Alcohol and Its Interactions

Alcohol is one of the few mind-altering drugs that has defined effects on behavior. Its interaction with borderline personality disorder is particularly significant.

What Is Alcoholism? Definition, diagnostic criteria, and types according to Jellinek

Relapse Risks Hidden sources of alcohol and dangerous medications

Personal Stories First-hand accounts from those affected

Important Notice

This text is for informational purposes and does not replace medical advice. If you are struggling with addiction, please contact an addiction counseling center or your doctor.

What Is Alcohol?

• Chemical formula: C₂H₅OH (Ethanol)
• Produced by the fermentation of sugar (conversion by yeast into ethanol and carbon dioxide)
• A cellular toxin that attacks every single cell in the body
• Crosses the blood-brain barrier without difficulty
• Dissolves only in water (water-containing body parts)

Effects on the Brain

Alcohol directly interferes with the brain’s biochemical metabolism:

1. First, the neocortex (cerebrum) is paralyzed — cognitive inhibitions are overridden
2. The limbic system is activated — where emotions and reward systems reside
3. Result: Disinhibition; feelings, fears, and repressed content that are normally kept in check come to the surface

Alcohol brings the deepest inner self to the surface and makes a person more unpredictable than any other drug.

Alcohol and Borderline

Critical Interaction

When alcohol is present in a borderline relationship — which is the case in 90% of instances — the already extreme dynamics are amplified exponentially. The person with borderline typically loses the last shred of their self-control.

Caution with diagnosis: Alcohol abuse can produce symptoms that resemble borderline personality disorder. This is also a common mistake among doctors who diagnose borderline when “only” alcohol abuse is present.

Amplifying Effect

• Alcohol intensifies the existing emotional state
• It brings underlying feelings and emotions to the surface
• A two-phase poison in depression: First it lifts the mood, then the original state becomes even worse

Blood Alcohol Levels and Effects

Values refer to a male, 67 kg, without alcohol tolerance:

BAC (‰)	Effect
up to 0.3	Usually no effect
up to 0.6	Warmth, relaxation, euphoria, mild motor impairment
up to 0.9	Disinhibited behavior, exaggerated emotionality, onset of intoxication, distorted perception
up to 1.2	Erratic behavior, staggering, slurred speech
up to 2.5	Severe perceptual and motor disturbances, possible loss of consciousness
above 2.5	Worsening of all symptoms
4-5.0	Total stupor or death

Calculation Formula

(Amount consumed in grams of alcohol) ÷ (Body weight × 0.7) = BAC in ‰

Rules of thumb:

• Drinking more slowly per hour: minus 0.1 ‰
• Drinking faster per hour: plus 0.1 ‰
• Per 10 kg more body weight: minus 0.1 ‰
• Per 10 kg less body weight: plus 0.1 ‰

Metabolism: Men metabolize 0.1 ‰ per hour, women 0.08 ‰.

Alcohol Content of Typical Beverages

Beverage	Vol%	Amount	Alcohol (g)
Beer	5%	0.5 l	20g
Wine	10%	0.125 l	10-13g
Sparkling wine	12%	0.1 l	10g
Liqueur	30%	4 cl	9g
Grain spirit	32%	4 cl	10g
Vodka, Gin	40%	4 cl	13g

Factors That Influence the Effect

• Sex (male/female)
• Eating habits (bulimia, anorexia)
• What was eaten and when
• Drinking speed and habits
• Psychological state (stress)
• General health (illness, menstruation)
• Use of medications

Alcohol and Medications

Dangerous Combination

Certain medications (morphines, benzodiazepines, barbiturates) bind to the same receptors in the brain as alcohol. The effect is exponentially amplified when combined with simultaneous medication abuse.

The Path to Abuse

According to research, those who later end up in abuse or addiction initially use alcohol as self-medication — to combat inner emptiness, anger, rage, helplessness, fear, depression, melancholy, or to quickly dampen emotions.

Physical vs. Psychological Dependence

• Physical dependence: Treatment is not difficult, usually takes just a few weeks
• Psychological dependence: Extremely difficult, requires at least 2 years and identifying the underlying causes (e.g., ADHD, borderline personality disorder)

It is useless to treat someone for alcohol addiction without finding and treating the underlying problem.

Does Alcohol Make You Fat?

Clearly yes.

• 1 gram of alcohol = 29 kJ of energy
• 1 liter of beer = 2000 kJ (20% of a man’s daily requirement)
• The excess energy is stored as fat

A Final Word

The person with alcoholism is stigmatized because it is supposedly “just a matter of willpower.” This is wrong. Medication abuse is also viewed differently by society — because it is invisible.

We often say: “There’s an alcoholic, disheveled on a park bench.” But that is only the bitter end that we get to see.

No one who became addicted or engaged in substance abuse ever raised their hand and shouted: “I want this.” It takes external circumstances for that. The drug only accelerates everything.

Childhood, mother, father, life, your circumstances — and ultimately the insurmountable, unprocessed pain within.

People who manage to break free from this cycle have my deepest respect. They are wonderful people. People who achieve this can achieve anything.

---

And one thing we should never forget: It can happen to anyone. Too many have said “it could never happen to me!”