Whether you’re raising a glass to celebrate a milestone, or sharing a bottle of wine with friends, alcohol is part of the social fabric in the United States for many people.

And yet, we don’t talk enough about the potential health ramifications of alcohol. According to the Mayo Clinic, drinking any amount of alcohol may carry health risks. While light-to-moderate drinkers (i.e. women who drink one or fewer drinks a day and men who drink two or fewer) may not suffer extensive health consequences related to drinking, those who drink heavily—for women, that means more than three drinks in one day or seven drinks in one week, says the Mayo Clinic, and for men it’s more than four drinks in one day or more than 14 in one week—may be at a greater risk of developing certain chronic diseases. Heavy drinking may also raise a person’s risk for injuries (both accidental and intentional) and even death. 

April is Alcohol Awareness Month, sponsored by National Council on Alcoholism and Drug Dependence (NCADD). As we head into spring and summer—and all of the associated pool parties, graduations, weddings and celebrations—it’s a good time for people who tipple to evaluate their relationship with alcohol, and consider the impact it could have on their health, today and years from now. We’ve pulled together some facts and stats that offer insights into the ways that drinking affects your body and brain. So grab a cup of tea, a bottle of seltzer or a mocktail and read on.

How the body processes alcohol

When you swallow those first sips of beer, it makes its way to your stomach, and is absorbed into the bloodstream. Then, it’s processed by the liver. According to Northwestern Medicine, alcohol reaches the brain in just five minutes, and you start to feel the effects within 10 minutes. Your liver manages to metabolize about an ounce of alcohol an hour. It’s when you consume more than you metabolize that you start to feel intoxicated. Northwestern Medicine says that if a person drinks enough that their blood alcohol content reaches .08—the legal limit for driving—it takes around five and a hours for the body to process it, and for it to leave the system.

 How the brain responds to alcohol

Studies have linked heavy drinking to actual shrinkage of the brain; and recent research by a team at University of Pennsylvania finds that even light-to-moderate drinking—one to two drinks a day—can actually change the structure of the brain.

While light to moderate drinking could bring on feelings like relaxation, excitement and euphoria, heavier drinking could lead to confusion, lack of coordination, impaired judgment, nausea, vomiting, blackouts, alcohol poisoning and even coma, according to Northwestern Medicine. That’s because alcohol impairs your brains pathways and impedes the processing of information. 

 Alcohol’s short term effects: What is a hangover?

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines a hangover as “a set of symptoms that occur as a consequence of drinking too much.” A hangover typically peaks when alcohol is no longer in your body and could last 24 hours or more; symptoms may include nausea, fatigue, weakness, muscle aches, headache, stomach pain, vertigo, thirst, sensitivity to light and sound, anxiety, irritability, sweating and increased blood pressure. While there are plenty of hangover “remedies” out there, in truth, the only way to prevent a hangover, says NIAAA, is to not drink at all, or keep consumption to a minimum.

 Alcohol’s long-term effects: what increased risks come with drinking?

Long-term use of alcohol can weaken your immune system, raise your risk for certain heart conditions and even some types of cancer. The Mayo Clinic lists the following health risks that drinkers may face.

  • Certain cancers, including breast, mouth, throat, esophagus, liver and colon
  • Heart problems, including high blood pressure, an enlarged heart, heart failure and stroke
  • Liver disease and digestive problems
  • Neurological complications, including memory problems and dementia
  • Depression, anxiety and other mental health problems
  • Alcohol use disorder or dependence on alcohol

 Do you need help?

In the United States, more than 178,000 people die because of excessive drinking every year, according to the National Center for Drug Abuse Statistics. Those deaths are entirely preventable. If you’re struggling with drinking, you might have alcohol use disorder (sometimes called alcoholism), which is a medical condition and brain disorder. You should talk to your health care provider about any concerns you might have. He or she may be able to offer you advice, refer you to another doctor or discuss goals to strive for to help you quit drinking or get it under control.

To assess your condition, he or she might ask some of the following questions, according to the NIAAA: 

  • In the last year, were there times you drank more or longer than you’d intended?  
  • Have you wanted to cut down or stop drinking, or tried to, but couldn’t?
  • Have you spent a lot of time drinking, and/or being sick because of it?
  • Have you wanted a drink so badly you couldn’t think of anything else?
  • Have you found that drinking—or being sick from drinking—often interferes with taking care of your home or family? Or caused job troubles? Or school problems?

When it comes to alcohol consumption, moderation is an admirable goal. A glass of wine with dinner, or a beer with friends at the game is nothing to shy away from. It’s when drinking becomes a habit, or when alcohol starts to impact your work and relationships that it’s time to consider taking a break or asking for help.