There are many short-term and long-term effects of alcohol use disorders. In the United States, 88,000 lives are lost each year to excessive alcohol use, which could be heavy drinking, alcohol use disorder, or binge drinking. Excessive drinking was responsible for the death of one in 10 adults between the ages of 20 and 64 in 2010, according to the Centers for Disease Control and Prevention (CDC).

What Is Wet Brain?

If a person struggles with an alcohol use disorder or heavy drinking for a long time and is unable to stop, they may develop a syndrome colloquially referred to as wet brain. This condition is a group of symptoms of two diseases – Wernicke’s disease and Korsakoff’s psychosis – referred to in medicine as Wernicke-Korsakoff’s syndrome.

Stages of Wet Brain

Wet brain develops because of a lack of thiamine, a complex B1 vitamin, and alcohol use disorder is the most common cause of this syndrome. Alcohol abuse inflames the intestines and stomach, preventing absorption of nutrients. People who struggle with alcohol use disorders may also neglect their diets, so they do not take vitamin supplements or consume foods rich enough in thiamine.

Thiamine is a vitamin required by the body to break down glucose, which helps to supply nutrients to the brain. It also helps in the production of amino acids, so without enough thiamine, the body is unable to produce all kinds of chemicals, including neurotransmitters like serotonin, dopamine, and norepinephrine. Once the brain stops producing neurotransmitters, brain function rapidly declines; without glucose, body systems begin to fail.

Wet brain has two main phases: the acute stage, known as Wernicke’s encephalopathy, which can be stopped if caught in time, and the chronic stage, known as Korsakoff’s syndrome, which can be treated but is incurable. While not every case of Wernicke’s encephalopathy progresses to Korsakoff’s psychosis, and the conditions can begin together, it is typical for Wernicke’s to occur first, and 80-90 percent of people struggling with alcohol use disorders develop Korsakoff’s psychosis later.

Stage 1: Wernicke’s Encephalopathy

There are three classic symptoms indicating Wernicke’s encephalopathy:

  1. Confusion and reduced mental activity, progressing toward dementia
  2. Loss of muscle coordination and voluntary movement (ataxia)
  3. Abnormal eye movements, eyelid drooping, and/or changes to vision, including double vision

Disorientation and confusion develop rapidly, over a few days or weeks. It is the main symptom of this condition, and it can also feature lethargy, inability to pay attention, sleepiness, and indifference or other personality changes. Delirium can occur in extreme cases. When left untreated, Wernicke’s encephalopathy can lead to coma.

Ataxia changes how the person walks because they experience great difficulty controlling their muscles and other voluntary movements. This could also show up as twitching, especially in the legs. The person may walk slowly and unsteadily, and eventually, they will need assistance walking or lose the ability to walk. A secondary symptom of Wernicke’s encephalopathy is peripheral neuropathy, or the loss of sensation in the extremities, which can also affect walking and voluntary movements.

The symptoms of Wernicke’s encephalopathy may reduce or stop almost as soon as they have begun, although side effects will persist. After a few days or weeks, the individual will be left with changes to their eyes, such as nystagmus, and ataxia. They are likely to progress to Korsakoff’s syndrome or psychosis after the primary confusion of Wernicke’s has gone away.

Stage 2: Korsakoff’s Psychosis

As the symptoms of Wernicke’s encephalopathy begin to reduce, most people who struggle with alcohol use disorder subsequently develop Korsakoff’s psychosis. Symptoms include:

  • Inability to form new memories
  • Memory loss, which can be severe and mimic dementia
  • Confabulation (making up stories) to fill in memory gaps
  • Hallucinations

The memory problems related to Korsakoff’s psychosis persist since it is a chronic illness. For some people, their social skills remain relatively unchanged; for others, gaps in long-term memory and the unfamiliarity of current people or surroundings can lead to behavioral and emotional disturbances.

There are few medical studies involving Korsakoff’s psychosis, but the research that has been conducted suggests that about 50 percent of those affected improve or recover; 25 percent remain unchanged after their symptoms set in; and 25 percent get worse. Neural imaging does not show this condition in the same way that it can reveal encephalopathy, and many symptoms of Korsakoff’s psychosis are masked by other symptoms of conditions related to long-term alcohol use disorder. Diagnosis is typically a physician’s best guess based on available information and, often, a previous diagnosis of Wernicke’s encephalopathy.

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Stage 3: Stupor, Coma, and Death

An untreated or severe, long-term alcohol use disorder leading to thiamine deficiency for a very long time can not only result in wet brain but can also lead to a progressive worsening of symptoms. This includes stupor, or the condition where a person is awake but unresponsive to outside stimuli; coma, where a person is unconscious and unresponsive; and death. While diet and other lifestyle factors can lead to Wernicke-Korsakoff’s syndrome, the colloquial term wet brain is a clear indication that problem drinking is the main factor in the development of this condition in the Western world.

Get Help to Overcome an Alcohol Use Disorder

It is very important to get help overcoming an alcohol use disorder as soon as possible in order to avoid many short-term dangers, like car accidents and STIs, and long-term health conditions, including cirrhosis and wet brain. Signs that a person is struggling with problem drinking, including heavy or excessive alcohol consumption or an alcohol use disorder, include the inability to stop drinking, irritability or aggressiveness when asked about alcohol consumption, smelling like alcohol, acting drunk or uncoordinated on a regular basis, and avoiding responsibilities or social events, often to consume alcohol instead.

As medical science better understands the root causes of alcohol use disorder, detox and rehabilitation programs are better prepared to help people overcome this condition. Undergoing detox with medical supervision and entering a rehabilitation program are the best initial steps to overcome addiction and learn how to maintain ongoing sobriety. Long-term social support from support groups, friends, and family can aid the recovery process greatly.