What is ethanol and how is it abused?

Ethanol, also medically referred to as EtOH, is the substance in alcoholic beverages that causes a person to become intoxicated. Ethyl alcohol, another name for the ethanol, is a natural bi-product of plant fermentation. On its own, it is clear, colorless and highly flammable. Ethanol is not just in alcoholic drinks like spirits, beers, wines and malts. It is also found in many different non-consumable substances including fuel and scents.  

Along with water, ethanol is the primary ingredient in most alcoholic drinks, although some sweet liquors may contain more sugar than ethanol. EtOH abuse, or ethanol abuse, refers to the misuse or overconsumption of alcohol. When a person drinks too much, too often or cannot control their alcohol use, they may have a larger issue. For some, this indicates an alcohol use disorder, which can be managed through treatment. Ethanol abuse can cause serious and lasting damage to a person’s mental, physical and emotional health.

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What is the difference between ethanol and alcohol?

Alcohol and ethanol sometimes are used to refer to the same substance, as ethanol is the ingredient in alcoholic beverages that causes intoxication. Alcoholic beverages are the only consumable version of ethanol.  However, that does not mean that all ethanol or ethyl alcohol is safe to consume. It is only safe to drink if it does not contain toxic impurities and hasn’t been denatured. There are other types of alcohol that should never be consumed. These include methanol (methyl alcohol) and isopropanol (rubbing alcohol or isopropyl alcohol). Methanol is used in fuel, antifreeze, paint remover, windshield wiper fluid and other substances. Isopropyl alcohol is often used for disinfecting. Methanol and isopropanol are both toxic to humans and when metabolized can cause liver failure and death.  In other words, if you choose to consume ethanol-based beverages, you should do so responsibly and only stick to legally sold alcohol meant for drinking.

Popularly abused ethanol (alcohol)

Ethanol used in alcoholic beverages is produced by the fermentation of fruits or grains. Because it is the ingredient responsible for feelings of intoxication, drink labels will indicate the ethanol concentration. In general, the amount of ethanol by volume is expressed as the alcohol percentage, also known as ABV. Another way alcohol content is described is as a “proof”.  To calculate a beverage’s proof, the ABV is simply doubled. For example, 80 proof is the same as 40% ABV. Different classes of alcoholic beverages have different proportions of ethanol. Those with the most are the strongest. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a standard drink contains around 14 grams (0.6 ounces) of pure alcohol.

Spirits

Spirits, also known as hard liquor, are generally considered the strongest type of alcoholic beverage.This is because they have the highest ethanol concentration. Spirits include tequila, vodka, rum, gin, bourbon, scotch, whiskey and others. Many hard liquors have around a 40% ethanol concentration. However, ethanol concentration can widely depending on the type of spirit as well as the specific brand. For example, vodkas range anywhere from 30-95% ABV, while gins, rums and whiskeys tend to fall somewhere between 36% to 50% ABV. Because the ethanol concentration in spirits is so high compared to other beverages, a serving (or a drink) is measured as 1.5 ounces of hard liquor.

Malt Liquors 

Malt liquor contains less ethanol concentration than spirits, with around a 7% ABV.  A serving of malt liquor, which is 8-9 ounces, is significantly larger than the spirit serving size.

Beer

Like malt liquor, beer contains less ethanol per unit volume than spirits. For this reason, the serving size is larger.  Beers range from 4% to 7% ABV with a standard serving size of 12 ounces. Pints sold at breweries and other places are usually larger than a standard serving, containing 15 ounces of beer on average. 

Wine

Ethanol concentration in wine tends to be higher than of beer, generally ranging from 11-18%. As such, wine’s standard serving size is only 5 ounces, compared to the beer’s 12 ounce standard serving. White wines like moscato have the lowest ABV, at around 5-7%, while the ABV of chardonnay and pinot grigio is higher, between 11-13%. Red wines tend to have higher ethanol concentrations than whites. Pinot noirs and bordeauxs may range from 13-14%, while some zinfandel and shiraz bottles fall between 16% and 18%. It is important to remember that although 5 ounces is the standard pour, often wine pours vary substantially, meaning a person may be consuming more ethanol than expected in a drink.

Ethanol abuse

While alcohol is a part of many cultural celebrations and events, it also can cause a great deal of damage and destruction when misused. Ethanol affects individuals in a variety of ways. Some are able to drink alcohol with few issues or incidents, while others find themselves unable to control the amount they drink, how often they drink or their behaviors. Alcohol (ethanol) abuse is a drinking pattern that results in significant and recurring negative consequences in a person’s life. Alcohol abuse can lead to dependency and alcoholism.

According to the Centers for Disease Control and Prevention (CDC), excessive alcohol use kills more than 95,000 people in the U.S. each year. Not only is it deadly, it is expensive. One study found that excessive alcohol use costs the U.S $249.0 billion each year, estimates which have likely only increased since the study was conducted. Costs related to alcohol include health problems, safety issues, crime, loss of productivity, car accidents, death and more. For example, drinking while pregnant can result in a number of medical issues which create overall costs for society. The disease of alcoholism specifically generates numerous costs related to health care, legal systems issues, job loss, childcare issues and beyond.  Be it a severe alcohol use disorder or a more moderate issue, alcohol abuse can create significant and lasting consequences.

Ethanol abuse by binge drinking

Of all the forms of excessive alcohol abuse, binge drinking produces the most significant costs to society. According to government reporting, binge drinking accounts for over 75% of the previously mentioned costs. In other words, binge drinking causes a great deal of damage.

But what exactly is binge drinking? Binge drinking occurs when a person consumes enough ethanol to raise their blood alcohol level to 0.08 g/dl or above. How much alcohol is required for this to occur depends on personal factors like size, weight, health, sensitivity and tolerance. For men, an average of 5 drinks in a two hour period constitutes binge drinking. For women, an average of 4 drinks in two hours may be considered binge drinking.

Binging on ethanol beverages can be extremely harmful to a person’s health and safety. Car accidents, the transmission of STDs, inter-partner violence and alcohol poisoning are just a few of the dangerous consequences. Despite the risks, binge drinking is quite common. 1 in 6 adults binge drink four times per month. On average, they consume 7 beverages per binge. Binging on ethanol beverages is most common among young adults ages 18-34. However, the behavior is still extremely prevalent among adults over 34. While binge drinking does not necessarily indicate a severe alcohol use disorder (AUD), those with AUDs are more likely to binge drink.  

Alcohol use disorders

According to the National Institute on Alcohol Abuse and Alcoholism, an “alcohol use disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.” An AUD is considered to be a disease that, if not treated, can cause lasting damage to the brain and body’s functioning. The term AUD encompasses a range of issues including alcohol dependence and alcoholism. AUDs range from moderate to severe. One’s risk for developing one depends on how much, how often, and how quickly they consume alcohol. Misusing alcohol, binge drinking and heavy use can increase a person’s risk of developing an AUD. Other factors like genetic predisposition, family history, mental health issues, and experiencing trauma also increase a person’s likelihood of developing an AUD.

Effects of ethanol abuse

As mentioned, ethanol abuse and AUDs cause a number of issues in a person’s life, damaging their mental and physical wellbeing. Drinking too much, on occasion or regularly, often results in many negative consequences, including death. Even short-term drinking can cause damage to the heart, interpersonal violence, car-crashes and overdose. Those who suffer from alcoholism face a higher risk of experiencing the following physical consequences:

• Heart disease
• Liver damage: Steatosis or fatty liver, alcoholic hepatitis, fibrosis, cirrhosis
• Pancreatitis
• Several types of cancer
• Weakened immune system and a higher likelihood of chronically of contracting pneumonia, tuberculosis and other diseases
• Brain damage
• Long-lasting changes in brain structure and function
• Memory loss
• Alcohol overdose
• Death

Mixing ethanol and other drugs

Combining alcohol with substances including central nervous system depressants, opioids, benzedrine, methedrine and other drugs can be extremely dangerous, causing overdose and even death. Before combining alcohol with any legal or illegal drug, you should always consult a doctor. If you are concerned about a loved one’s substance use or mixing of substances, learn how to recognize the signs of overdose from alcohol and other substances. Learning what to do in an emergency situation like an overdose can be lifesaving. Overdose symptoms can look different depending on the substances or combination of substances ingested, so inform yourself accordingly and take all necessary precautions. 

How to recognize an alcohol use disorder

AUDs often result in numerous negative financial, emotional, legal and relational consequences in a person’s life. Despite these issues, dependence and cravings make it extremely hard to quit. Those with a loved one suffering from alcoholism know all too well the damage the substance abuse can cause. Alcoholism hurts relationships, and often family and friends suffer just as much. Those close to the alcoholic face many of the same consequences and feel a constant stress over their loved one’s well being.   

If you are concerned about yourself or a loved one having a drinking problem, it is important to be able to recognize the signs and symptoms of an AUD. Abusing ethanol can cause long-term damage to a person’s life. Recognizing that there is a problem is the first step toward recovery. The following are a few signs that possibly indicate an alcohol use disorder:

• Inability to limit the amount of alcohol consumed
• Strong cravings or urges for alcohol
• Developing a tolerance and requiring increased amounts of alcohol to feel ethanol’s effects
• Unsuccessful attempts at cut down or stop drinking, despite wanting to do so
• Spending significant amounts of time drinking, seeking alcohol and/or recovering from alcohol use
• Problems fulfilling important responsibilities at home, school, work or in other areas because of alcohol use
• Continuing to drink despite it causing personal, emotional, physical, social, legal and/or relational issues
• Reducing time spent doing hobbies or other activities in order to drink/as a result of drinking
• Spending significant amounts of money on alcohol or not having money as a result of drinking
• Legal consequences related to drinking
• Using alcohol in unsafe situation (e.g. driving or swimming)
• Withdrawal symptoms –like nausea, sweating and shaking– or drinking to avoid symptoms

These are just some signs of an AUD, though not all symptoms have to be present. If you are concerned about yourself or a loved one, getting treatment for the disease is extremely important and can help prevent or reduce the many consequences of alcohol abuse.

Alcoholism recovery for ethanol abuse

If you or a loved one struggles with an AUD or substance use disorder (SUD), no matter how severe the problem, strong evidence-based treatments combined with behavioral therapies and other support can help you find recovery. Finding a certified, evidence-based rehabilitation program will allow you or your loved one to develop healthier ways of coping, address underlying traumas and manage triggers for a sustainable recovery from ethanol abuse. Liberty Ranch offers a science-based, integrative Intensive Outpatient Program (IOP).

Liberty Ranch Treatment Center

The IOP program takes a holistic approach to healing from alcoholism, applying psychological principles tested and validated through research and application with emotional cognitive-behavioral and rational-emotive therapies. The program offers individual counseling with an emphasis on solution-focused therapy as well as group and family therapy. Often alcoholism affects loved ones, and there is a great deal of healing to be done for both the individual and the family as a whole.Liberty Ranch facilitates the rebuilding of healthier relationships to support long-term sobriety and to avoid codependent behaviors. Many clients also struggle with comorbid conditions, which tend to be more common among alcoholics.  Liberty Ranch supports clients as they address their anxiety, depression, ADHD, bipolar disorders, trauma, PTSD, grief and personality disorders as a part of their treatment. 

Because making big changes requires time, practice and patience, Liberty Ranch recommends a longer stay in a program (9 to 12 months).  Longer stays in treatment have been shown to increase the odds of maintaining long-term sobriety, allowing participants to acquire the life skills necessary to support a healthy, substance-free lifestyle.

Liberty Ranch’s trained addiction specialists take a comprehensive approach to alcoholism.  Clients build life skills, work through issues and develop functional ways of reacting and behaving that promote long-term sobriety from ethanol abuse.