As pubs and bars reopen across England, many are excited about the opportunity to enjoy a drink with friends and family. While some evidence suggests alcohol consumption increased during lockdown, other reports suggest that over one in three adults drank less – or stopped altogether.
But though we may be excited to get back to the pub, our tolerance may be lower than it was pre-lockdown. Regularly drinking a certain amount of alcohol (for example, having four pints every Friday evening after work) can lead to increased tolerance, This is where the brain adapts to the effects of alcohol (such as relaxation and improved mood), and over time more alcohol is needed to achieve the same effects.
In this scenario you may need to drink five pints to get the same initial “buzz” you got from four pints. Tolerance is a hallmark feature of addiction, But it can also develop with regular and continued alcohol use in social drinkers. Following a period of reduced alcohol use or abstinence, alcohol tolerance can decrease to levels before regular use.
- 1 How long does it take to build a tolerance to alcohol?
- 2 Does drinking faster make you drunker?
- 3 Is it OK to get drunk once a week?
- 4 How often is too often to get drunk?
- 5 Do you ever build a tolerance to alcohol?
How can I increase my alcohol tolerance fast?
Download Article Download Article Increasing your alcohol tolerance is best done by gradually drinking more servings over time, but there are also things you can do before drinking that will help, too. Since drinking is a common aspect of many social occasions, like cocktail parties, work happy hours, dinners with family and friends, it’s important to be able to “hold your liquor” so that you can make the most of these events.
- 1 Know the difference between alcohol tolerance and dependence. Although there is a relationship between alcohol tolerance and dependence, they are not the same thing. A person can increase their alcohol tolerance without becoming dependent, though having too high an alcohol tolerance likely means you are also dependent.
- Tolerance means that your body adapts to the consumption of a specific amount of alcohol, even in amounts such as one beer or one glass of wine.
- Dependence means that you consistently and compulsively consume alcohol and need it to function, a dangerous state you want to avoid. If your alcohol tolerance becomes too high, it’s likely a sign that you’re dependent, which can be dangerous not only for you, but also the people around you.
- 2 Understand that different types of drinks are different. Not all alcoholic drinks are equal in alcohol strength, and even the type of drink may be handled differently by different individuals.
- In general, the smaller the typical serving size, the stronger the drink. A shot of whiskey can have as much alcohol as an entire light beer.
- In many countries, the alcohol content is labelled on the container. The higher the content, the higher the effect.
- Sweet fruity drinks and/or cocktails can be very difficult to judge on alcoholic content-especially for a novice. Since these can vary widely based on the bartender, there is no one standard.
- Not all types of drinks are standardized. A typical lager-style beer is usually about 5% alcohol, but some craft beers are 20% or more.
- Different drinks may produce different effects. Be aware that while inebriation has common effects, different types of drinks may cause slightly different effects. For example, a person may be much more mellow drinking wine than after having tequila.
- 3 Determine your current alcohol tolerance. Before you start to increase your consumption, estimate what your current tolerance is. This will help you figure out the safest way to consume more alcohol.
- Have one drink, then perhaps another in a safe environment with responsible drinkers. Do not put yourself in a situation where impairment is inherently dangerous, or with people who are irresponsible and are likely to push you past your comfort zone.
- If you do not normally consume alcohol, or have one or two drinks once a week, your tolerance will be comparatively low. If you consume two drinks five days a week, your tolerance will be accordingly higher.
- 4 Gradually consume more alcohol in a safe and responsible way. The easiest way to increase your tolerance for alcohol is to drink more of it. You’ll want to do this without harming yourself- or anyone else. It is important to realize that alcohol consumption is never risk-free and that while you may not feel the effects of alcohol consumption, you may nevertheless be too impaired to function normally.
- Go slowly. For example, consume only one additional drink than you normally would. If you never drink, start with one, or even a half of, alcoholic beverage. If you usually have one glass of wine or one spirit, have one and a half or two drinks. This will ensure that you do not consume too much alcohol as you increase your tolerance.
- Consider having one glass of water in between drinks to help yourself consume drinks slowly.
- Eat while drinking. Consuming food while drinking helps keep the alcohol from having quite as strong an effect. Drinking on an empty stomach will cause much more inebriation than on a full one.
- 5 Stay within sensible drinking guidelines. Remember, you are increasing your tolerance and avoiding dependence. By consuming alcohol within sensible guidelines, you will run less risk of becoming dependent or harming yourself.
- Remember that your judgement will be impaired on alcohol-you can be drunk and not think you are. For this reason, it is often good to have a friend to keep tabs on your drinking, and help you to stay within the sensible guidelines for drinking.
- Alcohol units are based on the percentage alcohol in a beverage and the amount of alcohol consumed. One unit of alcohol is 10 milliliters (0.34 fl oz) of pure alcohol. Since most alcohol beverages are not pure alcohol, the percentage of alcohol in the drink is a factor in the number of units. For reference, a bottle of wine has 9-10 units.
- For example, one pint of beer with a 4% alcohol volume 2.3 units. If you prefer spirits, such as scotch, a “single” scotch of 25 milliliters (0.85 fl oz) has one unit. Or maybe you prefer wine, in which case, one 175 milliliters (5.9 fl oz) glass has 2.3 units.
- The guidelines for sensible drinking recommend no more than 2-3 units of alcohol a day for women. This would be the equivalent of approximately one beer or glass of wine per day, or two to three single spirits.
- The guidelines for sensible drinking recommend no more than 3-4 units of alcohol a day for men. This would be the equivalent of approximately 1-2 beers or glasses of wine, or 3-4 spirits per day.
- 6 Know when to stop. As your alcohol tolerance increases, it may be difficult to figure out when you’ve had too much to drink. Making sure you know how much you’ve consumed will help you avoid getting drunk, alcohol poisoning, or possibly worse.
- 7 Have alcohol-free days every week. It’s a good idea to have at least two alcohol free days per week. This will keep you from becoming dependent on alcohol and help your body recover from previous consumption.
- If you find that you can’t go a day without alcohol consumption, this is a sign that you are dependent. If this is the case, seek professional help.
- 8 Know the dangers of alcohol consumption. Any time you consume an alcoholic beverage, you run the risk of harming your body. The only risk-free alcohol consumption is not drinking at all, and the more you drink, the greater your risk.
- Tolerance will not protect you from the dangers of alcohol.
- In the short term, alcohol consumption can cause the following health problems: weight gain, depression, skin problems, and memory loss.
- In the long term, alcohol consumption can cause the following health problems: high blood pressure, chronic liver disease, and breast cancer.
- 1 Understand how different bodily factors affect tolerance. How a person tolerates alcohol is affected by several factors, some of which are manageable. Your gender, body type, weight, use of medication, food consumption, and fatigue are just a few examples of elements that influence your alcohol tolerance.
- Woman, who generally have more body fat and less water percentage in their blood, have a lower tolerance level than men. This is because they do not have as much water to dilute the alcohol in their blood.
- 2 Control manageable factors of alcohol tolerance. While you cannot control elements like your gender, if you want to increase your alcohol tolerance, controlling manageable factors such as weight, fatigue, hydration, and food consumption can help increase your tolerance.
- 3 Gain weight, particularly muscle mass. One simple way to increase your tolerance is by gaining weight. Generally, the more a body weighs, the more quickly it can absorb alcohol, making your level of tolerance higher.
- It’s true that general body size affects tolerance, but muscle tissue absorbs alcohol much faster than fat.
- If you want to gain weight, remember to do so safely. Adding even 10 pounds to your weight will help increase your alcohol tolerance. But remember that just as alcohol consumption comes with risk factors, so does increased weight. In conjunction, for example, they can lead to high blood pressure.
- 4 Have a meal. If you have food in your stomach, alcohol will absorb less quickly, making the effects of alcohol less noticeable. Likewise, having nothing in your stomach will lower your tolerance.
- The size of the meal you have matters. For example, if you consume a larger meal, it will slow the absorption of alcohol into your blood, making your tolerance temporarily increase.
- The amount of time between food and alcohol consumption also affects your tolerance. For example, if you consume a large meal either just before or during alcohol consumption, your tolerance will be greater. If you have a smaller meal and wait to drink, your tolerance will be correspondingly lower.
- Remember that food only delays the absorption of alcohol into your system. You won’t necessarily be able to consume much more alcohol than you usually do, so it’s best to err on the side of caution and not go overboard.
- 5 Make sure you’re hydrated. Consuming alcoholic beverages when you’re dehydrated leads to decreased tolerance because there is less water in your blood to dilute the alcohol.
- For example, before you consume an alcoholic beverage, consider having a glass of water to make sure you are somewhat hydrated.
- Consider having a glass of water in between each drink. This will help you stay hydrated and ensure that you do not consume more than the sensible guidelines suggest.
- 6 Make sure you’re rested and healthy. If you’re fatigued and/ or ill, your body is less efficient at processing and eliminating alcohol.
- If you haven’t been sleeping or are fatigued from stress at work, consider having an alcohol free day. This will help your body recover and ensure you don’t consume too much alcohol.
- If you are ill and taking medications, know that they can interact with alcohol by increasing the effects of alcohol.
- If you are sick, consider having an alcohol free day. This will help your body recover, and ensure that you do not consume too much alcohol or experience any negative reactions from combining medication with alcohol.
- 7 Remember to follow the sensible guidelines for alcohol consumption. Even if you decide to increase your tolerance through controlling manageable factors such as weight, fatigue, illness, and food consumption, you still need to follow the sensible guidelines for alcohol consumption.
- Doing so will help ensure that you do not harm yourself, including becoming dependent on alcohol.
Add New Question
- Question Last Saturday night I drank 1 liter of straight vodka, and I was okay for the rest of the night, does that mean I am addicted to alcohol? No, it means you have a high tolerance for alcohol. When you start feeling a compulsion to drink even when you shouldn’t, then it can cause serious problems for you and your health.
- Question Can a hangover last a full day? It really depends on the amount of alcohol you consumed and your general tolerance. It also depends on whether you were hydrated before you started, or whether you were hydrating throughout the night. Remember to hydrate yourself.
- Question I have a hard time drinking strong spirits, it makes me feel like I’m about to throw up right after and I get gagging reflexes right after taking a shot. This wasn’t the case before, what can I do? I had a bad experience once with strong spirits. What I did to be able to drink them again was dilute them massively for a bit, then as I slowly got more and more drunk I added more spirit to it and then by the end of the night I could shot spirits like there was no tomorrow.
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- Sticking to one kind of alcoholic beverage during an event can make it easier to gauge how much alcohol you’ve consumed.
- Increasing your alcohol tolerance responsibly and safely is not something you can do overnight. Gradually increasingly your consumption and tolerance while staying within sensible drinking guidelines will take time and save you potential health risks.
- Binge drinking can severely damage your health or even be fatal.
- Increasing your alcohol tolerance can trigger an unexpected and sudden intolerance and/ or alcohol toxicity, which can be fatal.
Article Summary X To improve your alcohol tolerance, gradually consume more alcohol in a responsible way every time you drink. For example, if you normally feel intoxicated after one drink, try having one and a half or two drinks. Remember to increase your alcohol intake slowly so you don’t inadvertently harm yourself or someone else.
How long does it take to build a tolerance to alcohol?
Consumption-induced tolerance – Alcohol tolerance is increased by regular drinking. 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.
- 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.
- 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,
Studies have shown that 2–3 weeks of daily alcohol consumption increases tolerance.
How do you drink a lot and not get drunk?
– The body typically takes an hour to process one standard drink. If you drink fast or chug your bevs, your body doesn’t have the time it needs to do this, resulting in a buildup of alcohol in your bloodstream and a higher BAC. Sipping your drinks slowly so that you’re not exceeding more than one drink per hour is the best way not to get drunk.
Can some people not get drunk?
People who don’t get drunk – Some people seem to drink without getting drunk. It’s tempting to admire those individuals as if this kind of drinking is something to aspire to. In our culture, we idolise people who can hold their liquor. But in reality, if someone drinks a lot and never seems to get drunk, they have developed a high tolerance for alcohol.
- Tolerance occurs because of your body’s remarkable ability to process alcohol.
- Unlike with other drugs, your body actually tries to adapt to alcohol’s persistent presence.
- And so, over time, you find yourself drinking more to experience the same effects.
- Your tolerance for alcohol isn’t a badge of honour.
It’s a problem. Remember when you first drank alcohol? One or two drinks would have a big impact on you. If you’ve been drinking consistently for a while, you might have three, four or more drinks without really feeling drunk. But this doesn’t mean there aren’t effects, and you haven’t suddenly become immune to alcohol.
- Even if you don’t feel drunk, you can still be dangerously over the limit for driving, your judgement can be impaired, and you can do yourself hidden damage.
- Your tolerance for alcohol isn’t a badge of honour.
- It’s a problem.
- Tolerance isn’t the same thing as being physically dependent on alcohol, but you should take it as a warning sign.
If you become physically dependent on alcohol, your body relies on it to function. Once you get to that stage, suddenly stopping can be dangerous, even deadly, as you begin to experience alcohol withdrawal symptoms, And you don’t need to be drinking every day to experience these consequences.
How many drinks should get you drunk?
What is the clinical utility of the “heavy drinking day” metric? – Knowing what counts as a heavy drinking day —4 or more drinks for women and 5 or more for men—can be clinically useful in two ways. First, brief screening tools recommended by the U.S.
- Preventive Services Task Force—such as the AUDIT-C and the NIAAA single alcohol screening question—ask about heavy drinking days.24 (See Core article on,) These tools allow you to identify the patients who need your advice and assistance to cut down or quit.
- Second, when offering advice to patients who drink heavily, you may help motivate them to cut back or quit by sharing that having no heavy drinking days can bring marked improvements in how they feel and function.25 In studies, the gains were strong enough to prompt the FDA to accept no heavy drinking days as a positive outcome in alcohol treatment trials, in addition to the outcome of abstinence, the safest route.26 (See the Core article on,) It also helps to be aware of the typical weekly volume, because the more frequent the heavy drinking days, and the greater the weekly volume, the greater the risk for having AUD.27 (See Core article on,) In closing, to gauge how much alcohol is too much for patients, you will need to look at their individual circumstances and assess the risks and health effects.
At one end of the spectrum, any alcohol is too much for some patients, as noted above. At the other end, patterns such as heavy and binge drinking are clearly high risk and should be avoided. In the zone in between, for people who choose to drink, current research indicates the less, the better.8, 9 Other Core articles will help you to for heavy drinking, identify possible of alcohol use, for signs of AUD, and conduct a to guide patients in setting a plan to cut back or quit if needed.
- Absorption and distribution.
- When alcohol is consumed, it passes from the stomach and intestines into the bloodstream, where it distributes itself evenly throughout all the water in the body’s tissues and fluids.
- Drinking alcohol on an empty stomach increases the rate of absorption, resulting in higher blood alcohol level, compared to drinking on a full stomach.
In either case, however, alcohol is still absorbed into the bloodstream at a much faster rate than it is metabolized. Thus, the blood alcohol concentration builds when a person has additional drinks before prior drinks are metabolized. Metabolism. The body begins to metabolize alcohol within seconds after ingestion and proceeds at a steady rate, regardless of how much alcohol a person drinks or of attempts to sober up with caffeine or by other means.
Most of the alcohol is broken down in the liver by the enzyme alcohol dehydrogenase (ADH). ADH transforms ethanol, the type of alcohol in alcohol beverages, into acetaldehyde, a toxic, carcinogenic compound. Generally, acetaldehyde is quickly broken down to a less toxic compound, acetate, by aldehyde dehydrogenase (ALDH).
Acetate then is broken down, mainly in tissues other than the liver, into carbon dioxide and water, which are easily eliminated. To a lesser degree, other enzymes (CYP2E1 and catalase) also break down alcohol to acetaldehyde. Although the rate of metabolism is steady in any given person, it varies widely among individuals depending on factors including liver size and body mass, as well as genetics. Some people of East Asian descent, for example, carry variations of the genes for ADH or ALDH that cause acetaldehyde to build up when alcohol is consumed, which in turn produces a flushing reaction and increases cancer risk.28–30 People of other races and ethnicities can also carry variations in these genes.6 Blood alcohol concentration (BAC).
- Alcohol Metabolism
- Resources to Share with Patients Related to this Article
- More resources for a variety of healthcare professionals can be found in the,
- Dawson DA, Li TK, Grant BF. A Prospective Study of Risk Drinking: At Risk for What? Drug Alcohol Depend,2008;95(1-2):62-72. doi:10.1016/j.drugalcdep.2007.12.00
- Kerr WC, Stockwell T. Understanding standard drinks and drinking guidelines. Drug Alcohol Rev,2012;31(2):200-205. doi:10.1111/j.1465-3362.2011.00374.x
- Devos-Comby L, Lange JE. “My drink is larger than yours”? A literature review of self-defined drink sizes and standard drinks. Curr Drug Abuse Rev,2008;1(2):162-176. doi:10.2174/1874473710801020162
- Martinez P, Kerr WC, Subbaraman MS, Roberts SCM. New Estimates of the Mean Ethanol Content of Beer, Wine, and Spirits Sold in the United States Show a Greater Increase in Per Capita Alcohol Consumption than Previous Estimates. Alcohol Clin Exp Res,2019;43(3):509-521. doi:10.1111/acer.13958
- Chang JS, Hsiao JR, Chen CH. ALDH2 polymorphism and alcohol-related cancers in Asians: a public health perspective. J Biomed Sci,2017;24(1):19. doi:10.1186/s12929-017-0327-y
- Chen CH, Ferreira JCB, Joshi AU, et al. Novel and prevalent non-East Asian ALDH2 variants; Implications for global susceptibility to aldehydes’ toxicity. EBioMedicine,2020;55:102753. doi:10.1016/j.ebiom.2020.102753
- S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025,9th ed.; 2020. DietaryGuidelines.gov
- Rehm J, Roerecke M. Cardiovascular effects of alcohol consumption. Trends Cardiovasc Med,2017;27(8):534-538. doi:10.1016/j.tcm.2017.06.002
- Millwood IY, Walters RG, Mei XW, et al. Conventional and genetic evidence on alcohol and vascular disease aetiology: a prospective study of 500 000 men and women in China. Lancet Lond Engl,2019;393(10183):1831-1842. doi:10.1016/S0140-6736(18)31772-0
- Choi YJ, Myung SK, Lee JH. Light Alcohol Drinking and Risk of Cancer: A Meta-Analysis of Cohort Studies. Cancer Res Treat Off J Korean Cancer Assoc,2018;50(2):474-487. doi:10.4143/crt.2017.094
- Hartz SM, Oehlert M, Horton AC, et al. Daily Drinking Is Associated with Increased Mortality. Alcohol Clin Exp Res,2018;42(11):2246-2255. doi:10.1111/acer.13886
- GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet,2018;392(10152):1015-1035. doi:10.1016/S0140-6736(18)31310-2
- Griswold MG, Fullman N, Hawley C, et al. Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet,2018;392(10152):1015-1035. doi:10.1016/S0140-6736(18)31310-2
- Drinking Levels Defined. National Institute on Alcohol Abuse and Alcoholism (NIAAA). Accessed August 6, 2021.
- Excessive Alcohol Use. Centers for Disease Control and Prevention. Published September 21, 2020. Accessed August 6, 2021.
- White A, Tapert S, Shukla S. Binge Drinking: Predictors, Patterns, and Consequences (Editor’s Note). Alcohol Res Curr Rev,2018;39(1):1-3.
- Roerecke M, Rehm J. Chronic heavy drinking and ischaemic heart disease: a systematic review and meta-analysis. Open Heart,2014;1(1):e000135. doi:10.1136/openhrt-2014-000135
- Scoccianti C, Straif K, Romieu I. Recent evidence on alcohol and cancer epidemiology. Future Oncol Lond Engl,2013;9(9):1315-1322. doi:10.2217/fon.13.94
- Han BH, Moore AA, Ferris R, Palamar JJ. Binge Drinking Among Older Adults in the United States, 2015 to 2017. J Am Geriatr Soc,2019;67(10):2139-2144. doi:10.1111/jgs.16071
- Keyes KM, Jager J, Mal-Sarkar T, Patrick ME, Rutherford C, Hasin D. Is There a Recent Epidemic of Women’s Drinking? A Critical Review of National Studies. Alcohol Clin Exp Res,2019;43(7):1344-1359. doi:10.1111/acer.14082
- Wilsnack RW, Wilsnack SC, Gmel G, Kantor LW. Gender Differences in Binge Drinking. Alcohol Res Curr Rev,2018;39(1):57-76.
- Schuckit MA. A Critical Review of Methods and Results in the Search for Genetic Contributors to Alcohol Sensitivity. Alcohol Clin Exp Res,2018;42(5):822-835. doi:10.1111/acer.13628
- Hingson RW, Heeren T, Winter MR. Preventing impaired driving. Alcohol Res Health J Natl Inst Alcohol Abuse Alcohol,1999;23(1):31-39.
- O’Connor EA, Perdue LA, Senger CA, et al. Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults: An Updated Systematic Review for the U.S. Preventive Services Task Force, Agency for Healthcare Research and Quality (US); 2018. Accessed September 20, 2021.
- Falk D, Wang XQ, Liu L, et al. Percentage of subjects with no heavy drinking days: evaluation as an efficacy endpoint for alcohol clinical trials. Alcohol Clin Exp Res,2010;34(12):2022-2034. doi:10.1111/j.1530-0277.2010.01290.x
- Witkiewitz K, Wilson AD, Pearson MR, et al. Temporal Stability of Heavy Drinking Days and Drinking Reductions Among Heavy Drinkers in the COMBINE Study. Alcohol Clin Exp Res,2017;41(5):1054-1062. doi:10.1111/acer.13371
- Dawson DA, Grant BF, Li TK. Quantifying the Risks Associated With Exceeding Recommended Drinking Limits. Alcohol Clin Exp Res,2005;29(5):902-908. doi:
- Zaso MJ, Goodhines PA, Wall TL, Park A. Meta-Analysis on Associations of Alcohol Metabolism Genes With Alcohol Use Disorder in East Asians. Alcohol Alcohol Oxf Oxfs,2019;54(3):216-224. doi:10.1093/alcalc/agz011
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- Hurley TD, Edenberg HJ. Genes Encoding Enzymes Involved in Ethanol Metabolism. Alcohol Res Curr Rev,2012;34(3):339-344.
We invite healthcare professionals including physicians, physician assistants, nurses, pharmacists, and psychologists to complete a post-test after reviewing this article to earn FREE continuing education (CME/CE) credit. This CME/CE credit opportunity is jointly provided by the Postgraduate Institute for Medicine and NIAAA.
Why do I get drunk after 1 drink?
Why you get tipsy after just one drink: Scientists say alcohol really does go straight to the head! BETHESDA, Md. — The old adage claiming alcohol “goes straight to the head” is actually true according to new research. Scientists say booze breaks down in the brain, rather than the liver.
The finding turns previous theories upside down and scientists believe it holds the key to combating binge drinking and alcoholism. Researchers hope the results could also one day be used to treat conditions such as strokes, and, “Alcohol metabolism may be regulated directly in the brain,” says lead author Dr.
Li Zhang, of the National Institute on Alcohol Abuse and Alcoholism, in a statement per SWNS media. “It suggests the possibility of new targets for altering the effects – and potentially treating alcohol use disorder.” The study sheds fresh light on why people can get tipsy after only one or two drinks.
The response can trigger unsteadiness, slurred speech and slower reaction times. “Alcohol suppresses human brain function and affects behavior,” says Zhang. “The possibility of brain alcohol metabolism has been a controversial topic within the field for several decades.” But little is known about the neurological processes that control the action of metabolites in the brain.
The behavioral effects are caused by metabolites made as the body breaks down beer, wine or spirits. One such chemical, acetate, is produced by an enzyme called ALDH2, which is abundant in the liver. But tests on human brain samples and mice showed it’s also expressed in specialized brain cells known as astrocytes.
- They have been described as the tiles of the central nervous system and are found in the cerebellum, the brain region that controls balance and coordination.
- When ALDH2 was removed from the cells, the lab rodents became immune to motor impairments induced by,
- They performed as well as their peers on a rotating cylinder, or “rotarod,” that measures their balance and coordination skills.
“There’s a long-standing idea brain acetate derives largely from liver alcohol metabolism,” says Zhang. “Indeed, acetate can be transported through the blood–brain barrier with a high capacity. “Our data presented here directly challenge this idea. They suggest the central but not the peripheral alcohol metabolic pathway produces acetate.” Drinking fuels the metabolite and GABA, a neurotransmitter that calms the nerves and,
- Thought, speech and movements slow up as different parts of the brain cannot coordinate.
- It’s why we slur our words, fail to pick up on social signals, can’t make decisions and become clumsy.
- But this elevation was prevented when ALDH2 was deleted from astrocytes.
- In contrast, removing ALDH2 in the liver did not affect the levels of acetate or GABA in the brain,” explains Zhang.
“These findings suggest acetate produced in the brain and in the liver differ in their ability to affect motor function.”
The study published in opens the door to better regulation of the effects of drink on behavior.It could lead to improved therapies for alcoholism and and other conditions that reduce balance and coordination.These range from and Parkinson’s disease to multiple sclerosis.”Astrocytic ALDH2 is an important target not only for alcohol use disorders but also for other neurological diseases,” says Zhang. SWNS writer Mark Waghorn contributed to this report.
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Does drinking faster make you drunker?
Yes, drinking faster can certainly make you become drunker than you would be otherwise. How quickly you add alcohol to your system and allow your body to process it does makes a difference in your blood alcohol content. Think of it this way: One beer and one shot should each raise your BAC at about the same speed.
Is it OK to get drunk once a week?
Posted on April 9, 2018 by 10903 After a long day at work or a stressful week, a drink or two at home or out with friends might sound like just what you need to regroup. But what happens when a casual drink on a Saturday night turns into a blur – or ends up being a night you do things you wouldn’t normally do – or worse, that you regret? Sometimes known as a “weekend” alcoholic or binge drinker, this issue occurs when casual drinking turns into something more – a drinking problem, dependency issue or true alcoholism.
According to the 2016 National Survey on Drug Use and Health, there are more than 136 million alcohol users in the United States, and more than 47 percent of those users reported binge use in the last month. Experts explain moderate drinking as one drink per day for women and two drinks per day for men.
Exceeding that puts you at risk for becoming an alcoholic. Elizabeth Bulat, M.D., FASAM, an addiction treatment expert at Henry Ford Maplegrove Center, a substance abuse treatment center, discuss signs that you may be headed toward a drinking problem:
You drink alone – or use alcohol as a coping mechanism. Now, just because you have a glass or two of wine by yourself while reading a good book, taking a bath or catching up on your favorite show doesn’t mean you have a drinking problem. The issue occurs when drinking alone becomes a habit – or when it is coupled with being used to make you feel better. “When drinking alone turns into an isolation factor, that’s when there is a problem,” says Dr. Bulat. “Using alcohol as a coping mechanism is not only unhealthy, but it can indicate there is a further underlying problem.” You do things you wouldn’t normally do while sober. While the amount of alcohol you drink is a factor in determining if you could have a drinking problem, the true issue is in how the alcohol affects you. “If you asked someone while sober if they would drive after having a few drinks, they would most likely say no,” explains Dr. Bulat. “But for someone who might have a bit of a problem, after drinking, they would justify drinking and driving.” If your drinking causes you to do things you wouldn’t normally do – or that go against your judgement – you should look at your consumption and how your drinking is affecting you. In addition, not remembering events as they happened or completely blacking out while drinking, is cause for concern. Doing something spontaneous while intoxicated is one thing, but putting the safety of yourself or others at risk or harming your relationships is completely different. You’re drinking for the buzz. Forget socialization – if you are going out and drinking simply for the feeling alcohol provides, you could be headed toward trouble. “When someone is seeking the mood altering effects or uses alcohol as a coping mechanism or in isolation, that could be a red flag for an addictive type of behavior,” says Dr. Bulat. You are not able to completely stop or limit your drinking. If you truly think your drinking is becoming a problem, try limiting yourself to only a drink or two. Or, take it one step further and stop drinking entirely – even for just a temporary amount of time. “If you have a problem with something, generally you should try just stopping to see how you feel,” says Dr. Bulat. “If the idea of stopping your drinking causes you to feel defensive, there may be a problem.”
Heavy drinking – even binging one or two nights a week – is harmful for your health, according to Dr. Bulat. Consequences like liver damage, blood pressure issues along with vomiting and seizures from excessive drinking can all occur if you consume too much.
If you think that you or a loved one may have a problem with alcohol abuse or other drugs, talk to your primary care doctor, or contact an addiction specialist at Henry Ford Maplegrove Center at (800) 422-1183. Dr. Elizabeth Bulat is Service Chief of Addiction Medicine at Henry Ford’s Maplegrove Center in West Bloomfield.
Note: Re-edited from a post originally published September 2016.
Is it normal to drink a lot in your 20s?
What are the differences between drinking in your 20s and 30s? – Along with the effects on your body and mind, as explained above, you’ll notice societal differences as you age; for example, big nights out in your twenties may turn to dinner parties, or a glass of wine each night at home,
How often is too often to get drunk?
Many people with alcohol problems cannot tell when their drinking is out of control. It is important to be aware of how much you are drinking. You should also know how your alcohol use may affect your life and those around you. One drink equals one 12-ounce (oz), or 355 milliliters (mL), can or bottle of beer, one 5-ounce (148 mL) glass of wine, 1 wine cooler, 1 cocktail, or 1 shot of hard liquor.
How often you have an alcoholic drinkHow many drinks you have when you do drinkHow any drinking you are doing affects your life or the lives of others
Here are some guidelines for drinking alcohol responsibly, as long as you do not have a drinking problem. Healthy men up to age 65 should limit themselves to:
No more than 4 drinks in 1 dayNo more than 14 drinks in a week
Healthy women up to age 65 should limit themselves to:
No more than 3 drinks in 1 dayNo more than 7 drinks in a week
Healthy women of all ages and healthy men over age 65 should limit themselves to:
No more than 3 drinks in 1 dayNo more than 7 drinks in a week
Health care providers consider your drinking medically unsafe when you drink:
Many times a month, or even many times a week3 to 4 drinks (or more) in 1 day5 or more drinks on one occasion monthly, or even weekly
You may have a drinking problem if you have at least 2 of the following characteristics:
There are times when you drink more or longer than you planned to.You have not been able to cut down or stop drinking on your own, even though you have tried or you want to.You spend a lot of time drinking, being sick from drinking, or getting over the effects of drinking.Your urge to drink is so strong, you cannot think about anything else.As a result of drinking, you do not do what you are expected to do at home, work, or school. Or, you keep getting sick because of drinking.You continue to drink, even though alcohol is causing problems with your family or friends.You spend less time on or no longer take part in activities that used to be important or that you enjoyed. Instead, you use that time to drink.Your drinking has led to situations that you or someone else could have been injured, such as driving while drunk or having unsafe sex.Your drinking makes you anxious, depressed, forgetful, or causes other health problems, but you keep drinking.You need to drink more than you did to get the same effect from alcohol. Or, the number of drinks you are used to having now have less effect than before.When the effects of alcohol wear off, you have symptoms of withdrawal. These include, tremors, sweating, nausea, or insomnia. You may even have had a seizure or hallucinations (sensing things that are not there).
If you or others are concerned, make an appointment with your provider to talk about your drinking. Your provider can help guide you to the best treatment, More information and support for people with drinking problems and their families can be found at:
Alcoholics Anonymous (AA) – aa.org/
Alcohol use disorder – drinking problem; Alcohol abuse – drinking problem; Alcoholism – drinking problem; Alcohol dependence – drinking problem; Alcohol addiction – drinking problem Centers for Disease Control and Prevention website. Fact sheets: alcohol use and your health.
- Updated April 14, 2022.
- Accessed May 9, 2022.
- National Institute on Alcohol Abuse and Alcoholism website.
- Alcohol’s effects on the body.
- Accessed May 6, 2022.
- National Institute on Alcohol Abuse and Alcoholism website.
Understanding alcohol use disorder. www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder, Updated April 2021. Accessed May 6, 2022. O’Connor PG. Alcohol use disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine,26th ed.
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- Alcohol use disorders.
- In: Rakel RE, Rakel DP, eds.
- Textbook of Family Medicine,9th ed.
- Philadelphia, PA: Elsevier Saunders; 2016:chap 48.
- US Preventive Services Task Force.
- Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US Preventive Services Task Force recommendation statement.
JAMA,2018;320(18):1899-1909. PMID: 30422199 pubmed.ncbi.nlm.nih.gov/30422199/, Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M.
Do you ever build a tolerance to alcohol?
Alcohol and Tolerance – Alcohol Alert No.28-1995 National Institute on Alcohol Abuse and Alcoholism No.28 PH 356 April 1995 Alcohol and Tolerance Alcohol consumption interferes with many bodily functions and affects behavior. However, after chronic alcohol consumption, the drinker often develops tolerance to at least some of alcohol’s effects.
Tolerance means that after continued drinking, consumption of a constant amount of alcohol produces a lesser effect or increasing amounts of alcohol are necessary to produce the same effect (1). Despite this uncomplicated definition, scientists distinguish between several types of tolerance that are produced by different mechanisms.
Tolerance to alcohol’s effects influences drinking behavior and drinking consequences in several ways. This Alcohol Alert describes how tolerance may encourage alcohol consumption, contributing to alcohol dependence and organ damage; affect the performance of tasks, such as driving, while under the influence of alcohol; contribute to the ineffectiveness or toxicity of other drugs and medications; and may contribute to the risk for alcoholism.
- Functional Tolerance Humans and animals develop tolerance when their brain functions adapt to compensate for the disruption caused by alcohol in both their behavior and their bodily functions.
- This adaptation is called functional tolerance (2).
- Chronic heavy drinkers display functional tolerance when they show few obvious signs of intoxication even at high blood alcohol concentrations (BAC’s), which in others would be incapacitating or even fatal (3).
Because the drinker does not experience significant behavioral impairment as a result of drinking, tolerance may facilitate the consumption of increasing amounts of alcohol. This can result in physical dependence and alcohol-related organ damage. However, functional tolerance does not develop at the same rate for all alcohol effects (4-6).
- Consequently, a person may be able to perform some tasks after consuming alcohol while being impaired in performing others.
- In one study, young men developed tolerance more quickly when conducting a task requiring mental functions, such as taking a test, than when conducting a task requiring eye-hand coordination (4), such as driving a car.
Development of tolerance to different alcohol effects at different rates also can influence how much a person drinks. Rapid development of tolerance to unpleasant, but not to pleasurable, alcohol effects could promote increased alcohol consumption (7).
- Different types of functional tolerance and the factors influencing their development are described below.
- During repeated exposure to low levels of alcohol, environmental cues and processes related to memory and learning can facilitate tolerance development; during exposure to high levels of alcohol, tolerance may develop independently of environmental influences.
Acute tolerance, Although tolerance to most alcohol effects develops over time and over several drinking sessions, it also has been observed within a single drinking session. This phenomenon is called acute tolerance (2). It means that alcohol-induced impairment is greater 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 (8-10).
- Acute tolerance does not develop to all effects of alcohol but does develop to the feeling of intoxication experienced after alcohol consumption (4).
- This may prompt the drinker to consume more alcohol, which in turn can impair performance or bodily functions that do not develop acute tolerance.
- Environment-dependent tolerance.
The development of tolerance to alcohol’s eff ects over several drinking sessions is accelerated if alcohol is always administered in the same environment or is accompanied by the same cues. This effect has been called environment-dependent tolerance.
Rats that regularly received alcohol in one room and a placebo in a different room demonstrated tolerance to the sedative and temperature-lowering effects of alcohol only in the alcohol-specific environment (11). Similar results were found when an alcohol-induced increase in heart rate was studied in humans (12).
When the study subjects always received alcohol in the same room, their heart rate increased to a lesser extent after drinking in that room than in a new environment. Environment-dependent tolerance develops even in “social” drinkers in response to alcohol-associated cues.
- In a study analyzing alcohol’s effects on the performance of an eye-hand coordination task, a group of men classified as social drinkers received alcohol either in an office or in a room resembling a bar.
- Most subjects performed the task better (i.e., were more tolerant) when drinking in the barlike environment (13).
This suggests that for many people, a bar contains cues that are associated with alcohol consumption and promote environment-dependent tolerance. Learned tolerance. The development of tolerance also can be accelerated by practicing a task while under the influence of alcohol.
This phenomenon is called behaviorally augmented (i.e., learned) tolerance. It first was observed in rats that were trained to navigate a maze while under the influence of alcohol (14). One group of rats received alcohol before their training sessions; the other group received the same amount of alcohol after their training sessions.
Rats that practiced the task while under the influence of alcohol developed tolerance more quickly than rats practicing without prior alcohol administration. Humans also develop tolerance more rapidly and at lower alcohol doses if they practice a task while under the influence of alcohol.
When being tested on a task requiring eye-hand coordination while under the influence of alcohol, people who had practiced after ingesting alcohol performed better than people who had practiced before ingesting alcohol (15). Even subjects who only mentally rehearsed the task after drinking alcohol showed the same level of tolerance as those who actually practiced the task while under the influence of alcohol (15).
The expectation of a positive outcome or reward after successful task performance is an important component of the practice effect on tolerance development. When human subjects knew they would receive money or another reward for successful task perfmance while under the influence of alcohol, they developed tolerance more quickly than if they did not expect a reward (16).
- The motivation to perform better contributes to the development of learned tolerance.
- Learned and environment-dependent tolerance have important consequences for situations such as drinking and driving.
- Repeated practice of a task while under the influence of low levels of alcohol, such as driving a particular route, could lead to the development of tolerance, which in turn could reduce alcohol-induced impairment (16).
However, the tolerance acquired for a specific task or in a specific environment is not readily transferable to new conditions (17,18). A driver encountering a new environment or an unexpected situation could instantly lose any previously acquired tolerance to alcohol’s impairing effects on driving performance.
Environment-independent tolerance. Exposure to large quantities of alcohol can lead to the development of functional tolerance independent of environmental influences. This was demonstrated in rats that inhaled alcohol vapors (19). In another study, mice demonstrated tolerance in environments different from the one in which the alcohol was administered (20).
Significantly larger alcohol doses were necessary to establish this environment-independent tolerance than to establish environment-dependent tolerance (20) Metabolic Tolerance Tolerance that results from a more rapid elimination of alcohol from the body is called metabolic tolerance (2).
It is associated with a specific group of liver enzymes that metabolize alcohol and that are activated after chronic drinking (21,22). Enzyme activation increases alcohol degradation and reduces the time during which alcohol is active in the body (2), thereby reducing the duration of alcohol’s intoxicating effects.
However, certain of these enzymes also increase the metabolism of some other drugs and medications, causing a variety of harmful effects on the drinker. For example, rapid degradation of sedatives (e.g., barbiturates) (23) can cause tolerance to them and increase the risk for their use and abuse.
Increased metabolism of some prescription medications, such as those used to prevent blood clotting and to treat diabetes, reduces their effectiveness in chronic drinkers or even in recovering alcoholics (24). Increased degradation of the common painkiller acetaminophen produces substances that are toxic to the liver (25) and that can contribute to liver damage in chronic drinkers.
Tolerance and the Predisposition to Alcoholism Animal studies indicate that some aspects of tolerance are genetically determined. Tolerance development was analyzed in rats that were bred to prefer or not prefer alcohol over water (26,27). The alcohol-preferring rats developed acute tolerance to some alcohol effects more rapidly and/or to a greater extent than the nonpreferring rats (26).
- In addition, only the alcohol-preferring rats developed tolerance to alcohol’s effects when tested over several drinking sessions (27).
- These differences suggest that the potential to develop tolerance is genetically determined and may contribute to increased alcohol consumption.
- In humans, genetically determined differences in tolerance that may affect drinking behavior were investigated by comparing sons of alcoholic fathers (SOA’s) with sons of nonalcoholic fathers (SONA’s).
Several studies found that SOA’s were less impaired by alcohol than SONA’s (28,29). Other studies found that, compared with SONA’s, SOA’s were affected more strongly by alcohol early in the drinking session but developed more tolerance later in the drinking session (30).
These studies suggest that at the start of drinking, when alcohol’s pleasurable effects prevail, SOA’s experience these strongly; later in the drinking session, when impairing effects prevail, SOA’s do not experience these as strongly because they have developed tolerance (30). This predisposition could contribute to increased drinking and the risk for alcoholism in SOA’s.
Alcohol and Tolerance-A Commentary by NIAAA Director Enoch Gordis, M.D. Tolerance can be a useful clue for clinicians in identifying patients who may be at risk for developing alcohol-related problems. For example, younger patients who are early in their drinking histories and who report that they can “hold their liquor well” may be drinking at rates that will place them at risk for medical complications from alcohol use, including alcoholism.
The fact that tolerance to all of alcohol’s effects does not develop simultaneously is also important; people who are mildly tolerant may exhibit more symptoms of impairment when faced with unfamiliar activities, such as driving in an unknown area, than when they are engaged in routine actions, such as driving home from work.
Lastly, although we know that initial sensitivity to alcohol may play a role in the development of alcoholism, the role of tolerance in maintaining addiction to alcohol needs further exploration. References (1) American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.
Washington, DC: the Association, 1994. (2) Tabakoff, B.; Cornell, N.; & Hoffman, P.L. Alcohol tolerance. Annals of Emergency Medicine 15(9):1005-1012, 1986. (3) Chesher, G., & Greeley, J. Tolerance to the effects of alcohol. Alcohol, Drugs and Driving 8(2):93-106, 1992. (4) Vogel-Sprott, M.D. Acute recovery and tolerance to low doses of alcohol: Differences in cognitive and motor skill performance.
Psychopharmacology 61(3):287-291, 1979. (5) Pohorecky, L.A.; Brick, J.; & Carpenter, J.A. Assessment of the development of tolerance to ethanol using multiple measures. Alcoholism: Clinical and Experimental Research 10(6):616-622, 1986. (6) Tabakoff, B., & Kiianmaa, K.
Does tolerance develop to the activating, as well as the depressant, effects of ethanol? Pharmacology Biochemistry & Behavior 17(5):1073-1076, 1982. (7) Tabakoff, B., & Hoffman, P.L. Tolerance and the etiology of alcoholism: Hypothesis and mechanism. Alcoholism: Clinical and Experimental Research 12(1):184-186, 1988.
(8) Beirness, D., & Vogel-Sprott, M. The development of alcohol tolerance: Acute recovery as a predictor. Psychopharmacology 84(3):398-401, 1984. (9) Bennett, R.H.; Cherek, D.R.; & Spiga, R. Acute and chronic alcohol tolerance in humans: Effects of dose and consecutive days of exposure.
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- Acute tolerance to ethanol using drug discrimination and open-field procedures in rats.
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- 11) Mansfield, J.G., & Cunningham, C.L.
- Conditioning and extinction of tolerance to the hypothermic effect of ethanol in rats.
Journal of Comparative and Physiological Psychology 94(5):962-969, 1980. (12) Dafters, R., & Anderson, G. Conditioned tolerance to the tachycardia effect of ethanol in humans. Psychopharmacology 78(4):365-367, 1982. (13) McCusker, C.G., & Brown, K. Alcohol-predictive cues enhance tolerance to and precipitate “craving” for alcohol in social drinkers.
- Journal of Studies on Alcohol 51(6):494-499, 1990.
- 14) LeBlanc, A.E.; Gibbins, R.J.; & Kalant, H.
- Behavioral augmentation of tolerance to ethanol in the rat.
- Psychopharmacologia 30:117-122, 1973.
- 15) Vogel-Sprott, M.; Rawana, E.; & Webster, R.
- Mental rehearsal of a task under ethanol facilitates tolerance.
Pharmacology Biochemistry & Behavior 21(3):329-331, 1984. (16) Sdao-Jarvie, K., & Vogel-Sprott, M. Response expectancies affect the acquisition and display of behavioral tolerance to alcohol. Alcohol 8(6):491-498, 1991. (17) Siegel, S., & Sdao-Jarvie, K.
Attenuation of ethanol tolerance by a novel stimulus. Psychopharmacology 88(2):258-261, 1986. (18) Tsibulsky, V.L., & Amit, Z. Role of environmental cues as Pavlovian-conditioned stimuli in enhancement of tolerance to ethanol effects: 1. Lethal effects in mice and rats. Pharmacology Biochemistry & Behavior 45(2):473-479, 1993.
(19) Tabakoff, B., & Culp, S.G. Studies on tolerance development in inbred and heterogeneous stock National Institutes of Health rats. Alcoholism: Clinical and Experimental Research 8(5):495-499, 1984. (20) Melchior, C.L., & Tabakoff, B. Modification of environmentally cued tolerance to ethanol in mice.
Journal of Pharmacology and Experimental Therapeutics 219(1):175-180, 1981. (21) Lieber, C.S. Metabolism of ethanol and associated hepatotoxicity. Drug and Alcohol Review 10(3):175-202, 1991. (22) Lieber, C.S. The microsomal ethanol oxidizing system: Its role in ethanol and xenobiotic metabolism. Biochemical Society Transactions 16(3):232-239, 1988.
(23) Misra, P.S.; Lefèvre, A.; Ishii, H.; Rubin, E.; & Lieber, C.S. Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats. American Journal of Medicine 51(3):346-351, 1971. (24) Lieber, C.S.
Interaction of ethanol with other drugs. In: Lieber, C.S., ed. Medical and Nutritional Complications of Alcoholism: Mechanisms and Management. New York: Plenum Press, 1992. pp.165-183. (25) Sato, C.; Matsuda, Y.; and Lieber, C.S. Increased hepatotoxicity of acetaminophen after chronic ethanol consumption in the rat.
Gastroenterology 80(1):140-148, 1981. (26) Waller, M.B.; McBride, W.J.; Lumeng, L.; & Li, T.-K. Initial sensitivity and acute tolerance to ethanol in the P and NP lines of rats. Pharmacology Biochemistry & Behavior 19(4):683-686, 1983. (27) Lê, A.D., & Kiianmaa, K.
- Characteristics of ethanol tolerance in alcohol drinking (AA) and alcohol avoiding (ANA) rats.
- Psychopharmacology 94(4):479-483, 1988.
- 28) Schuckit, M.A.
- Ethanol-induced changes in body sway in men at high alcoholism risk.
- Archives of General Psychiatry 42(4):375-379, 1985.
- 29) Schuckit, M.A., & Gold, E.O.
A simultaneous evaluation of multiple markers of ethanol/placebo challenges in sons of alcoholics and controls. Archives of General Psychiatry 45(3):211-216, 1988. (30) Newlin, D.B., & Thomson, J.B. Alcohol challenge with sons of alcoholics: A critical review and analysis.
Psychological Bulletin 108(3):383-402, 1990. ACKNOWLEDGMENT: The National Institute on Alcohol Abuse and Alcoholism wishes to acknowledge the valuable contributions of Boris Tabakoff, Ph.D., professor and chairman of the Department of Pharmacology, University of Colorado School of Medicine, Denver, CO, to the development of this Alcohol Alert.
All material contained in the Alcohol Alert is in the public domain and may be used or reproduced without permission from NIAAA. Citation of the source is appreciated. Copies of the Alcohol Alert are available free of charge from the Scientific Communications Branch, Office of Scientific Affairs, NIAAA, Willco Building, Suite 409, 6000 Executive Boulevard, Bethesda, MD 20892-7003.