Why does alcohol make us both happy and miserable – and what else does it do to our minds and bodies?

It sends us to sleep and wakes us in the night, excites us and depresses us, gives us confidence one moment, anxiety the next. How does this messy drug wield so much power? Whatever you think of alcohol, you have to admit that it’s versatile. Ever since the first humans started smashing up fruit and leaving it in pots to chug a few days later, we’ve been relying on it to celebrate and commiserate, to deal with anxiety and to make us more creative. We use it to build confidence and kill boredom, to get us in the mood for going out and to put us to (nonoptimal) sleep. Where most mind-altering substances have one or two specific use-cases, alcohol does the lot. That’s probably why it’s been so ubiquitous throughout human history – and why it can be so hard to give up entirely. “We often call alcohol pharmacologically promiscuous,” says Dr Rayyan Zafar, a neuropsychopharmacologist from Imperial College London. “It doesn’t just calm you: it can stimulate reward pathways, dampen threat signals, release endogenous opioids that can relieve pain or stress, alter decision-making and shift mood, all at the same time.” By way of comparison, we know that cocaine primarily ac