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Alcohol's myopic effects cause intoxicated individuals to respond almost exclusively to their immediate environment. This nearsightedness limits their ability to consider future consequences of their actions as well as regulate their reactive impulses. Alcohol's ability to alter behavior and decision making stems from its impact on synaptic transmission at GABA receptors.

Three Classes of Myopia
Alcohol's myopic effects on the drinker's cognitive processes can be characterized into three classes--self-inflation, relief, and excess.

Self-inflation:

Alcohol consumption alters the drinker’s self-image by “enhancing feelings of self-appraisal and even narcissism.” Alcohol inhibits sophisticated levels of mental processing that are necessary to recognize personal flaws. The ‘tunnel vision’ effect of alcohol myopia, which limits the attentional capacity of the drinker, causes individuals to focus on favorable and superficial characteristics of themselves. Overall, the self-inflating effect of alcohol can increase the drinker’s self-confidence and therefore lead him or her to engage in activities or social situations that would normally make he or she nervous or uncomfortable when sober.

Relief:

Alcohol can alleviate the drinker’s feelings of stress or anxiety. Alcohol myopia limits those under the influence of alcohol to see the world through a nearsighted lens ; in other words, consumption of alcohol will lead individuals to temporarily forget about previous worries or problems, for these feelings lay outside of the restricted set of immediate cues that the drinker can respond to. By depriving him of the attention capacity necessary to process undesirable thoughts, alcohol myopia can bring the drinker a sense of relief.

Excess:

Alcohol exaggerates the drinker’s perception of the world around him. The drinker’s response to this exaggerated world manifests in erratic and dramatic behaviors. Under the influence of alcohol, individuals are incapable of sufficiently processing the long-term consequences of their actions; they will respond to immediate and salient cues in the moment. In this way, drunk individuals can be described as “slaves to the present moment.”

Alcohol is believed to disinhibit urges normally considered socially unacceptable. The sober brain is able to utilize the frontal cortex to make executive decisions and restrain these impulses. However, the drunk brain is unable to regulate the urges for excessive behavior.

By leading the brain to overreact to present cues and disregard the implications of one’s actions, alcohol often provokes aggressive behavior. Alcohol consumption can result in a “Jekyll and Hyde” effect in individuals who are typically amiable when sober but are perhaps predisposed to aggressive behavior. Additionally, alcohol has a dramatic connection to criminal behavior, rage, physical destruction, and sexual assault.

It is important to note, however, that alcohol myopia's effects on excessive behavior do not incite aggression in all drinkers. In some intoxicated individuals, excess simply manifests itself in their becoming significantly more talkative, flirtatious, or adventurous.

Effects on Neurotransmission
Alcohol is classified as a sedative hypnotic drug. Alcohol produces a sedative effect by acting on receptors of the inhibitory neurotransmitter GABA. GABA receptors contain a binding site for GABA, a chloride ion channel, and an additional binding site for alcohol molecules.

GABA produces its normal inhibitory effects on cell activity by reducing a neuron’s firing rate. When a GABA molecule attaches to its binding site, it activates the receptor, resulting in an inflow of chloride ions. The increase in concentration of negative charge inside the cell hyperpolarizes the membrane. This hyperpolarization decreases the likelihood that the membrane will send an action potential to neighboring neurons; the difference of charge across the membrane has increased, while it would need to decrease in order to reach the threshold charge necessary to propagate an action potential.

Alcohol agonizes GABA and therefore amplifies the transmitter’s inhibitory effects. When alcohol molecules bind to its site on the GABA receptor, they lengthen the time that the receptor’s chloride ion pore remains open, resulting in an even greater hyperpolarization of the membrane. Additionally the binding of alcohol causes the GABA transmitter to bind to its receptors more frequently, and therefore augments the transmitter’s ability to inhibit cell activity.

Overall, alcohol’s interactions with GABA receptors decrease neuronal firing across the body and inhibit cortical activation. Behavioral changes associated with alcohol myopia stem from the inhibitory effects of this reduction of firing and activation.

Drunk Driving
The Alcohol Myopia Model proposes that intoxication increases the likelihood that an individual will decide to drive in an unsafe situation. The drinker is unable to properly weigh the future consequences of his or her decision to drive; “inhibitory cues that prohibit driving are less likely to be considered because they lack salience and immediacy." Meanwhile, the intoxicated individual responds to the immediate motivations to drive. For example, he will focus on the rewards of getting home quickly and not having to pay for a cab. Therefore, under the influence of alcohol, driving becomes the simplest and most compelling option. Studies show that when questioned, intoxicated individuals reported “greater intentions to drink and drive...and fewer moral obligations against drinking and driving” than they did when sober.