Acute alcohol intoxication decreases glucose metabolism but increases acetate uptake in the human brain

► Acute alcohol reduces glucose metabolism and increases acetate uptake in human brain. ► Enhanced brain acetate uptake with alcohol was highest in heavy alcohol users. ► Alcohol produced opposite changes in regional brain metabolism than acetate uptake. ► Results consistent with the use of acetate as brain energy source during intoxication. ► Heavy alcohol exposure may facilitate use of acetate as an energy substrate in brain.