Here’s what happens to your brain when you stop drinking alcohol

There is no free ride for the brain when it comes to alcohol. The 2024 National Survey on Drug Use and Health found that almost 80 percent of Americans older than 12 years of age reported that they had had at least some alcohol at some point in their lives. But there is “no free ride in the brain,” said George Koob, the director of the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health.

Research shows that over time, alcohol can change the brain, leading to decreases in gray matter volume. And even relatively low levels of alcohol may worsen feelings of anxiety and depression, disrupt sleep, and, over time, increase dementia risk, in addition to upping other health problems, such as breast and colorectal cancer risk. But there is now increasing evidence that the brain can recover to an extent when drinking is reduced or stopped.

“The remarkable thing about the brain is that it is an incredibly plastic organ, and that we see neuroplasticity in the development of addiction and neuroplasticity in the ability to achieve recovery,” said James MacKillop, a clinical psychologist and the Peter Boris chair in addiction research at McMaster University. “And that’s a really important and powerful story that I think isn’t always communicated as widely as it should be.” Here’s what alcohol does to the brain, its health effects, and what happens when we reduce and abstain. Alcohol causes a “stew of pharmacological effects” that can be first stimulating and then sedating, MacKillop said.

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With the first drinks, alcohol can produce “a euphoric intoxication,” Koob said. Alcohol causes the release of endorphins, which are our brain’s natural opioid molecules, which in turn activate the dopamine neurons in our reward circuitry. At the same time, alcohol cranks up neurons that inhibit activity while dampening neurons that activate – which, in the short term, reduces stress and anxiety. But “when the alcohol wears off, those stress systems come back with a vengeance,” Koob said.

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