What about "Social Drinkers"?
It is important to define exactly what we mean when
we say that someone is a social
drinker. The most consistent definition, looking across the literature on alcohol use and treatment, would be this:
someone who drinks regularly but does
not get drunk when he drinks or have any of the clinical signs of addiction to alcohol. People who fit
this pattern of drinking generally do
not have nearly as severe deficits in mental functioning as those who drink heavily.
Among social drinkers,
the pattern of alcohol consumption plays a very important role in determining
whether the person will develop deficits
in mental functioning. The more alcohol he drinks during each drinking session, the higher the likelihood that
mental deficits will develop.
Consider two people who each drink five drinks per week, on average. The first person has one drink on each of the five days
of the week, and the second person has
four drinks on each Saturday night and
one in the middle of each week. The second person will be more likely to develop the kinds of deficits in the aforementioned
abilities for chronic alcoholics.
This is a particularly important point for young people, because heavy drinking on weekends is a typical pattern for
many high school and college students as well as
for young people in the work world.
It is difficult to say what amount of drinking over
time will result in deficits in
mental function. There have been many studies addressing this issue in different groups of people, and it's
very hard to boil all of these down to a clear and concise statement of risk.
However, when all the complexities of
the research are taken into consideration, it is reasonable to estimate that people who drink three or
more drinks per day on average are at substantial risk of developing permanent
deficits in certain cognitive
abilities. This is not to say that drinking less is per‑
Tolerance
Development
across Several Drinking Sessions
Tolerance means that after continued drinking, consuming
an identical amount of alcohol produces a lesser effect—in other words, more
alcohol is necessary to produce the
original effect. The development of tolerance indicates that alcohol exposure has changed the brain. In some ways it
is less sensitive to the alcohol, but in other ways it may remain quite sensitive. The brain effects that produce the high may
diminish, while the effects that are
toxic to the brain cells themselves may remain the same. Another problem is that as tolerance develops, the
drinker may drink more each time to
get the high. As we just learned, such a drinking pattern is more likely to
produce deficits in mental functioning over time. Also, because the brain is the organ of addiction,
the tolerant person who increases her
drinking runs a greater risk of addiction. Finally, although the brain may need more alcohol to produce the
high, the liver and other internal
organs are dealing with more and more alcohol, and they are at risk for permanent damage.
Development
within One Drinking Session
Although tolerance to most alcohol effects develops gradually and over several drinking sessions, it has also been
observed even within a single drinking session. This is called acute tolerance
and means that the intoxication is
greatest soon after the beginning of drinking. Acute tolerance does not develop to all the effects of alcohol, but
it does develop to the feeling of
being high. So, the drinker may drink more to maintain the feeling of being high, while the other
intoxicating effects of alcohol (those that
interfere with driving, mental function, and judgment) continue to build,
placing the drinker at greater and greater risk.
