What Kind of Drug Is Alcohol?

Most of us grow up learning that drugs are bad, and we should stay away from them. Then again, didn’t many of us also learn that alcohol is a drug? Alcohol is classified as a drug but is not commonly seen (or treated) as one in our society and culture today.

From “Wine Wednesdays'' with the neighborhood moms to pandemic-era virtual mixology classes, alcohol is often seen as a celebratory sidekick in our lives. However, alcohol is classified as a drug, so are we overlooking its drug-like effects? Let’s take an in-depth look at the type drug that alcohol is. We’ll learn more about how it affects our brain and body, and identify its similarities to other drugs.

Classification of Drugs

To better understand alcohol as a drug, let’s first take a look at drug classifications and how common drugs fit into them. 

According to the Centers for Disease Control and Prevention (CDC), a drug is any chemical substance that alters the way an individual’s mind or body functions. Drugs can be classified according to several criteria, including dependency potential, chemical composition, and overall effects. There are seven main effect-oriented categories of drugs:

• Depressants. These are drugs that reduce or slow down messaging between the brain and body. They can lower inhibitions and promote relaxation. Some depressants act paradoxically. For instance, antidepressant medications work by depressing certain brain functions, but the end result is the increased efficiency of mood-boosting functions. Examples of depressants include sleep medication, anxiety medications, and certain types of pain relievers. 
• Stimulants. Stimulants are drugs that increase or speed up messaging between the brain and the body. These drugs act in the same way but can produce different effects. For instance, stimulants like cocaine and caffeine are associated with feelings of alertness and excitability. However, when treating certain neurological dysfunctions (such as attention deficit hyperactivity disorder, or  ADHD), stimulants like Adderall and Ritalin can actually calm down hyperactivity while increasing focus.
• Opioids. These drugs are derived from (or chemically similar to) opium, a naturally occurring compound found in poppy plants. Opioids are used for pain management and are reported to induce feelings of euphoria. For this reason, opioids are one of the most commonly misused categories of drugs. Examples include morphine and oxycodone. 
• Inhalants. Inhalants cause a wide range of psychoactive effects and travel through the respiratory system by being “sniffed.” Common inhalants include nitrites (poppers) and aerosols.

• Hallucinogens. These mind-bending drugs alter our perception of the five senses and cause us to experience occurrences that are not real. Hallucinogens are categorized as either psychedelics (such as LSD or psilocybin), deliriants (such as Benadryl or the anti-nausea medication scopolamine), and dissociatives, which we’ll discuss next.
• Dissociatives. These drugs cause feelings of disassociation (disconnecting from one’s body, self, or thoughts) and are commonly used as club drugs. Dextromethorphan (DXM) and ketamine are commonly misused dissociatives. 
• Cannabinoids. These drugs are derived from the cannabis plant. Effects can vary depending on the form and manner in which the cannabinoid is consumed. Examples include THC (found in marijuana) and CBD (used to treat nausea and epilepsy). It’s worth noting that our brains produce natural cannabinoids (called endocannabinoids) that regulate dozens of processes in the body, including the immune system, appetite, pain sensation, mood, fertility, pregnancy, and memory.

These categories may seem straightforward, but some drugs tend to be puzzling. For instance, how can alcohol make us calm but also promote uninhibited behavior and a rapid heart rate? Is alcohol a depressant or a stimulant?

What Type of Drug Is Alcohol?

Alcohol is classified as a central nervous system (CNS) depressant. As we’ve learned, depressants suppress messaging between our brain and body. The CNS is the central hub of all signals in our body. It receives, processes, and responds to sensory information and tells the rest of the body how to respond. This can affect a multitude of functions including movement, speech, awareness, and our five senses.

This explains why our thoughts and actions are impaired when we are intoxicated. When we take a look at the specific neurotransmitters targeted by alcohol, we can better understand its complex effects and why it’s considered a drug.

Why Is Alcohol Considered a Drug?

Simply put, alcohol is considered a drug because it changes our mental and physical state. It does this by altering the function of our neurotransmitters.

The main neurochemicals targeted by alcohol include dopamine, gamma-aminobutyric acid (GABA), serotonin, and glutamate. Alcohol suppresses glutamate (a stimulating neurotransmitter) and increases the function of GABA (a calming neurotransmitter). This combination slows down messages between our brain and body and gives alcohol its depressant effects.

At the same time, alcohol increases the function of serotonin (a mood-regulating hormone) and stimulates the release of dopamine (the “feel-good” hormone). Working together, these neurotransmitters give us a temporary feeling of happiness and activate our brain’s reward circuit, which keeps us coming back for more. 

Since alcohol impacts our normal functioning by disrupting neurotransmitters, it also has the ability to cause psychological and physical dependence — a defining characteristic of a drug.

Impacts of Alcohol on the Body and Brain

Like many drugs, alcohol has properties that lead to physical and psychological changes. Let’s take a look at the direct impacts that alcohol has on the systems in our body.

• Brain. Alcohol travels through the bloodstream and crosses the blood-brain barrier to reach our body’s control system — the brain. By targeting certain neurotransmitters, alcohol affects the way our brain perceives and processes information. This can change our emotions, behaviors, thoughts, or bodily functions.
• Heart. We may have heard that a glass of red wine can be good for our heart health. Unfortunately, the risks outweigh the benefits. Alcohol can increase our heart rate and long-term damage to the lining of heart muscle. Alcohol is linked to a higher risk of heart disease and stroke.
• Lungs. Although smoking is most commonly associated with negative impacts on the respiratory system, alcohol also has significant impacts on the health and function of our lungs. Alcohol irritates lung tissue, causes inflammation in our breathing pathways, and suppresses certain reflexes. Alcohol impacts cellular function throughout our body, and the lungs are not immune to the effects of long-term alcohol misuse. 
• Liver. Our liver is the main organ that metabolizes alcohol. The metabolic process produces a toxin called acetaldehyde; regular exposure to acetaldehyde damages and stresses the liver. Prolonged and excessive alcohol consumption leads to complications such as liver fibrosis, cirrhosis, hepatitis, and fatty liver disease.
• Pancreas. Toxic byproducts of alcohol metabolism harm our pancreas, causing progressive inflammation. This can lead to conditions such as pancreatitis and fibrosis.
• Immune system. Alcohol has short-term effects on the immune system due to suppression of our immune response. It also has long-term impacts on the cells that fight off infections, leading to a weakened immune system. This makes us more susceptible to infection and disease.
• Digestive system. Since alcohol is ingested, it goes through the same digestive process as food. During its journey through our gastrointestinal tract, it causes irritation and aggravates conditions such as acid reflux, irritable bowel syndrome, gastritis, and metabolism.
• Increased cancer risk. Alcohol is associated with increased risk of just about every type of cancer. This is partially due to the toxic carcinogen acetaldehyde (a byproduct of alcohol metabolism) and by suppressing the cancer-fighting aspects of our immune system.

How Does Alcohol Compare to Other Drugs?

While alcohol is categorized as a drug, it’s not a controlled substance like other drugs with similar risks. Drug classifications and legality are influenced by a number of factors, such as politics, public perception, cultural norms, and science. Alcohol is particularly dangerous due to a number of factors:

1. Legality. Since alcohol is not a controlled substance, there are no barriers or legal consequences for alcohol misuse unless a crime is committed while drinking (such as driving under the influence or disorderly conduct). 
2. Availability. Alcohol is one of the most easily accessible drugs. Delivery apps can even bring alcohol straight to your doorstep, putting it a click or tap away.

3. Social acceptance. Alcohol is not always seen or treated like a drug due to drinking culture. Not only is it acceptable, but many social groups may even encourage it.

4. Direct cause of diseases. All drug misuse causes negative health effects, but excessive alcohol consumption is the direct cause of many diseases and cancers.

5. Highest rate of related deaths. Alcohol contributes to more deaths than all other drug categories combined. In the U.S. alone, there are over 140,000 alcohol-related deaths per year. 

Cultural norms often downplay alcohol as an enhancement to our lives rather than the harmful substance that it is. Society paints drinking as a way to relax, socialize, and get rid of negative emotions while understating the negative aspects of alcohol. This is a major reason that alcohol dependence is so prevalent today. 

Signs of Alcohol Dependence

Like many drugs, alcohol has a high risk of dependence. Here are some ways to identify alcohol dependence: 

• Increased tolerance. Our body and brain adjust to the effects of alcohol over time. Those of us who are dependent on alcohol may find that we need more and more alcohol to reach the desired effects.
• Drinking in secret. This is common for those of us who feel ashamed about our drinking habits or want to prevent confrontation with our friends or family. However, hiding the issue can prevent us from getting help. 
• Prioritizing alcohol over other commitments. A major indicator of alcohol dependence is casting aside priorities like work or family commitments to drink.
• Ignoring negative effects. This may include making excuses for negative behaviors resulting from drinking or brushing off undesired health symptoms. It’s the same reasoning behind blaming post-holiday weight gain on an inaccurate scale rather than the extra cookies we saved for ourselves before setting some out for Santa.
• Withdrawal symptoms. If stopping or reducing the amount of alcohol produces withdrawal symptoms, we may be dangerously dependent on alcohol. Our brain and body adapt to regular alcohol use and react negatively when forced to adjust to a new normal. Withdrawal symptoms can range from merely unpleasant to dangerous. If you are experiencing withdrawal, consult a doctor right away.

Next Steps

Practicing moderation or choosing sobriety are the most effective strategies to prevent alcohol dependence. While there’s a social aspect of alcohol, there are also plenty of alcohol-free activities to enjoy. And thanks to the sober-curious movement, mocktails and non-alcoholic beverages are becoming increasingly available (and socially acceptable). If we’re concerned about our relationship with alcohol, seeking treatment or support can help us overcome challenges on our journey to better health.

The Bottom Line

Alcohol is classified as a drug for clear reasons. However, societal and cultural influences have allowed it to slip into our social fabric without being seen for its drug-like effects. Understanding alcohol’s impacts on our body can help us make intentional decisions about drinking.

While alcohol has the potential to cause dependence and addiction, there are strategies and tools we can implement that allow us to have a healthier relationship with alcohol. A mindful life awaits, free from alcohol’s effects!