According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 16 million adults ages 18 and older had a diagnosable alcohol use disorder, or alcoholism.1 Thousands more people across the country struggle with heavy drinking or binge drinking; though such problematic drinking behaviors aren’t always part of an alcohol use disorder, they can be extremely dangerous.
What Is Alcohol Poisoning?
Alcohol poisoning is one of the risks of problematic drinking. This kind of poisoning occurs when a person consumes too much alcohol in a short period of time – blood alcohol levels climb as the body’s ability to metabolize the substance is outpaced by the ongoing consumption and the symptoms of toxicity begin to mount.2 The Centers for Disease Control and Prevention (CDC) found, in 2015, that an average of 6 people died every day from alcohol poisoning.3 While many people are concerned about college students who binge drink at parties, 76 percent of people who died from alcohol poisoning were between the ages of 35 and 64.3 There are 2,200 alcohol poisoning deaths in the US every year, and alcoholism was a factor in 30 percent of these deaths.3
There are 2,200 alcohol poisoning deaths in the US every year, and alcohol dependence or alcohol use disorder typically are factors in 30 percent of these deaths.
Binge drinking is defined as five or more drinks per occasion for men (four or more for women); the CDC reports an average of eight drinks per binge episode for adults.3
Signs and Symptoms of Alcohol Poisoning
Alcohol poisoning may result in the following signs and symptoms:2
- Hypothermia or low body temperature.
- Breathing changes—irregular or slowed.
- Pallid or blue-tinged skin from oxygen deprivation.
- An unrousable loss of consciousness.
Alcohol poisoning is extremely dangerous, and could require emergency medical attention.
The acronym CUPS—used as a mnemonic device—can be a useful method for remembering several prominent symptoms of alcohol poisoning:
- Cold or clammy skin (also bluish or very pale)
- Puking uncontrollably or frequently
- Slow or shallow breathing
A person exhibiting such signs may need immediate medical attention.
How Does the Body Process Alcohol?
Relatively safe levels of drinking should not exceed more than one standard drink per hour. Standard serving measurements for types of alcohol include:4
- 12 ounces of beer at 5% alcohol.
- A 5-ounce glass of wine at 12% alcohol.
- 1.5 ounces of hard liquor at 80 proof (40% alcohol).
One of any of these constitutes one serving; consuming one per hour will raise an adult’s blood alcohol concentration (BAC) relatively slowly. Consuming more than that is likely to raise the BAC to 0.08 or higher—the point at which it is illegal to drive due to intoxication.3
Certain dangerous cognitive and physical changes begin to manifest beyond a 0.08 BAC; some life-threatening symptoms may begin to arise around 0.3 and higher. People who have little tolerance to alcohol are more likely to die when their raise their BAC between 0.3 and 0.45.5
- Impaired balance, coordination, speech, reaction time, and comprehension.
- Impaired decision-making abilities and judgment.
- Loss of consciousness.
- Blackouts or amnesia.
Alcohol poisoning may develop surprisingly quickly, and with less alcohol than one might think. Its arrival will be influenced by body weight, gender, age, alcohol tolerance, general state of health, and other factors. Generally, a man weighing about 160 pounds will experience alcohol poisoning after consuming 15 shots of hard liquor in 3-4 hours; a woman weighing 120 pounds is likely to develop alcohol poisoning after consuming nine shots of hard liquor in the same amount of time. Again, individual factors can change these amounts, but essentially, consuming more than one alcoholic beverage per hour will initiate the onset of intoxication.6 And as consumption escalates from this point, the more likely alcohol poisoning becomes.
How Long Does Alcohol Remain in the Body?
There are different tests to determine whether a person has consumed alcohol within a certain timeframe:7
- A blood test can detect alcohol metabolites for 12 hours after consumption.
- A breathalyzer can detect alcohol in the system for 24 hours.
- Saliva tests can detect alcohol consumption for 1-5 days after consumption.
- Certain urine assays can test for alcohol 3-5 days after consumption.
- Hair follicle tests can detect any alcohol consumption within the past 90 days.
The first two tests rely on the detection of certain metabolites while the body continues to break down alcohol and eliminate it from the body. Despite the relatively long detection times of these tests, drinking one drink will have a significant intoxicating effect on the brain for that long.
Consuming several drinks in a short amount of time could result in some alcohol continuing to enter the bloodstream from the GI tract even after the person stops drinking. If a person binge drinks, their BAC might continue to rise for 30-40 minutes after drinking stops, placing them at higher risk of increasingly severe alcohol poisoning. Because their BAC may continue to rise, even after they stop drinking, it is important to make sure the person gets help from medical professionals.8
The alcohol a person consumes that leads to alcohol poisoning will remain in their body for several hours, continuing to cause damage to the brain and other organs. Because their BAC continues to rise, even after they stop drinking, it is important to make sure the person gets help from medical professionals.
Call 911 immediately if alcohol poisoning is suspected.
How to Help a Person With Alcohol Poisoning
People with alcohol poisoning might not just sleep this condition off. Their symptoms could potentially get worse; they could choke on their own vomit, stop breathing due to dangerous respiratory depression, have a seizure, or never wake up. Emergency medical help is the only way to be safe, and it is better to call 911 than allow a person to suffer this condition, even if they have only a few symptoms.
While waiting for emergency responders to arrive, a person suffering from alcohol poisoning can be helped with a few steps:8
- If the person is awake, try to keep them awake.
- If they are conscious, keep them in a sitting position.
- Get them to drink small sips of water to stay hydrated.
- Keep them away from alcoholic beverages or other drugs.
- If the person is unconscious, put them in the recovery position.
- Stay with them until help arrives.
Urban Myths about Helping Someone Who Drank Too Much
Some widespread advice regarding how to help a person who is very intoxicated is simply wrong. Common misconceptions about ways to help a person sober up or avoid alcohol poisoning include:
- Drink coffee. This will actually dehydrate them further, increasing the risk of seizures.
- Sleep it off. If a person is left alone and goes to sleep, they may never wake up.
- Walk it off. Walking around increases the risk of falls, which can cause serious injuries.
- Exercise. Although the body may process alcohol faster with aerobic exercise, for people who are suffering alcohol poisoning, this will cause their BAC to continue to rise.
- Take a cold shower. One of the symptoms of alcohol poisoning is hypothermia, so a cold shower will only cause the body’s temperature to fall further, leading to shock.
- Take medicine. Anything other than water can interact with alcohol, increasing the risk of choking, vomiting, or additional poisoning.
Treating Problematic Drinking
After a person experiences alcohol poisoning, it may be an ideal time to talk to them about their problematic drinking. There are many ways for a person to get help with alcohol use disorder, binge drinking, heavy drinking, or any other kind of problem drinking.
Although these are all different approaches to treatment, a combination may best promote long-term recovery.
- Behavioral treatment: Cognitive Behavioral Therapy and other behavioral therapeutic approaches focus on adjusting a person’s understanding of routine activities and reactions to stress, managing life, and engaging with others. Many inpatient and outpatient rehabilitation programs are structured around evidence-based behavioral therapies which are administered on a daily basis for weeks, months, or however long of a program is required for recovery.
- Medications: Certain FDA-approved medications may be used to treat alcohol use disorder. Some, like disulfiram or naltrexone, when taken consistently help to make drinking unpleasant or change the experience of drinking. Acamprosate is another medication used to decrease continued drinking behavior. Of note, these types of medication therapy for alcohol use disorder are not used to ease withdrawal symptoms, but begins after a person successfully detoxes.
- Mutual support groups: The most popular form of support group to overcome problem drinking is Alcoholics Anonymous, but there are dozens of variations, and even divergent approaches to peer support throughout the recovery process.
- Alcohol Use Disorder | National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders. Accessed June 20, 2019.
- Mayo Clinic. Alcohol Poisoning. https://www.mayoclinic.org/diseases-conditions/alcohol-poisoning/symptoms-causes/syc-20354386. Accessed June 20, 2019.
- Alcohol Poisoning Deaths | VitalSigns | CDC. https://www.cdc.gov/vitalsigns/alcohol-poisoning-deaths/. Accessed June 20, 2019.
- Alcohol Poisoning | Student Health and Counseling Services. https://shcs.ucdavis.edu/topics/alcohol-poisoning. Accessed June 20, 2019.
- What Happens to Your Body at Different BAC Levels? https://www.alcohol.org/effects/blood-alcohol-concentration/. Accessed June 20, 2019.
- Alcohol Poisoning | LiveWell. http://depts.washington.edu/livewell/alcohol-drug-education/alcohol-poisoning/. Accessed June 20, 2019.
- Cederbaum AI. Alcohol Metabolism. Clin Liver Dis. 2012;16(4):667-685. doi:10.1016/j.cld.2012.08.002
- Alcohol poisoning – NHS. https://www.nhs.uk/conditions/alcohol-poisoning/#. Accessed June 20, 2019.
- Treatment for Alcohol Problems: Finding and Getting Help | National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help. Accessed June 20, 2019
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