{{short description|Bodily responses to the functional effects of ethanol in alcoholic beverages}} [[File:William Hogarth - Gin Lane.jpg|thumb|250px|''Beer Street and Gin Lane'' by William Hogarth, 1751, detailing the Gin Craze in UK cities during the early Industrial Revolution.]] '''Alcohol tolerance''' refers to the bodily responses to the functional effects of ethanol. This includes direct tolerance, speed of recovery from insobriety and resistance to the development of alcohol use disorder.
==Consumption-induced tolerance== Alcohol tolerance is increased by regular drinking.<ref name=niaaa1/> This reduced sensitivity to the physical effects of alcohol consumption requires that higher quantities of alcohol be consumed in order to achieve the same effects as before tolerance was established. Alcohol tolerance may lead to (or be a sign of) alcohol dependence.<ref name="niaaa1">{{cite journal |date=April 1995 |title=Alcohol and Tolerance |url=http://www.niaaa.nih.gov/publications/aa28.htm |archive-url=https://web.archive.org/web/20050404172912/http://www.niaaa.nih.gov/publications/aa28.htm |url-status=dead |archive-date=2005-04-04 |journal=National Institute on Alcohol Abuse and Alcoholism (NIAAA), Alcohol Alert |issue=28 |access-date=2009-08-13 }}</ref>
Heavy alcohol consumption over a period of years can lead to "reverse tolerance". A liver can be damaged by chronic alcohol use, leading to a buildup of fat and scar tissue.<ref>{{cite web | title = Alcohol-Induced Liver Disease | publisher = UC San Diego Health | url = https://health.ucsd.edu/specialties/gastro/areas-expertise/liver-center/pages/alcohol-induced-liver-disease.aspx | access-date = 4 October 2020 | archive-date = 17 April 2021 | archive-url = https://web.archive.org/web/20210417103603/https://health.ucsd.edu/specialties/gastro/areas-expertise/liver-center/pages/alcohol-induced-liver-disease.aspx | url-status = dead }}</ref> The reduced ability of such a liver to metabolize or break down alcohol means that small amounts can lead to a high blood alcohol concentration (BAC) and more rapid intoxication.{{citation needed|date=August 2018}} Studies have shown that 2–3 weeks of daily alcohol consumption increases tolerance.<ref>{{cite journal | title = Deliberate induction of alcohol tolerance: empirical introduction to a novel health risk | year =2010 | publisher =University of Missouri and the Midwest Alcoholism Research Center | pmc =4708259 | last1 =Martinez | first1 =J. A. | last2 =Steinley | first2 =D. | last3 =Sher | first3 =K. J. | journal =Addiction | volume =105 | issue =10 | pages =1767–1770 | doi =10.1111/j.1360-0443.2010.03042.x | pmid =20840199 }}</ref>
==Physiology of alcohol tolerance== [[File:Ethanol_to_acetaldehyde.svg|thumb|250px|Alcohol dehydrogenase is a dimeric zinc metalloenzyme that catalyzes the reversible oxidation of alcohols to aldehydes]]
Direct alcohol tolerance is largely dependent on body size. Large-bodied people will require more alcohol to reach insobriety than lightly built people.<ref>{{cite web|title=Factors That Affect How Alcohol is Absorbed & Metabolized|url=https://alcohol.stanford.edu/alcohol-drug-info/buzz-buzz/factors-affect-how-alcohol-absorbed|website=Student affairs - Office of Alcohol Policy and Education|publisher=Stanford University|access-date=26 May 2018}}</ref> The alcohol tolerance is also connected with activity of ''alcohol dehydrogenases'' (a group of enzymes responsible for the breakdown of alcohol) in the liver, and in the bloodstream.
High level of alcohol dehydrogenase activity results in fast transformation of ethanol to more toxic acetaldehyde. Such atypical alcohol dehydrogenase levels are less frequent in alcoholics than in non-alcoholics.<ref name="Hurley TD 2012">{{cite journal | author = Hurley TD, Edenberg HJ | year = 2012 | title = Genes encoding enzymes involved in ethanol metabolism | journal = Alcohol Res. | volume = 34 | issue = 3| pages = 339–344 | pmid = 23134050 | pmc = 3756590 }}</ref> Furthermore, among alcoholics, the carriers of this atypical enzyme consume lower ethanol doses, compared to the individuals without the allele.{{Citation needed|date=May 2021}}
An estimated one out of twenty people have an alcohol flush reaction. It is not in any way an indicator for the drunkenness of an individual.<ref>{{cite web|url=http://www.diffordsguide.com/en/magazine/2013-09-10/5/the-asian-gene|title=Myth or reality? The Asian alcohol 'gene' explained|work=Difford's Guide|date=September 10, 2013|access-date=2013-10-22|archive-url=https://web.archive.org/web/20131022042015/http://www.diffordsguide.com/en/magazine/2013-09-10/5/the-asian-gene|archive-date=2013-10-22|url-status=dead}}</ref><ref>{{cite web|url=http://www.rgl.wa.gov.au/ResourceFiles/Policies/Identifying_the_Signs_of_Intoxication.pdf|title=Identifying the Signs of Intoxication|date=December 2010|publisher=Government of Western Australia|archive-url=https://web.archive.org/web/20110327023124/http://www.rgl.wa.gov.au/ResourceFiles/Policies/Identifying_the_Signs_of_Intoxication.pdf|archive-date=March 27, 2011|url-status=dead}}</ref> A mild flushing reaction occurs when the body metabolizes alcohol more quickly into acetaldehyde, a toxic metabolite.<ref name="Hurley TD 2012"/><ref>{{cite journal |pmid=17718397 |year=2007 |last1=Eng |first1=MY |last2=Luczak |first2=SE |last3=Wall |first3=TL |title=ALDH2, ADH1B, and ADH1C genotypes: A literature review |volume=30 |issue=1 |pages=22–7 |journal=Alcohol Research & Health |pmc=3860439}}</ref> A more severe flushing reaction occurs when the body metabolizes the acetaldehyde more slowly, generally due to an inactive aldehyde dehydrogenase enzyme. Both of those conditions—faster conversion of alcohol to acetaldehyde and slower removal of acetaldehyde—reduce the risk for excessive drinking and alcohol dependence.<ref name="Hurley TD 2012"/>
==Alcohol tolerance in different ethnic groups== {{See also|Race and health|Genetic epidemiology}}
To engage in alcohol consumption and the development of an alcohol use disorder appear to be common to primates, and is not a specific human phenomenon.<ref>{{cite journal|last1=Juarez|first1=J|last2=Guzman-Flores|first2=C|last3=Ervin|first3=FR|last4=Palmour|first4=RM|title=Voluntary alcohol consumption in vervet monkeys: individual, sex, and age differences.|journal=Pharmacology Biochemistry and Behavior|date=December 1993|volume=46|issue=4|pages=985–8|pmid=8309979|doi=10.1016/0091-3057(93)90232-I|s2cid=33697201}}</ref> Humans have access to alcohol in far greater quantity than non-human primates, and the availability increased, particularly with the development of agriculture.<ref>{{Cite journal|date=1986-01-01|url=http://dx.doi.org/10.1093/oxfordjournals.alcalc.a044598|journal=Alcohol and Alcoholism|doi=10.1093/oxfordjournals.alcalc.a044598|issn=1464-3502|title=Racial Differences in Alcohol Sensitivity|url-access=subscription}}</ref> The tolerance to alcohol is not equally distributed throughout the world's population.<ref>{{cite journal|last1=Chan|first1=AW|title=Racial differences in alcohol sensitivity.|journal=Alcohol and Alcoholism (Oxford, Oxfordshire)|date=1986|volume=21|issue=1|pages=93–104|pmid=2937417}}</ref> Genetics of alcohol dehydrogenase indicate resistance has arisen independently in different cultures.<ref name=Pakstis>{{cite journal |doi=10.1086/341290 |title=A Global Perspective on Genetic Variation at the ADH Genes Reveals Unusual Patterns of Linkage Disequilibrium and Diversity |year=2002 |last1=Osier |first1=Michael V. |last2=Pakstis |first2=Andrew J. |last3=Soodyall |first3=Himla |last4=Comas |first4=David |last5=Goldman |first5=David |last6=Odunsi |first6=Adekunle |last7=Okonofua |first7=Friday |last8=Parnas |first8=Josef |last9=Schulz |first9=Leslie O. |display-authors=8|journal=American Journal of Human Genetics |volume=71 |pages=84–99 |pmid=12050823 |pmc=384995 |issue=1}}</ref> In North America, Native Americans have the highest probability of developing an alcohol use disorder compared to Europeans and Asians.<ref>{{cite web|url=http://health.nytimes.com/health/guides/disease/alcoholism/risk-factors.html|title=Alcohol Use Disorder|work=NY Times|year=2013|access-date=July 21, 2016}}</ref><ref>Mail ''& al.'' (eds., 2002): Alcohol Use Among American Indians and Alaska Natives: Multiple Perspectives on a Complex Problem. ''NIAAA Research Monograph'' No. 37. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism{{page needed|date=February 2013}}</ref><ref>{{cite journal |doi=10.1111/j.1530-0277.1998.tb03685.x |title=Trends in Alcohol-Related Problems among Whites, Blacks, and Hispanics: 1984-1995 |year=1998 |last1=Caetano |first1=Raul |last2=Clark |first2=Catherine L |journal=Alcoholism: Clinical and Experimental Research |volume=22 |issue=2 |pages=534–538|pmid=9581665 }}</ref><ref>{{cite web|title=Ethnicity and Health Disparities in Alcohol Research|url=http://pubs.niaaa.nih.gov/publications/arh40/152-160.htm|archive-url=https://web.archive.org/web/20121019235352/http://pubs.niaaa.nih.gov/publications/arh40/152-160.htm|url-status=dead|archive-date=October 19, 2012|author1=Karen Chartier|author2=Raul Caetano}}</ref> Different alcohol tolerance also exists within Asian groups, such as between Chinese and Koreans.<ref>{{cite journal|last1=Duranceaux & al.|title=Ethnic differences in level of response to alcohol between Chinese Americans and Korean Americans.|journal=J Stud Alcohol Drugs|date=2008|volume=69|issue=2|pages=227–234|pmid=18299763|pmc=2739570|doi=10.15288/jsad.2008.69.227}}</ref> The health benefits of a modest alcohol consumption reported in people of European descent appear not to exist among people of African descent.<ref>{{cite journal|last1=Jackson|first1=Chandra L.|last2=Hu|first2=Frank B.|last3=Kawachi|first3=Ichiro|last4=Williams|first4=David R.|last5=Mukamal|first5=Kenneth J.|last6=Rimm|first6=Eric B.|title=Black–White Differences in the Relationship Between Alcohol Drinking Patterns and Mortality Among US Men and Women|journal=American Journal of Public Health|date=July 2015|volume=105|issue=S3|pages=S534–S543|doi=10.2105/AJPH.2015.302615|pmid=25905819|pmc=4455501}}</ref>
Higher body masses and the prevalence of high levels of alcohol dehydrogenase in an individual increase alcohol tolerance, and both adult weight and enzymes vary with ethnicity.<ref>{{cite journal |doi=10.1007/BF00554070 |title=Human stomach alcohol and aldehyde dehydrogenases (ALDH): A genetic model proposed for ALDH III isozymes |year=1988 |last1=Yin |first1=S. -J. |last2=Cheng |first2=T. -C. |last3=Chang |first3=C. -P. |last4=Chen |first4=Y. -J. |last5=Chao |first5=Y. -C. |last6=Tang |first6=H. -S. |last7=Chang |first7=T. -M. |last8=Wu |first8=C. -W. |journal=Biochemical Genetics |volume=26 |issue=5–6 |pages=343–60 |pmid=3214414|s2cid=9315241 }}</ref><ref>{{cite journal |pmid=5112118 |year=1971 |last1=Fenna |first1=D |last2=Schaefer |first2=O |last3=Mix |first3=L |last4=Gilbert |first4=JA |title=Ethanol metabolism in various racial groups |volume=105 |issue=5 |pages=472–5 |pmc=1931291 |journal=Canadian Medical Association Journal}}</ref> Not all differences in tolerance can be traced to biochemistry, however.<ref>{{cite journal |author1=Bennion L. |author2=Li T. K. | year = 1976 | title = Alcohol metabolism in American Indians and whites | journal = New England Journal of Medicine | volume = 294 | issue = 1| pages = 9–13 | doi=10.1056/nejm197601012940103|pmid=1244489}}</ref> Differences in tolerance levels are also influenced by socio-economic and cultural difference including diet, average body weight and patterns of consumption.<ref>{{cite book|author1=Waldram, J. B.|author2=Herring, A.|author3=Young, K.|name-list-style=amp|year=1995|title=Aboriginal Health in Canada: Historical, Cultural, and Epidemiological Perspectives|location=Toronto|publisher=University of Toronto Press|url=https://books.google.com/books?id=O-jBWP_HgT8C&dq=Aboriginal+Health+in+Canada:+Historical,+Cultural,+and+Epidemiological+Perspectives&pg=PR9|isbn=9780802085795}}</ref><ref>{{cite book|last1=Saggers|first1=Sherry|last2=Gray|first2=Dennis|year=1998|title=Dealing with Alcohol: Indigenous Usage in Australia, New Zealand and Canada|location=Cambridge|publisher=Cambridge University Press|isbn=0-521-62032-5}}{{page needed|date=February 2013}}</ref>
==In animals== Ethanol is caloric but highly intoxicating for most animals, which typically tolerate only up to 4% in their diet. However, a 2024 study found that oriental hornets fed sugary solutions containing 1% to 80% ethanol for a week showed no adverse effects on behavior or lifespan.<ref>{{cite news |title=Hornets can hold their alcohol like no other animal on Earth |url=https://www.newscientist.com/article/2452557-hornets-can-hold-their-alcohol-like-no-other-animal-on-earth/ |work=New Scientist}}</ref>
==Footnotes== {{reflist}}
==References== *Carroll, Charles R. '' Drugs in Modern Society ''. NY: McGraw-Hill, 2000 (fifth ed.). *{{cite journal |last1=Chesher |first1=G. |last2=Greeley |first2=J. |title=Tolerance to the effects of alcohol |journal=Alcohol, Drugs and Driving |year=1992 |volume=8 |issue=2 |pages=93–106}} *{{cite journal |pmid=10090900 |year=1999 |last1=Osier |first1=M |last2=Pakstis |first2=AJ |last3=Kidd |first3=JR |last4=Lee |first4=JF |last5=Yin |first5=SJ |last6=Ko |first6=HC |last7=Edenberg |first7=HJ |last8=Lu |first8=RB |last9=Kidd |first9=KK |title=Linkage disequilibrium at the ADH2 and ADH3 loci and risk of alcoholism |volume=64 |issue=4 |pages=1147–57 |pmc=1377839 |journal=American Journal of Human Genetics |doi=10.1086/302317}} *{{cite journal |pmid=7635462 |year=1995 |last1=Muramatsu |first1=T |last2=Wang |first2=ZC |last3=Fang |first3=YR |last4=Hu |first4=KB |last5=Yan |first5=H |last6=Yamada |first6=K |last7=Higuchi |first7=S |last8=Harada |first8=S |last9=Kono |first9=H |title=Alcohol and aldehyde dehydrogenase genotypes and drinking behavior of Chinese living in Shanghai |volume=96 |issue=2 |pages=151–4 |journal=Human Genetics |doi=10.1007/BF00207371|s2cid=1624596 }} *{{cite journal |pmid=9500299 |year=1998 |last1=Neumark |first1=YD |last2=Friedlander |first2=Y |last3=Thomasson |first3=HR |last4=Li |first4=TK |title=Association of the ADH2*2 allele with reduced ethanol consumption in Jewish men in Israel: A pilot study |volume=59 |issue=2 |pages=133–9 |journal=Journal of Studies on Alcohol|doi=10.15288/jsa.1998.59.133 }} *{{cite journal |doi=10.1007/s11177-005-0231-5 |title=Polymorphism of Alcohol Dehydrogenase Gene ADH1B in Eastern Slavic and Iranian-Speaking Populations |year=2005 |last1=Borinskaya |first1=S. A. |last2=Gasemianrodsari |first2=F. |last3=Kalyina |first3=N. R. |last4=Sokolova |first4=M. V. |last5=Yankovsky |first5=N. K. |journal=Russian Journal of Genetics |volume=41 |issue=11 |pages=1291–4|s2cid=4686166 }} Translated from {{cite journal |pmid=16358724 |year=2005 |title=Polymorphism of alcohol dehydrogenase gene ADH1B in eastern Slavic and Iranian-speaking populations |volume=41 |issue=11 |pages=1563–6 |journal=Genetika}} *{{cite journal |doi=10.1016/j.ajhg.2008.12.007 |title=Distribution of the Alcohol Dehydrogenase ADH1B∗47His Allele in Eurasia |year=2009 |last1=Borinskaya |first1=Svetlana |last2=Kal'Ina |first2=Nina |last3=Marusin |first3=Andrey |last4=Faskhutdinova |first4=Gulnaz |last5=Morozova |first5=Irina |last6=Kutuev |first6=Ildus |last7=Koshechkin |first7=Vladimir |last8=Khusnutdinova |first8=Elza |last9=Stepanov |first9=Vadim |display-authors=8|journal=American Journal of Human Genetics |volume=84 |pages=89–92; author reply 92–4 |pmid=19124091 |issue=1 |pmc=2668054}} *{{cite journal |doi=10.1111/j.1469-1809.2009.00517.x |title=Refined Geographic Distribution of the Oriental ''ALDH2*504Lys'' (nee ''487Lys'') Variant |year=2009 |last1=Li |first1=Hui |last2=Borinskaya |first2=Svetlana |last3=Yoshimura |first3=Kimio |last4=Kal’Ina |first4=Nina |last5=Marusin |first5=Andrey |last6=Stepanov |first6=Vadim A. |last7=Qin |first7=Zhendong |last8=Khaliq |first8=Shagufta |last9=Lee |first9=Mi-Young |display-authors=8|journal=Annals of Human Genetics |volume=73 |issue=3 |pages=335–45 |pmid=19456322 |pmc=2846302}}
==Further reading== *{{cite journal|title=Alcohol consumption among racial/ethnic minorities: theory and research|journal=Alcohol Health Res World.|year=1998|volume=22|issue=4|pages=233–41|vauthors=Caetano R, Clark CL, Tam T|pmid=15706749|pmc=6761890|url=http://www.hawaii.edu/hivandaids/Alcohol%20Consumption%20Among%20RacialEthnic%20Minorities%20%20%20%20%20Theory%20and%20Research.pdf|archive-url=https://web.archive.org/web/20150616021529/http://www.hawaii.edu/hivandaids/Alcohol%20Consumption%20Among%20RacialEthnic%20Minorities%20%20%20%20%20Theory%20and%20Research.pdf|archive-date=June 16, 2015|url-status=dead}} {{alcohealth}} {{Psychoactive substance use}}
Tolerance Category:Race and health