in the urine and are converted into vapor and expelled through our breathing. This forms the basis of the alcohol breath test.
Acetaldehyde
Acetaldehyde is a cancer-causing substance and reacts with our body’s DNA to produce cancer-promoting compounds. Moreover, it damages our cells and prevents the body from repairing the damaged cells. It has been implicated in liver and stomach cancer. Researchers show that it also increases the risk of oropharyngeal cancer (cancer of the mouth and pharynx) through its local action. Other cancers in which acetaldehyde is a likely culprit include voice box (larynx), breast, rectum, stomach, colon, and mouth.
Alcohol metabolism depends on a variety of factors. Some of these include:
- Gender
- Bodyweight
- General health
- Relationship with food intake
- Genetics
- Binge drinking versus slowly sipping alcohol
- Drugs
- Age
Gender: (source: NIAAA, 2024a)
Although alcohol metabolism is weight dependent, gender also plays a very significant role. When body weights are the same, alcohol levels are approximately 25% higher in women compared to men. Women develop alcohol-related liver cirrhosis, heart failure (alcoholic dilated cardiomyopathy), and nerve damage after fewer years of drinking than men. This is because of decreased gastric metabolism of alcohol in women. They are also inclined to develop memory problems earlier than their male counterparts.
Bodyweight:
Alcohol metabolism is directly proportional to body weight. It determines the body space through which alcohol can diffuse through the body. A person weighing 200 lbs will have a lower blood alcohol concentration compared to a person weighing 120 lbs. In an average 70 kg man, the body removes alcohol at the rate of 140-210 daily, which is roughly equivalent to 7g or one drink per hour.
General Health:
Alcohol metabolism also depends on the general health of the individual. In individuals with liver damage, alcohol may not be metabolized as rapidly.
Relationship with food intake:
Alcohol intake is also dependent on food intake. Drinking alcohol in a fasting state irritates the gastric mucosal line, and it is absorbed more quickly into the system. Eating food, especially protein-rich food, delays the absorption of alcohol. So drinking on an empty stomach is not recommended. (source: MedlinePlus, 2024)
Genetics:
Genetics plays an essential role in how we metabolize alcohol. Variability in the genes that produce ADH and ALDH enzymes plays a significant role in metabolizing alcohol and may account for the risk differences in different people.
Binge drinking:
Binge drinking has been defined as consuming five or more drinks in about 2 hours for men or four or more drinks for women. This greatly overtaxed the capacity of the liver to metabolize alcohol as opposed to individuals who slowly sip their drinks.
Drugs:
Drugs can affect the metabolism of the liver. Some medications like medicines for epilepsy or seizures and over-the-counter medicines like acetaminophen all interact with alcohol and produce alterations in alcohol metabolism. Other medicines include Xanax and other anxiolytics, some drugs used to treat diabetes, and medications used to treat common colds. Even drinking a small amount of alcohol in these people may prove to be dangerous. (source: NHS, 2022)
Age:
Older people can metabolize alcohol slowly as compared to younger ones. This, coupled with an increased incidence of diseases and medications in the elderly, make them metabolize alcohol much more slowly than younger people.
When consumed on an early stomach, the effects of alcohol occur immediately. It is rapidly absorbed into the bloodstream and produces euphoria and central nervous system depression.
It alters the perception of pain and other sensations. It has a half-life of 4 to 5 hours which means that half of the alcohol is eliminated from the body. It is absorbed much more rapidly than it is metabolized. For an average person who weighs 150 pounds, for example, one standard drink will increase their blood-alcohol concentration by about 0.02%. However, approximately the rate of removal of alcohol is about 0.016% per hour. Therefore, consuming one standard alcoholic drink will increase blood alcohol concentration. It will rapidly increase with the consumption of more beverages until it overwhelms the body’s capacity to metabolize alcohol.
Factors determining how long alcohol stays in our system
After we start drinking, alcohol levels peak in the blood after an hour or an hour and a half, and after that, the body starts metabolizing it. There are numerous factors that determine how long alcohol stays in the system. Some of these are: (source: Medscape, 2025)
- The type of alcoholic beverage
- Food
- Water
- Binge drinking
- Preexisting liver damage
The type of alcoholic beverage:
Knowing about the alcohol units in your drink is very important because it can affect the amount of alcohol that can stay in your system. For example, a large glass of wine can take up to 3 hours, a glass of beer up to 2 hours, and a small amount of liquor about 1 hour.
Food:
Food can slow alcohol metabolism so that it stays in the system longer and is slowly absorbed.
Water:
Water can reduce blood alcohol concentration (BAC), so drinking water makes it easy to flush or metabolize. However, the body can only metabolize it at the rate of 20 mg/dl of alcohol per hour.
Binge drinking: (source: NIAAA, 2023)
Binge drinking can take the body several hours to metabolize alcohol.
Preexisting liver damage:
Preexisting liver damage can significantly dampen down the alcohol metabolism, so it stays in the body for a longer time.
Alcohol is metabolized through the liver and eliminated via sweat, feces, urine, and through our breath.
How Long Alcohol Can be Detected in Urine?
Urine tests are of various types and can detect alcohol efficiently and reliably several hours after drinking—the check for alcohol metabolites in the urine. The average tests available in the hospitals can detect alcohol metabolites from 12 hours to 2 days. However, more advanced tests have more sensitivity and can detect it for more than 3 days (80 hours) after your last drink.
Alcohol Stay Period in Blood
The amount of alcohol in the blood is known as blood alcohol concentration. It is referred to as the percentage of alcohol that is present in the blood in units of mass of alcohol per volume. For most people, one ounce of alcohol will produce a 0.015% blood-alcohol concentration. Alcohol detection tests can detect alcohol in the blood for up to 6 hours after the last drink. (source: SAMHSA, 2024)
How Long Alcohol Can be Detected from Saliva?
Alcohol can be detected in the saliva for up to 12 to 24 hours.
Alcohol Stay Time Duration in Breath
Breath tests for alcohol are frequently employed particularly while checking people who are driving under the influence. They use a device called a breathalyzer which can detect alcohol on your breath for up to 24 hours. It can be manual or electronic.
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It has green bands showing the average alcohol concentration. Two green bands reveal that blood alcohol concentration is between 0.05% and 0.10%, and three bands signify that it’s above 0.10%. If it is above 0.02, reaction time and judgment are markedly hampered, and it is not safe to drive or perform any precision-related task. The legal limit for drinking and driving is under 0.05%.
How long Alcohol can be Detected from Hairs?
Hair follicles can be tested for alcohol and can be positive 3 months after the last drink. However, this method is not commonly used.
In general, alcohol can be detected for up to 5 days after the last drink. But there is no clear-cut answer to this question. Different people metabolize it at different rates. If you are worried about passing an alcohol test, you should consider seeking help for alcohol-use disorder.
FAQs
Breathalyzers can give false-positive test results, especially after using Listerine mouthwash which contains a high
amount of alcohol. Therefore it is not recommended to do a test for 15 minutes after eating or drinking something. On average, it can be detected up to 24 hours after the last drink you have had.
The Article
References
- MedlinePlus. (2024). Alcohol withdrawal. National Library of Medicine. https://medlineplus.gov/ency/article/000764.htm [medlineplus.gov]
- National Institute on Alcohol Abuse and Alcoholism. (2024). Alcohol use disorder: A comparison between DSMu2013IV and DSMu20135. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-use-disorder-comparison-between-dsm [niaaa.nih.gov]
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