Alcohol poisoning

Overview

Alcohol poisoning is a serious — and sometimes deadly — result of drinking large amounts of alcohol in a short period of time. Drinking too much too quickly can affect breathing, heart rate, body temperature and gag reflex. In some cases, this can lead to a coma and death.

Alcohol poisoning also can occur when adults or children accidentally or intentionally drink household products that contain alcohol.

If you think that someone has alcohol poisoning, get medical attention right away.

Symptoms

Alcohol poisoning symptoms include:

Confusion.
Vomiting.
Seizures.
Slow breathing, which is fewer than eight breaths a minute.
Breathing that's not regular. This is when there is a gap of more than 10 seconds between breaths.
Skin that looks blue, gray or pale.
Low body temperature, also known as hypothermia.
Trouble staying conscious or awake.

When to see a doctor

It's not necessary to have all the above symptoms before seeking medical help. A person with alcohol poisoning who has passed out or can't wake up could die.

Alcohol poisoning is an emergency

If you think that someone has alcohol poisoning, seek medical care right away. This is true even if you don't see the usual signs.

Here's what to do:

Call 911 or your local emergency number right away. Never assume the person will sleep off alcohol poisoning.
Be prepared to give information. If you know the kind and amount of alcohol the person drank, and when, tell hospital or emergency staff.
Don't leave an unconscious person alone. Because alcohol poisoning affects the way the gag reflex works, someone with alcohol poisoning may vomit and choke and not be able to breathe. While waiting for help, don't try to make the person vomit because that could cause choking.
Help someone who is vomiting. Try to keep the person sitting up. If the person must lie down, turn the head to the side to help prevent choking. Try to keep the person awake.

Don't be afraid to get help

It can be hard to decide if you think someone is drunk enough to need medical help. But it's best to take action right away rather than be sorry later. You may worry about what will happen to you or a friend or family member, especially if underage. But the results of not getting help in time can be far more serious.

Causes

Alcohol in the form of ethanol, also called ethyl alcohol, is in alcoholic beverages. It's also in mouthwash, some cooking extracts, some medicines and certain household products. Ethyl alcohol poisoning generally results from drinking too many alcoholic beverages in a short period of time.

Other forms of alcohol can cause toxic poisoning that requires emergency treatment. They include:

Isopropyl alcohol, which is found in rubbing alcohol, lotions and some cleaning products.
Methanol or ethylene glycol, which is a common ingredient in antifreeze, paints and solvents.

Binge drinking

A major cause of alcohol poisoning is binge drinking. This is when a male rapidly consumes five or more alcoholic drinks within two hours or a female consumes at least four drinks within two hours. An alcohol binge can occur over hours or last up to several days.

A person can consume a fatal dose of alcohol before passing out. Even when the person is unconscious or stops drinking, the stomach and intestines continue to release alcohol into the bloodstream, and the level of alcohol in the body continues to rise.

How much is too much?

Unlike food, which can take hours to digest, the body absorbs alcohol quickly — long before most other nutrients. And it takes a lot more time for the body to get rid of alcohol. Most alcohol is processed by the liver.

The more you drink, especially in a short period of time, the greater your risk of alcohol poisoning.

Here's what one drink means.

Beer: 12 fluid ounces (360 milliliters) with about 5% alcohol.
Malt liquor: 8 to 9 fluid ounces (240 to 270 milliliters) with about 7% alcohol.
Wine: 5 fluid ounces (150 milliliters) with about 12% alcohol.
Liquor such as gin, rum, vodka or whiskey: 1.5 fluid ounces (45 milliliters) of an 80-proof drink, which has about 40% alcohol.

But the amount of alcohol in one drink may be much higher than those in the list above. For example, some craft beers may have four times the amount of alcohol that's in a regular beer. Alcohol content is displayed on the label. Or you can ask the server about alcohol content. Be aware of the alcohol content of what you're drinking and adjust how much you drink based on this knowledge.

Mixed drinks may contain more than one serving of alcohol.

Risk factors

Several factors can increase your risk of alcohol poisoning, including:

Your height and weight.
Health conditions that affect how your body processes alcohol.
Whether you've eaten recently.
Whether you've had alcohol along with other drugs, including medicines you take for health reasons.
The percentage of alcohol in your drinks.
How fast and how much alcohol you drink.
How your body processes alcohol.

Complications

Severe complications can result from alcohol poisoning, including:

Choking. Alcohol may cause vomiting. Because it depresses the gag reflex, this increases the risk of choking on vomit if a person passes out.
Stopping breathing. Accidentally inhaling vomit into the lungs can lead to a dangerous or fatal interruption of breathing, also known as asphyxiation.
Severe loss of fluids. Vomiting can result in severe dehydration, which happens when the body doesn't have enough water and other fluids. This can lead to dangerously low blood pressure and a fast heart rate.
Seizures. The blood sugar level may drop low enough to cause seizures.
Hypothermia. The body temperature may drop so low that it leads to cardiac arrest.
Unusual heartbeat. Alcohol poisoning can cause a heartbeat that is not regular. It can even cause the heart to stop.
Brain damage. Heavy drinking may cause brain damage that can't be reversed.
Death. Any of the issues above can lead to death.

Prevention

To avoid alcohol poisoning:

Drink alcohol in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to two drinks a day for males and one drink a day for females. When you drink, enjoy your drink slowly.
Don't drink alcohol along with certain medicines. Some medicines can cause harmful effects when taken with even small amounts of alcohol. And certain health conditions may mean it takes less alcohol than expected to reach the level of alcohol poisoning. Ask your health care provider if these risks apply to you.
Don't drink on an empty stomach. Having some food in your stomach may slow the process of absorbing alcohol somewhat. But it won't prevent alcohol poisoning during binge drinking.
Communicate with your teens. Talk to your teenagers about the dangers of alcohol, including binge drinking. Evidence suggests that children who are warned about alcohol by their parents and who report close relationships with their parents are less likely to start drinking.
Store products safely. If you have small children, store alcohol-containing products, including cosmetics, mouthwashes and medicines, out of their reach. Use childproof bathroom and kitchen cabinets to prevent access to household cleaners. Keep toxic items in your garage or storage area safely out of reach. Consider keeping alcoholic beverages under lock and key.
Get follow-up care. Ask about follow-up care for alcohol poisoning. Meeting with a health care provider, particularly an experienced chemical dependency counselor, can help prevent future binge drinking.

Diagnosis

In addition to checking for visible signs and symptoms of alcohol poisoning, your doctor will likely order blood and urine tests to check blood alcohol levels and identify other signs of alcohol toxicity, such as low blood sugar.

Treatment

Alcohol poisoning treatment usually involves supportive care while the body rids itself of the alcohol. This typically includes:

Monitoring to prevent breathing or choking problems.
Oxygen therapy.
Fluids given through a vein to prevent dehydration.
Use of vitamins and glucose to help prevent serious complications.

People who accidentally consume methanol or isopropyl alcohol may need hemodialysis. This is a mechanical way of filtering waste and toxins from the blood. It can speed the removal of alcohol from the blood.

Lifestyle and home remedies

Home remedies for alcohol poisoning won't work. Alcohol poisoning is an emergency situation.

Dangerous myths

You can't reverse the effects of alcohol poisoning, and you could make things worse through some actions. Here's what doesn't work:

Sleeping it off. A person can lose consciousness while asleep.
Black coffee or caffeine. Coffee and other caffeinated drinks do not stop or reduce the effects of alcohol poisoning.
A cold shower. The shock of cold can cause a person to pass out.
Walking it off. This does not make alcohol leave the body faster.