Alcohol Poisoning

What is alcohol poisoning?

Alcohol poisoning happens when there’s so much alcohol in your bloodstream that it starts shutting down life-supporting areas of your brain. These areas control your breathing, heart rate and temperature. Alcohol poisoning is life-threatening.

Alcohol poisoning typically happens when you consume a large amount of alcohol in a short amount of time. It often happens from drinking excess alcohol-containing beverages, like beer, wine and/or liquor. But it can also occur due to non-beverage alcohol (ethanol), which is in things like mouthwash, cologne and cough medicine.

If you think someone has alcohol poisoning, get them medical help as soon as possible.

Other names for alcohol poisoning include alcohol overdose and ethanol toxicity.

What are the symptoms of alcohol poisoning?

Common symptoms of alcohol poisoning include:

• Confusion and slowed responses.
• Lack of coordination or being unable to walk.
• Difficulty remaining conscious.
• Vomiting.
• Delayed or absent gag reflex, which could lead to choking on vomit.
• Slow breathing (fewer than eight breaths per minute) or irregular breathing.
• Slow heart rate.
• Problems with bladder or bowel control (incontinence).
• Cold, clammy or bluish-colored skin (cyanosis), especially around the lips and fingernails.
• Low body temperature (hypothermia).
• Seizures.

The person may also smell strongly of alcohol.

If someone near you has these symptoms, call 911 (or your local emergency services number) or take them to the nearest emergency room. Alcohol poisoning can be fatal.

What should I do if I see someone who may have alcohol poisoning?

You can do several things to help someone who shows signs of alcohol poisoning:

• Seek help: Call 911 or other emergency services for help.
• Keep them awake: Stay with the person and keep them awake.
• Provide water if they’re awake: Have them sip water to keep them hydrated if they’re awake. If they’re unconscious, don’t give them anything. They could choke.
• Prevent choking: If they’re unconscious, turn them on their side. If the person vomits, they won’t choke on it.
• Keep them warm: Cover them with a warm blanket. Alcohol poisoning can cause low body temperature.
• Explain your actions: Talk to them and let them know why you’re doing things. Otherwise, they may become belligerent.

When paramedics arrive, be ready to tell them what you can about the person. You might need to describe how much they drank or what they’ve been doing since you called.

What causes alcohol poisoning?

As your body digests and absorbs alcohol, the alcohol enters your bloodstream. Your blood alcohol content (BAC) begins to rise. Your liver breaks down alcohol to remove it from your body because it’s a toxin. But when BAC levels are high, your liver can’t remove the toxins quickly enough.

The extra alcohol in your bloodstream acts as a depressant. This means that it slows down your body’s normal functions. If you continue to drink (and drink quickly), your BAC continues to rise. The depressant effect becomes more and more intense.

If the depressant effects begin affecting key functions of your body, like your breathing and consciousness, it’s considered alcohol poisoning. Every person is different, so there’s no way to know how much you can drink before you’re at risk of alcohol poisoning. That’s why you should always drink in moderation and slowly.

Here’s how different percentages of BAC can affect you physically and mentally:

• BAC 0.0%: There’s no alcohol in your blood (you’re sober).
• BAC 0.02%: You may experience an altered mood, relaxation and a slight loss of judgment.
• BAC 0.05%: You may feel uninhibited and have lowered alertness and impaired judgment.
• BAC 0.08%: You may have reduced muscle coordination, find it more difficult to detect danger and have impaired judgment and reasoning.
• BAC 0.10%: You may have a reduced reaction time, slurred speech and slowed thinking.
• BAC 0.15%: You may experience an altered mood, nausea and vomiting, and a loss of balance and some muscle control.
• BAC 0.15% to 0.30%: You may experience confusion, vomiting and drowsiness.
• BAC 0.30% to 0.40%: You’ll likely have alcohol poisoning and experience a loss of consciousness.
• BAC over 0.40%: This is a potentially fatal blood alcohol level. You’re at risk of coma and death from respiratory arrest (absence of breathing).

What are the risk factors for alcohol poisoning?

Alcohol poisoning can affect anyone. But several factors can increase your risk, including:

• Binge drinking: The faster you drink alcohol in a short amount of time, the more at risk you are for alcohol poisoning. This is especially true for people who binge drink. Binge drinking is a pattern of drinking alcohol that brings your BAC to 0.08% or higher. This typically occurs after a woman consumes four drinks or man consumes five drinks in about two hours.
• Combining medications and alcohol: Drinking alcohol and taking opioids or sedative hypnotics (like sleeping pills or anti-anxiety medications) can increase your risk of an overdose. Alcohol use while taking over-the-counter (OTC) antihistamines can also be dangerous. All these medications are depressants that slow down your central nervous system (brain and spinal cord) — just like alcohol. So the effect is much stronger when you combine them.
• Drinking on an empty stomach: If you don’t eat food before or while drinking alcohol, you’re at a higher risk of alcohol poisoning. Your small intestine absorbs alcohol the quickest. The longer alcohol stays in your stomach, the slower your body absorbs it. Food in your stomach prevents alcohol from passing quickly into your small intestine.
• Your age: Teenagers and young adults who drink alcohol are more likely to experience alcohol overdose. This is because they’re more likely to engage in binge drinking.
• Your sex: Males are more likely to experience alcohol poisoning. About 75% of people who die from it are men.

How is alcohol poisoning diagnosed?

Healthcare providers mainly diagnose alcohol poisoning based on the following:

• Known or admitted consumption of alcohol.
• Signs of alcohol poisoning, like slowed responses, slowed breathing and vomiting.

Because alcohol poisoning can be a medical emergency, they typically order several tests to check your overall health. These may include:

• Blood alcohol content (BAC) test with a breathalyzer or blood test.
• Electrolyte panel blood test.
• Liver function tests.
• Electrocardiogram (EKG) to check your heart.

How is alcohol poisoning treated?

If someone has alcohol poisoning, they may need lifesaving treatment right away. In a medical setting, healthcare professionals will use:

• IV fluids: Providers give intravenous (IV) fluids to treat dehydration. Fluids can also increase blood sugar levels if they’re low.
• Oxygen therapy: Providers can give oxygen using a nasal cannula (flexible tube clipped to your nose). They may put a small tube into your windpipe if you have trouble breathing (intubation).
• Stomach pumping: Using a tube, providers can clear your stomach of toxins.
• Blood filtration: If your kidneys can’t do their job, providers may start dialysis to filter alcohol from your blood.

Can I treat alcohol poisoning at home?

Someone with alcohol poisoning needs medical help in a hospital. You shouldn’t try to treat it at home or “sleep it off.” A major danger of alcohol poisoning is choking on your vomit, which can happen when you’re unconscious or sleeping. This can cause death.

How can I prevent alcohol poisoning?

To prevent alcohol poisoning, limit your alcohol consumption. If you or a friend are drinking, pay attention to how much you consume and how quickly. If a friend appears to be drinking too much too fast, try to intervene and limit how much more they have. Moderation is always important. Drink no more than one alcohol-containing beverage an hour.

Each of the following examples of those forms is equal to one drink.

Additionally, you can prevent alcohol poisoning by:

• Avoiding drinking games: Games can put pressure on participants to binge drink.
• Staying hydrated: Drink water after every alcohol-containing beverage.
• Not mixing alcohol and medicine: Never drink alcohol while taking medications.
• Eating first: Don’t drink on an empty stomach.
• Staying alert: Avoid a drink if you don’t know its contents or if it’s mixed with energy drinks.

If you think you or someone else may have issues with alcohol or alcohol use disorder, reach out for help. Talk to your healthcare provider or call the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-HELP (4357). Someone will be available to help.

What is the prognosis for alcohol poisoning?

The prognosis (outlook) for alcohol poisoning depends on many factors, including:

• The level of intoxication.
• If you have alcohol use disorder and for how long.
• If you have any traumatic injuries.
• If you have end-organ damage.

People who don’t have any major complications from alcohol poisoning typically have a good prognosis.

What are the possible complications of alcohol poisoning?

Alcohol poisoning is serious. Someone who has too much alcohol to the point of an overdose can have the following complications:

• Blackouts or amnesia.
• Hypoglycemia (low blood sugar), which can cause seizures.
• Alcohol-induced hepatitis.
• Acute or chronic liver failure.
• Irregular heartbeats, like atrial fibrillation, supraventricular tachycardia or ventricular tachycardia.
• Severe vomiting, which can lead to dehydration and seizures.
• Permanent brain damage.
• Loss of consciousness, which can lead to coma or death.

People with alcohol poisoning are also more likely to experience injuries, which can be severe.