Alcohol Poisoning and What You Can Do to Prevent It

Whether it’s at a party or on a date, drinking alcoholic beverages is a social norm many people have come to associate with adulthood. However, things can go from having a great time to a medical emergency fast if you drink too much. Alcohol poisoning, another term for overdrinking, kills about 2000 people each year in the US directly and another 30,000 people indirectly (through things like drunk driving). Even if the victim survives, he or she could be left with permanent brain or liver damage. Recognizing the signs of alcohol poisoning and knowing what to do when you see them can go a long way in preventing many of those complications and deaths.

How Does Alcohol Affect Your Body?

The alcohol in alcoholic beverages is ethanol. It’s processed mainly by the liver, and the liver can handle roughly 15 mg of ethanol per dL of blood an hour. But medical conditions that affect the liver, like cirrhosis, lower this rate. Also, women generally absorb alcohol faster than men. Alcohol enters the bloodstream quickly, compared to the digestion of food, and takes more time to get rid of. That’s why drinking a lot in a short amount of time is dangerous.

Alcohol is a depressant, meaning it slows down the central nervous system. It targets specific neurotransmitter systems like those involving γ-aminobutyric acid (GABA), glutamate, glycine, acetylcholine, and serotonin. As a result, various bodily systems are impaired, leading to the symptoms of alcohol poisoning.

Signs of Alcohol Poisoning

The symptoms of alcohol poisoning are mainly dependent on how much you drink. As more alcohol gets into your system, the symptoms become more life-threatening. However, other factors, such as your size/weight, state of health, medications (if any), and whether you’ve eaten anything recently can all affect your risk. Here are the main signs of alcohol poisoning:

slurred speech
reduced motor coordination
confusion
stupor
vomiting
lapsing in and out of consciousness
slow or irregular breathing (less than 8 breaths a minute)
pale, bluish, cold, and/or clammy skin (from too little oxygen)

If someone with alcohol poisoning isn’t treated, these life-threatening situations can occur:

coma
vomit entering lungs (from reduced gag reflex) and causing asphyxiation (choking); if the victim survives this, he or she can get pneumonia from all the bacteria in the lungs
hypothermia (low body temperature)
severe dehydration (from excessive vomiting)
hypoglycemia (very low blood sugar)
seizures (from hypoglycemia or dehydration)
irregular heart rate, cardiac arrest

Blood Alcohol Concentration (BAC)

This is what people test for to determine how intoxicated you are. It can either be in percent, as you see below, or in g/dL (grams of alcohol per dL or deciliter of blood; 1% = 1 g/dL). Note that this isn’t the same measurement as the one from a breathalyzer, though. The breathalyzer measurement is 1/2100 of the BAC.

Blood alcohol concentration and its effects (Source: NIAAA)

Five drinks for men and four for women in less than 2 hours (“binge drinking”) is enough to push a person’s BAC above .08%, the legal limit for driving in the US. The handy graphic below shows the definition of a “standard drink”.

Definition of a “standard drink” (Source: NIAAA)

What You Can Do About Alcohol Poisoning

Obviously, the best way to prevent alcohol poisoning is to simply not drink. But for many, that’s simply too restrictive. So, the next best thing to do is to drink responsibly and to recognize the warning signs. If someone you know starts exhibiting some of those signs, make sure he or she is in a safe place and call 911 immediately. Don’t wait for all the symptoms to appear. It could save that person’s life.

While waiting for help to arrive, make sure to do the following:

Have information ready. When help does arrive, it’s important to tell them what kind of alcohol was involved, how much the victim drank and when, the kinds of medication the victims is using, and any health conditions he or she has.
Don’t leave victims alone. If they lose consciousness they could end up choking on their vomit or fall over and get injured.
Try to position the person upright (and leaning forward) or turn his or her head to the side if lying down. These positions can help prevent the victim from choking on vomit.
Don’t give the victim food. It could make him or her choke or vomit.
Don’t try to make the victim vomit. While it might help get rid of some of the alcohol, it’s not worth the risk of him or her choking.
Cover the victim with a warm blanket. It can help stave off hypothermia.
If the person is awake, you can have him or her sip water slowly. It can help with dehydration, but be careful about choking.

To help prevent alcohol poisoning in the first place, follow these tips:

Drink in moderation. For women (any age) and men over 65, that means just one drink a day. For men under 65, it’s two drinks a day.
Don’t drink a lot in a short amount of time. When you’re drinking you might lose track of how much you’ve had. It’s possible that you can ingest a fatal amount of alcohol before you pass out. Don’t binge drink and stop anyone you know from doing so.
Don’t drink on an empty stomach. While it won’t prevent alcohol poisoning from happening in someone who’s been binge drinking, food can slow the rate at which alcohol enters the bloodstream to a more manageable level.
Be cautious about drinking mixed drinks. These drinks may have more alcohol than you think causing you to unintentionally drink too much.
Educate teenagers about alcohol. The more they know about the dangers, the less likely they’ll be careless when they start drinking, if at all.
Keep products with alcohol in them away from small children. Kids are curious, and if they find one of those products, they might try to drink it. Due to their small size, it’s way easier for them to get a fatal dose of alcohol.
Make sure someone who’s had too much to drink before gets some kind of counseling. It can help prevent a future incident, especially if they have a risk of becoming or are an alcoholic.

Myths About Alcohol

The best course of action for dealing with alcohol poisoning is to get help immediately. Don’t think you can solve the problem with these myths.

Caffeine can turn a drunk person sober. Alcohol is a depressant, so a stimulant like caffeine should return you to normal, right? Wrong. It doesn’t affect the same neurotransmitter systems. In fact, caffeine not only won’t do anything to prevent alcohol poisoning, it can impair your ability to recognize its symptoms, making it easier to drink too much.
Cold showers help. A cold shower will only make hypothermia more likely, and the shock from cold water may make the victim lose consciousness. A drunk person may claim to feel warmer, but all that’s happening is the dilation of blood vessels (especially the small ones under the skin), which sometimes shows up as flushed skin. This actually causes a person to lose his or her core body temperature faster since blood flow to the extremities, where more heat is lost, is increased.
You can “walk it off”. Not only does letting the victim try to walk increase the chance of injury (from falling or getting hit by a car by wandering into traffic), it does nothing to get rid of the alcohol in the body.
You can “sleep it off”. By allowing the victim to lose consciousness, it increases the chance of him or her choking. Like the “walk it off” myth, it also does nothing to help remove the alcohol in the body.