Alcohol Poisoning & Overdose: Signs, Effects & Treatment

Since alcohol lowers inhibitions, even occasional, social drinkers can lose sight of how much alcohol they’ve had. About 90% of people who drink excessively would not be expected to meet the clinical diagnostic criteria for having a severe alcohol use disorder (AUD).¹ However, there’s also a significant danger of an alcohol overdose for people suffering from AUD, particularly when they relapse, due to decreased tolerance.²

A quick and immediate reaction is of utmost importance since too much alcohol can cause death. The rate of alcohol-related visits to ER increased by nearly 50% between 2006 and 2014.³ According to the CDC, there are approximately 2,200 fatalities due to severe alcohol poisoning every year in the U.S.⁴ Some of those that do recover may continue to experience chronic complications, even permanent changes to the brain functions.⁵Treating excessive drinking disorders can prevent such incidents from happening or repeating.⁶

What Is Alcohol Poisoning or Overdose?

Drinking alcohol too fast in a short period of time causes it to get absorbed and enter the bloodstream quickly. The liver can process about one drink an hour. One drink is usually defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of whiskey.³ This can overload the liver and lead to high levels of alcohol in the blood.⁷

In these situations, blood alcohol content (BAC) may reach toxic values and affect basic life functions. This is alcohol poisoning.⁷

What Causes Alcohol Poisoning or Overdose?

A major cause of alcohol poisoning is binge or high-intensity drinking. Drinking on an empty stomach as well as using prescription medications or illegal drugs with alcohol is particularly dangerous. Drinking large quantities of alcohol can overwhelm the body’s ability to break down and clear alcohol from the bloodstream. This leads to rapid increases in BAC and significantly impairs brain and other bodily functions.⁸

Binge drinking is defined as a pattern of alcohol consumption that brings the BAC to 0.08% or more. This usually corresponds to 5 or more drinks on a single occasion for men or 4 or more drinks for women, generally within about 2 hours.⁹

A person can consume a fatal dose of alcohol before passing out. Even when unconscious or after they’ve stopped drinking, alcohol continues to be released from the stomach and intestines into the bloodstream and the level of alcohol continues to rise.¹⁰

Signs and Symptoms of Alcohol Poisoning/Overdose

Even small increases in BAC can decrease motor coordination, make a person feel sick, and cloud judgment. Significant impairments in motor coordination, decision-making, impulse control, and other functions increase the risk of harm. Continuing to drink despite clear signs of alcohol intoxication can result in an alcohol overdose. When BAC reaches high levels, blackouts (gaps in memory), loss of consciousness, and death can occur.⁸

Critical alcohol overdose symptoms and signs include:⁹

• Slurred speech
• Mental confusion
• Impaired coordination
• Stumbling or falling
• Hypothermia (low body temperature), bluish skin color, or paleness
• Loss of consciousness
• Vomiting
• Shaking
• Seizures
• Slow or irregular breathing
• Slow heart rate
• Dulled responses (such as no gag reflex – which prevents choking)

What BAC Causes Alcohol Poisoning?

BAC is the percent of alcohol in a person’s bloodstream. It can provide a general idea of how dangerous different levels of alcohol intoxication can be:⁹

• 0.00-0.05% – Mild Impairment: mild speech, memory, attention, coordination, and balance impairments; relaxation; sleepiness
• 0.06-0.15% – Increased Impairment: increasing intoxication, risk of aggression in some people; significant impairment in driving skills; risk of injury to self and others; moderate memory impairments
• 0.16-0.30% – Severe Impairment: speech, memory, attention, coordination, and balance significantly impaired; driving-related skills, judgment, and decision making dangerously impaired; blackouts, vomiting; loss of consciousness
• 0.31-0.45% – Life-Threatening: loss of consciousness; danger of life-threatening alcohol overdose; significant risk of death due to suppression of vital life functions.

How Much Alcohol Is Dangerous?

Because of variation in physiology and individual alcohol tolerance, relying solely on the number of drinks is risky. Reactions to alcohol vary according to:¹¹

• Age.
• Gender.
• Bodyweight and body fat percentage.
• Race or ethnicity.
• Physical condition.
• Amount of food consumed before drinking.
• How quickly the alcohol was consumed.
• Use of drugs or prescription medicines.

Tolerance to alcohol can also be affected by genetics, adaptation to chronic alcohol use, and synergistic effects of drugs.¹²

BAC of 0.40 % or higher is considered to be potentially lethal. At this level, there’s a risk of coma or alcohol overdose death. Combining medications with alcohol can have unpredictable consequences. Particularly dangerous are combinations of alcohol and:¹³

• Depressants (Xanax, Valium) because of their synergistic effect.
• Stimulants (Ritalin, Adderall, Concerta) may conceal the effects of alcohol, making users unable to gauge their level of intoxication.
• Prescription opiates (Vicodin, OxyContin, Percocet) combined with alcohol can result in slowed or arrested breathing, lowered pulse and blood pressure, unconsciousness, coma, and potential death.

How to Prevent Alcohol Poisoning or Overdose?

The best way to prevent alcohol poisoning is to drink responsibly and avoid binge drinking. Drink in moderation, keeping track of the number of drinks you’ve had. For healthy adults, that means up to one drink a day for women of all ages and men older than 65, and up to two drinks a day for men aged 65 and younger. In the U.S., one “standard” drink contains roughly 14 grams of pure alcohol, which is found in:¹⁴

• 12 ounces of regular beer, usually about 5% alcohol.
• 5 ounces of wine, about 12% alcohol.
• 1.5 ounces of distilled spirits, about 40% alcohol.

To prevent alcohol poisoning and drunk responsible, there are a few helpful guidelines:¹⁵

1. Don’t drink on an empty stomach. Even though food won’t prevent alcohol poisoning if you’re binge drinking, it will slow down absorption so it doesn’t enter your bloodstream as fast.
2. Drink water. It’s recommended to have a 16-ounce drink of water for every standard drink you consume.
3. Don’t drink too fast. Your body can process roughly 1 unit of alcohol per hour, so give it time to process the alcohol and prevent your BAC from getting too high.
4. Know your limits. Even if there’s no specific amount of alcohol that is guaranteed to be fatal for everyone, most people should know what they can handle.
5. Avoid the combination of alcohol and drugs like sedatives or narcotic pain medications, because they both suppress activity in brain areas that regulate breathing and other vital functions.¹⁶
6. Pay attention to mixed drinks with an unknown alcohol content that may contain more than one serving of alcohol. Energy drinks contain caffeine, which can mask alcohol’s effects when combined.¹⁷

How to Treat Alcohol Poisoning or Overdose

Learn to recognize the symptoms of alcohol overdose and call 911 for help immediately. Not everyone has all the symptoms, but keep in mind that a passed-out person may even die, so getting help right away is crucial.

Hospital treatment for alcohol overdose can include:^15,18

• Intravenous (IV) fluids to maintain levels of hydration, blood sugar, and vitamins.
• Intubation or oxygen therapy to help with breathing and choking troubles.
• Flushing or pumping the stomach to clear alcohol from the body.
• Hemodialysis, to speed up the removal of alcohol from the blood.
• Medications to stop the seizure activity.

After acute alcohol poisoning is averted, it may be time to consider the possibility that experiencing an overdose on alcohol is a sign that treatment for alcohol abuse at a specialized facility may be needed. While some individuals may start with professional intervention, others can look into different treatment options by contacting a helpline. Nonetheless, excessive drinking (drinking alcohol too fast, too much, or too often) can lead to a serious AUD that warrants long-term treatment.

About ⅓ of people who are treated for alcohol problems have no further symptoms 1 year later. Many others substantially reduce their drinking and report fewer alcohol-related problems.¹⁴ A variety of treatment methods are currently available. There’s no one-size-fits-all solution, but understanding the different options can be an important first step.

Behavioral Treatment and Counseling

Behavioral treatment and counseling led by health professionals can be beneficial. Different inpatient facilities for alcohol addiction treatment as well as outpatient programs structured around behavioral therapies are evidence-based and administered for as long as needed for recovery.¹⁹

There are 3 FDA-approved medications in the U.S. that have been shown to effectively help people stop or reduce their drinking and prevent relapse:¹⁹

• Naltrexone can help people reduce heavy drinking.
• Acamprosate makes it easier to maintain abstinence.
• Disulfiram blocks the metabolism of alcohol by the body, causing unpleasant symptoms such as nausea and flushing of the skin. This can deter people from drinking while taking it.

When there are accompanying medical and/or mental health conditions, a more comprehensive treatment is usually needed. Such a program takes into account all the facets of an individual’s condition and treats them accordingly.

American Addiction Centers (AAC) facilities are well-equipped to provide such treatment. A number of highly skilled addiction specialists and other healthcare personnel work together to provide optimal, customized care programs for each person after the initial admission process.

The process of alcohol detoxification is adequately managed, usually with medication-assisted treatment for alcohol abuse to ensure that the patient doesn’t suffer from severe, life-threatening withdrawal symptoms. Behavioral therapy, individual and group therapy, counseling, group support, and ongoing aftercare are options to consider and choose from.Additionally, AAC can verify your insurance coverage for addiction treatment. You can check this by entering your information on the website or calling the helpline to speak to one of the admissions representatives who can check your insurance benefits and payment options during your call and inform you about treatment programs.