Alcohol is primarily a CNS depressant, and the degree of depression is directly proportional to the quantity of ethanol consumed. However, behavioral stimulation can be found after ingestion of small amounts of ethanol. This stimulation is expressed as decreased social and psychological inhibition and is most likely the result of a depression of inhibitory pathways in the brain with release of cortical activity. The behavioral and physiological effects are associated with different blood ethanol concentrations. As the blood ethanol concentration begins to increase, behavioral activation, characterized by euphoria, talkativeness, aggressiveness, and loss of behavioral control, generally precedes the overt CNS depression induced by ethanol. At progressively higher blood ethanol concentrations, the stage of relaxation is transformed into decreased social inhibitions, slurred speech, ataxia, decreased mental acuity, decreased reflexive responses, coma, and, finally, death resulting from respiratory arrest. In moderation, however, there is no evidence that the judicious use of small amounts of alcoholic beverages (e.g., a glass of wine with meals) is permanently harmful.
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