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It is frequently mentioned that drinks of very high ABV should not be drunk neat because of their harmful effects. Examples of such claims can be found e.g. here: What is the strongest drink in the world?

I'm curious though, what the exact hazards are? Obviously I'm asking about hazards that stem from the concentration alone and not from the quantity, which is the easier to overdose the higher the concentration is. In other words, how is it worse for health to drink a shot of 95.6% rectified spirits than to drink the same amount of alcohol, but diluted fairly with water?

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    This is a great question and I hope you get a great answer. – Ken Graham Aug 21 '17 at 12:05
  • A as in one shot. I don't think it matters. Why would you only drink one shot? – paparazzo Aug 24 '17 at 18:54
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Here are some hard alcohol risks.

Hard Alcohol Risks:

Hard alcohol consumption is contraindicated in certain segments of the population because of the latter’s higher susceptibility to the effects of the beverage. For instance, individuals who have difficulty sleeping, or suffer from depression or other mental disorders, are advised against intake as the psychoactive mechanism of the drink can further worsen said conditions. Consumption is also strongly advised against in pregnant women as it can lead to severe gross motor development, fetal alcohol syndrome, and sudden infant death syndrome, to name a few, in children who got exposed to hard alcohol in the womb. Persons who have to deal with chronic gastrointestinal disorders like irritable bowel syndrome have to steer clear as intake can severely aggravate the conditions as well.

This beverage has a substantial concentration of ethanol per volume as well. Excess ethanol consumption inflicts sever damage to the liver and can bring about scarring or cirrhosis, inflammation or alcoholic hepatitis, and even cancer of said organ. This type of alcohol is associated with other cancers such as those afflicting the mouth and pharynx, the bowels, the breasts, the prostate, and the stomach.

Hard alcohol has a powerful diuretic effect as well. Because this is the case, individuals who have diarrhea, renal problems, or other medical conditions that are prone to severe dehydration must avoid consumption of this drink as well. Such fluid-draining effect of hard alcohol can instigate premature wrinkling of the skin due to dehydration, and may increase the frequency and severity of dermatological allergies like psoriasis and eczema. - Secrets of the Superhuman Food Pyramid: Negative Effects of Hard Alcohol

These are just the tip of the iceberg, for drinking those extremely high levels of alcohol could lead to alcohol poisoning very fast and thus cause unconsciousness or even worse, death.

Alcohol overdosing is nothing unusual. It’s hard to come across anything beyond 40 percent at bars (unless on demand) because the higher the ABV (alcohol by volume), the higher are your chances of you getting knocked out. But still, there exists a dark land of spirits where ABV can go up to a suicidal 96 percent.

Spirytus Rektyfikowany (96% Alcohol)

The purity of rectified spirit has a practical limit of 95.6% ABV; this hard to pronounce Polish Vodka is a murderous 96% ABV. In short, abusing this drink can literally make you meet God! Spirytus is actually more potent than the widely-known Everclear and sits atop as the world’s strongest alcoholic beverage. - 10 Alcoholic Drinks So Strong They Can Knock Out The Manliest Of You

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    Most of this is about alcohol in general not about to high concentration. – paparazzo Aug 24 '17 at 18:46

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