<unk> has a variety of short-term and long-term adverse effects. It also has reinforcement-related adverse effects, including addiction, dependence, and withdrawal. Social harm A 2010 study ranking various illegal and legal drugs based on statements by drug-harm experts.<unk> was found to be the overall most dangerous drug, and the only drug that mostly damaged others.<unk> causes a plethora of detrimental effects in society. It is highly associated with drinking in public, impaired social distancing, passive drinking, drunk dialing, drunk driving, sexual risk-taking or drug facilitated sexual assault (especially with caffeinated<unk> c drinks), and both violent and non-violent crime. About one-third of arrests in the United States involve<unk> misuse. Many emergency room visits also involve<unk> use. As many as 15% of employees show problematic<unk> related behaviors in the workplace, such as drinking before going to work or even drinking on the job. Heavy drinking is associated with vulnerability to injury, marital discord, and domestic violence.<unk> use is directly related to considerable morbidity and mortality, for instance due to overdose and<unk> related health problems.<unk> related crimes Automobile accidents A 2002 study found 41% of people fatally injured in traffic accidents were in<unk> related crashes. Misuse of<unk> is associated with more than 40% of deaths that occur in automobile accidents every year. The risk of a fatal car accident increases exponentially with the level of<unk> in the driver's blood. Most drunk driving laws in the United States governing the acceptable levels in the blood while driving or operating heavy machinery set typical upper limits of legal blood<unk> content (BAC) at 0.08%. Sexual assault<unk> is often used to facilitate sexual assault or rape. Over 50% of reported rapes involve<unk>  It is the most commonly used date rape drug. Violent crime Over 40% of all assaults and 40 to 50% of all murders involve<unk>  More than 43% of violent encounters with police involve<unk> <unk> is implicated in more than two-thirds of cases of intimate partner violence. In 2002, it was estimated that 1 million violent crimes in the United States were related to<unk> use.<unk> is more commonly associated with both violent and non-violent crime than are drugs like marijuana. Health consequences<unk> use disorder is a major problem and many health problems as well as death can result from excessive<unk> use.<unk> dependence is linked to a lifespan that is reduced by about 12 years relative to the average person. In 2004, it was estimated that 4% of deaths worldwide were attributable to<unk> use. Deaths from<unk> are split about evenly between acute causes (e.g., overdose, accidents) and chronic conditions. The leading chronic<unk> related condition associated with death is<unk> c liver disease.<unk> dependence is also associated with cognitive impairment and organic brain damage. Some researchers have found that even one<unk> c drink a day increases an individual's risk of health problems by 0.4%. Adverse effects Short-term effects delphic analysis regarding 20 popular recreational substances.<unk> was ranked 6th in dependence, 11th in physical harm, and 2nd in social harm. Central nervous system impairment<unk> causes generalized central nervous system depression, is a positive allosteric GABAA modulator and is associated and related with cognitive, memory or memory loss, motor, and sensory impairment. It slows and impairs cognition and reaction time and the cognitive skills, impairs judgement, interferes with motor function resulting in motor incoordination, loss of balance, confusion, sedation, numbness and slurred speech, impairs memory formation, and causes sensory impairment. At high concentrations, it can induce amnesia, analgesia, spins, stupor, and unconsciousness as result of high levels of ethanol in blood. At very high concentrations,<unk> can cause anterograde amnesia, markedly decreased heart rate, pulmonary aspiration, positional<unk> nystagmus (PAN), respiratory depression, shock, coma and death can result due to profound suppression of central nervous system function because to the<unk> overdose and can finish in consequent dysautonomia. Gastrointestinal effects Diagram of mucosal layer<unk> can cause nausea and vomiting in sufficiently high amounts (varies by person).<unk> stimulates gastric juice production, even when food is not present, and as a result, its consumption stimulates acidic secretions normally intended to digest protein molecules. Consequently, the excess acidity may harm the inner lining of the stomach. The stomach lining is normally protected by a mucosal layer that prevents the stomach from, essentially, digesting itself. However, in patients who have a peptic ulcer disease (PUD), this mucosal layer is broken down. PUD is commonly associated with the bacteria H. pylori. H. pylori secrete a toxin that weakens the mucosal wall, which as a result lead to acid and protein enzymes penetrating the weakened barrier. Because<unk> stimulates a person's stomach to secrete acid, a person with PUD should avoid drinking<unk> on an empty stomach. Drinking<unk> causes more acid release, which further damages the already-weakened stomach wall. Complications of this disease could include a burning pain in the abdomen, bloating and in severe cases, the presence of dark black stools indicate internal bleeding. A person who drinks<unk> regularly is strongly advised to reduce their intake to prevent PUD aggravation. Ingestion of<unk> can initiate systemic pro-inflammatory changes through two intestinal routes: (1) altering intestinal microbiota composition (dysbiosis), which increases lipopolysaccharide (LPS) release, and (2) degrading intestinal mucosal barrier integrity – thus allowing this (LPS) to enter the circulatory system. The major portion of the blood supply to the liver is provided by the portal vein. Therefore, while the liver is continuously fed nutrients from the intestine, it is also exposed to any bacteria and/or bacterial derivatives that breach the intestinal mucosal barrier. Consequently, LPS levels increase in the portal vein, liver and systemic circulation after<unk> intake. Immune cells in the liver respond to LPS with the production of reactive oxygen species (ROS), leukotrienes, chemokines and cytokines. These factors promote tissue inflammation and contribute to organ pathology. Allergic-like reactions Ethanol-containing beverages can cause<unk> flush reactions, exacerbations of rhinitis and, more seriously and commonly, bronchoconstriction in patients with a history of asthma, and in some cases, urticarial skin eruptions, and systemic dermatitis. Such reactions can occur within 1–60 minutes of ethanol ingestion, and may be caused by: * genetic abnormalities in the metabolism of ethanol, which can cause the ethanol metabolite, acetaldehyde, to accumulate in tissues and trigger the release of histamine, or * true allergy reactions to allergens occurring naturally in, or contaminating,<unk> c beverages (particularly wine and beer), and * other unknown causes. Long-term effects Prolonged heavy consumption of<unk> can cause significant permanent damage to the brain and other organs resulting in disfunction or death. Brain damage<unk> can cause brain damage, Wernicke's encephalopathy and<unk> c Korsakoff syndrome (AKS) which frequently occur simultaneously, known as Wernicke–Korsakoff syndrome (WKS). Lesions, or brain abnormalities, are typically located in the diencephalon which result in anterograde and retrograde amnesia, or memory loss. Liver damage During the metabolism of<unk> via the respective dehydrogenases, NAD (nicotinamide adenine dinucleotide) is converted into reduced NAD. Normally, NAD is used to metabolize fats in the liver, and as such<unk> competes with these fats for the use of NAD. Prolonged exposure to<unk> means that fats accumulate in the liver, leading to the term 'fatty liver'. Continued consumption (such as in<unk> use disorder) then leads to cell death in the hepatocytes as the fat stores reduce the function of the cell to the point of death. These cells are then replaced with scar tissue, leading to the condition called cirrhosis. Birth defects Ethanol is classified as a teratogen. According to the U.S. Centers for Disease Control (CDC),<unk> consumption by women who are not using birth control increases the risk of fetal<unk> syndrome. The CDC currently recommends complete abstinence from<unk> c beverages for women of child-bearing age who are pregnant, trying to become pregnant, or are sexually active and not using birth control. Cancer IARC list ethanol in<unk> c beverages are classified as a Group 1 carcinogens in human beings and argues that "There is sufficient evidence and research showing the carcinogenicity of acetaldehyde (the major metabolite of ethanol) which is excreted by the liver enzyme when one drinks<unk> " Other effects Frequent drinking of<unk> c beverages is a major contributing factor in cases of elevated blood levels of triglycerides. Reinforcement disorders Addiction<unk> addiction is termed<unk> use disorder. Two or more consecutive<unk> free days a week have been recommended to improve health and break dependence. Dependence and withdrawal Discontinuation of<unk> after extended heavy use and associated tolerance development (resulting in dependence) can result in withdrawal.<unk> withdrawal can cause confusion, anxiety, insomnia, agitation, tremors, fever, nausea, vomiting, autonomic dysfunction, seizures, and hallucinations. In severe cases, death can result. Delirium tremens is a condition that requires people with a long history of heavy drinking to undertake an<unk> detoxification regimen. Overdose Death from ethanol consumption is possible when blood<unk> levels reach 0.4%. A blood level of 0.5% or more is commonly fatal. Levels of even less than 0.1% can
Alcohol 
Toxic alcohol
Benzyl alcohol
Tobacco
Cannabis
Cannabis 
Smokeless tobacco
Polychlorinated biphenyl