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What Does it Mean When You Have a High “Tolerance” for Alcohol?

Alcohol tolerance refers to some people’s ability to consume larger amounts of alcohol than others before feeling its effects.

Someone with a high tolerance to alcohol requires more alcohol to feel its effects or appear intoxicated. 

Someone with a low tolerance to alcohol requires less alcohol to feel its effects or appear intoxicated. 

Gender, biology, body weight, genetics, drinking behavior, and how many alcoholic beverages are consumed all play a role in tolerance.

Tolerance can encourage greater alcohol consumption which contributes to alcohol dependence and can cause adverse health effects.

Does Drinking More Alcohol Increase Your Tolerance?

Drinking more alcohol can increase alcohol tolerance. The human body can adapt to increased alcohol use, resulting in more rapid metabolism of alcohol. A more rapid metabolism means that those who drink alcohol on a regular basis can seem less intoxicated than others who have consumed a similar amount of alcohol.

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Is a High Tolerance for Alcohol Genetic?

Genetic factors influence alcohol tolerance.

For some people, low tolerance is caused by a natural lack of an enzyme called acetaldehyde dehydrogenase.

When most people ingest alcohol, an enzyme called alcohol dehydrogenase helps metabolize the ethanol. The liver converts the ethanol to acetaldehyde, a substance that can cause cell damage. Another enzyme called aldehyde dehydrogenase 2 helps convert acetaldehyde to acetic acid, which is nontoxic.

In people with alcohol intolerance, a genetic mutation makes ALDH2 less active or inactive. As a result, the body can’t convert acetaldehyde to acetic acid. Acetaldehyde starts to build up in your blood and tissues, causing symptoms.

Individuals of Asian and Native American descent are more likely to have this enzyme deficiency. 

What is Functional Tolerance to Alcohol?

According to the National Institute on Alcohol Abuse and Alcoholism, functional tolerance is a lessened response to alcohol, that is independent of the rate of metabolism of alcohol.

Humans develop functional tolerance when brain functions begin to adapt to compensate for the effects of alcohol.

If someone is a chronic heavy drinker, they will display functional tolerance when they have a high blood alcohol concentration (BAC). However, they’ll show very few signs of intoxication, which in other people without a high tolerance would experience slurred speech, balance issues, vomiting, unconsciousness, or even a fatal overdose.

5 Types of Functional Alcohol Tolerance

The five types of functional alcohol tolerance include:

Environment-Dependent Tolerance

Environment-dependent tolerance is an accelerated tolerance of the effects of alcohol when it is continually consumed in a familiar environment. Environment-dependent tolerance is why some individuals can consume more alcohol with a lesser degree of intoxication in a familiar environment compared to a new environment.

Environment-Independent Intolerance

Environment-independent tolerance is an accelerated intolerance to alcohol’s effects when alcohol is continually consumed in a new environment or accompanied by different cues.

Environment-independent tolerance is why some individuals feel more significant alcohol effects while in a new environment.

Metabolic

Metabolic tolerance is a tolerance to alcohol that results from a more rapid elimination of alcohol from the body. Metabolic tolerance increases with chronic alcohol consumption. Metabolic tolerance is why chronic heavy drinkers may eliminate alcohol two or up to four times as fast as moderate drinkers and therefore need double or greater amounts of alcohol to maintain the same blood alcohol concentration (BAC).

Learned

Learned tolerance, also called behaviorally augmented tolerance, is learned behavior that compensates for alcohol’s impairing effects. Over time, drinkers can develop the ability to control their motor skills better while under the influence of alcohol, giving the appearance of greater alcohol tolerance.

Acute 

Acute alcohol tolerance, also called session tolerance or the Mellanby effect, develops during a single exposure to alcohol. Acute tolerance means that alcohol-induced impairment is more significant when measured soon after beginning alcohol consumption than when measured later in the drinking session, even if the BAC is the same at both times. Acute alcohol tolerance can lead a drinker to consume more alcohol, wrongfully assuming that they are less intoxicated than they genuinely are.

Can Functional Tolerance Lead to Alcohol Dependence?

Functional tolerance can lead to alcohol use disorder. Because the drinker does not experience significant behavioral impairment due to drinking, functional tolerance may facilitate increasing amounts of alcohol, resulting in dependence and alcohol-related organ damage.

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Negative Effects of High Alcohol Tolerance

A higher tolerance to alcohol can give a false impression of just how drunk someone is. You may think a person who is not stumbling or slurring their words is less intoxicated. However, you should not assume that individuals with a higher tolerance are better able to perform tasks that require concentration and reaction time, as if they had not consumed alcohol. The amount of alcohol consumed still affects them even though it may not appear so.

You should not assume that someone with a higher alcohol tolerance won't see the long-term effects of heavy drinking. They are still at risk for complications related to how much alcohol they have consumed in a lifetime, including cirrhosis of the liver, brain disease, neuropathy, pancreatitis, stomach cancer, or other health problems.

People with high tolerance are also more prone to developing alcoholism.

Is it Possible to Lower your Alcohol Tolerance?

It is possible to lower your alcohol tolerance. If you think your tolerance is rising, you should give your body a break from alcohol with some alcohol-free days each week.

Most people can decrease their alcohol tolerance by having an alcohol-free period.

Once you’ve lowered your tolerance, you won’t need as much alcohol to feel the effects, making it far easier to drink more sensibly. If you’ve fallen into a heavier drinking pattern, having a break also allows you to build new, more positive drinking patterns.

If you suspect that you or someone you know may be addicted to alcohol, you should immediately seek medical treatment. To learn more about alcohol addiction treatment options, reach out to an addiction specialist on AlcoholRehabHelp today.

Resources

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“Alcohol and Tolerance - Alcohol Alert No. 28-1995.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, Oct. 2000, https://pubs.niaaa.nih.gov/publications/aa28.htm

Birch, Jenna. So THAT'S Why Alcohol Affects People Differently. 29 Aug. 2020, www.huffpost.com/entry/alcohol-tolerance-reasons_l_5d2e098be4b0a873f642acde

“How to Take a Break and Reset Your Tolerance.” Drinkaware, www.drinkaware.co.uk/advice/how-to-reduce-your-drinking/how-to-take-a-break-and-reset-your-tolerance

“NIH - Mechanisms of Alcohol Tolerance (R21/R33 Clinical Trial Not Allowed).” From the Dean's Office, 22 Feb. 2018, https://news.med.virginia.edu/deansoffice/2018/02/nih-mechanisms-of-alcohol-tolerance-r21r33-clinical-trial-not-allowed/#:~:text=Functional%20tolerance%20is%20further%20defined,known%20as%20the%20Mellanby%20effect

Salahi, Lara. “7 Reasons You're Drunker Than Your Friends.” ABC News, ABC News Network, 4 Aug. 2011, https://abcnews.go.com/Health/Wellness/reasons-drunker-friends/story?id=14221338

Ursell, Amanda. “We Reveal Why Some Women Have No Alcohol Tolerance and Give Tips on How to Stay in Control.” The Sun, The Sun, 9 Aug. 2017, www.thesun.co.uk/living/4208744/expert-nutritionist-low-alcohol-tolerance-women-fabulous/

Vogel-Sprott, Muriel. “Is Behavioral Tolerance Learned?” National Institute on Alcohol Abuse and Alcoholism, ALCOHOL HEALTH & RESEARCH WORLD, https://pubs.niaaa.nih.gov/publications/arh21-2/161.pdf

Vogel-Sprott, M. “Is behavioral tolerance learned?.” Alcohol health and research world vol. 21,2 (1997): 161-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826826/

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