One of the most important concepts, and one of the easiest to grasp, is how substance abuse (particularly, for our purposes today, alcohol use) impacts our ability to plan and organize our thoughts and behaviors.

Executive functions, including impulse control, planning, organization, moral judgments, and consequential thinking, are focused mainly in our brain’s frontal lobe.  Frequent readers will remember how this brain development isn’t finished until the early 20s (a great argument for juvenile justice reform).  This is the first part of our brain to really get drunk.

Because the frontal lobe is affected by alcohol so quickly, we lose our ability to properly plan and appreciate consequences of our behavior.  It’s the reason driving after a couple beers makes so much sense to the one drinking.  It’s the reason we have unprotected sex with people we don’t know after closing down the bar.  It’s the reason all those plans for calling our ride, or walking home, go out the window because it’s 1am and it’s cold and we’re tired and we could surely drive just this once, right?

Having a bit of alcohol in our system also impairs our ability to stop drinking.  It’s easy, when sober, to think that two beers will be where we’ll stop; it’s a lot harder after those beers to say no to the next drink.  (This is also due to alcohol’s biphasic effect – we’re feeling good, happy, relaxed after a few, but the depressant effect kicks in more strongly the more we drink.)

There are a million songs about bad decisions under the influence, but I think the most illustrative tune is this Flogging Molly classic, Drunken Lullabies (lyrics here).

The chorus – and we find ourselves in the same old mess, singing drunken lullabies.  We can’t learn when we’re drunk, and we can’t plan properly when we’re drunk, and when we’re drunk, we just want to keep drinking!

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