Alcohol is metabolized mostly by the liver. In general, the liver can process one standard drink in one hour. If you consume more than this, the additional alcohol will accumulate in the blood and body tissues (like the brain) until it can be metabolized. This is why having a lot of shots or playing drinking games can result in high blood alcohol concentrations that last for several hours.

People often underestimate how much they have had to drink because they aren’t using standard drink measurements. 

Different people will process alcohol at different rates. This means you could have the same number of drinks as a friend but feel greater effects from the alcohol than they do. Factors including body size, differing levels of enzymes responsible for metabolizing alcohol, hormones, percentage of body water relative to body fat, and prescription medicines can all affect alcohol tolerance.

Learn more specific BAC information based on your weight, what you've had to drink, and the time period over which you have had those drinks.

The Time Factor

Now that you know how to calculate BAC, see how alcohol affects your body at different levels.

0.02 - 0.03

Legal definition of intoxication in R.I. for people under 21 years of age. Few obvious effects; slight intensification of mood.

0.05 - 0.06

Feeling of warmth, relaxation, mild sedation; exaggeration of emotion and behavior; slight decrease in reaction time and in fine-muscle coordination; impaired judgment about continued drinking.

0.07 - 0.09

More noticeable speech impairment and disturbance of balance; impaired motor coordination, hearing and vision; feeling of elation or depression; increased confidence; may not recognize impairment.

0.08

Legal definition of intoxication in R.I. for people 21 years and older.

0.11 - 0.12

Coordination and balance becoming difficult; distinct impairment of mental faculties and judgment.

0.14 - 0.15

Major impairment of mental and physical control; slurred speech, blurred vision and lack of motor skills; needs medical evaluation.

0.20

Loss of motor control; must have assistance standing or walking; mental confusion; needs medical assistance.

0.30 and higher

Severe intoxication; potential loss of consciousness; needs hospitalization.

A person's experience with alcohol's effects on the body is in part determined by their sex assigned at birth. According to research, a cisgender woman or person assigned female at birth will feel the effects of alcohol more than a cisgender man or person assigned male at birth, even if they are the same weight. There is also increasing evidence that people assigned female at birth are more susceptible to alcohol's damaging effects than are those assigned male.

Please note that if you are taking hormones as part of a gender affirming process, you may find that your experience with alcohol's effects on your body will change but there is not adequate research as yet to describe the full scope and variability of these effects.

Below are explanations of why our bodies process alcohol differently based on our sex assigned at birth:

Ability to Dilute Alcohol

Cisgender women and those assigned female at birth have less body water (52% v. 61%). A body with more water will automatically dilute the alcohol more, even if the two people weigh the same amount.

Ability to Metabolize Alcohol

Cisgender women and those assigned female at birth have less dehydrogenase, a liver enzyme that breaks down alcohol, meaning they will break down alcohol more slowly.

Hormonal Factors

In people who menstruate, premenstrual hormonal changes cause intoxication to set in faster during the days right before a menstrual period. Birth control pills or other medication with estrogen will also slow down the rate at which alcohol is eliminated from the body.

Susceptibility to Long-term Alcohol-induced Damage

Studies have shown that cisgender women and those assigned female at birth who are heavy drinkers are at greater risk of liver disease, damage to the pancreas and high blood pressure. Research also tells us that proportionately more cisgender women or those assigned female at birth die from cirrhosis than do cisgender men or those assigned male.

Food

Having food in your stomach can have an influence on the absorption of alcohol. The food will slow the emptying of the stomach into the small intestine, where alcohol is very rapidly absorbed. Peak BAC could be as much as 3 times higher in someone with an empty stomach than in someone who has eaten a meal before drinking. Eating regular meals and having snacks while drinking will keep you from getting too drunk too quickly.

Asian Descent

Some people of Asian descent have more difficulty metabolizing alcohol. They may experience facial flushing, nausea, headache, dizziness and rapid heartbeat. It appears that one of the liver enzymes that is needed to process alcohol is not active in these individuals. It is estimated that up to 50% of Asian people are susceptible to these reactions to alcohol.

Family History

Research studies have found that children of alcoholics are four times more likely than the general population to develop alcohol problems. However, many people with a family history of alcoholism do not become alcoholics. Additional factors that increase the risk of developing alcoholism include having an alcoholic parent who is depressed or has other psychological problems, or growing up in a family where both parents abuse alcohol or other drugs.

Blackouts (sometimes referred to as alcohol-related memory loss or "alcoholic amnesia") occur when people have no memory of what happened while intoxicated. During a blackout, someone may appear fine to others; however, the next day they cannot remember parts of the night and what they did. The cause of blackouts is not well understood but may involve the interference of short-term memory storage, deep seizures, or in some cases, psychological depression.

Blackouts shouldn't be confused with passing out, which happens when people lose consciousness from drinking excessive amounts of alcohol. Losing consciousness means that the person has reached a very dangerous level of intoxication; they could aspirate on their vomit or slip into a coma. If someone has passed out, call EMS immediately (401-863-4111).

Hangovers are the body's reaction to poisoning and withdrawal from alcohol. Hangovers begin 8 to 12 hours after the last drink and symptoms include fatigue, depression, headache, thirst, nausea, and vomiting. The severity of symptoms varies according to the individual and the quantity of alcohol consumed.

People have tried many different things to relieve the effects of a hangover. The only way to prevent a hangover is to drink in moderation.

Things that Might Help Prevent a Hangover

• Eat a good dinner and continue to snack throughout the night.
• Start out slowly to see how the alcohol is affecting you.
• Avoid drinking games or shots. Drinking a large amount of alcohol in a short amount of time is the most likely way to become dangerously intoxicated.
• Drink water in between drinks to stay hydrated.

Things that Won't Help a Hangover

• Drinking a little more alcohol the next day. This simply puts more alcohol in your body and prolongs the effects of the alcohol intoxication.
• It's best not to take a pain reliever before going to bed. Give your body a chance to process the alcohol before taking any medication.

Things That Might Help a Hangover

• When you wake up, it's important to eat a healthy meal. Processing alcohol causes a drop in blood sugar and can contribute to headaches.
• Drink plenty of water to get rehydrated.
• Take a pain reliever like Tylenol (acetaminophen) when you wake up. Do not take a pain reliever before going to bed because it will tax your liver. Let your body process the alcohol while you are sleeping.
• Avoid excessive caffeine as it may contribute to dehydration. However, if you drink coffee every morning, have your first cup not more than a couple of hours after your regular time. Don't force your body to go through caffeine withdrawal while you are recovering from a hangover.