What Is Alcohol Poisoning?

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Alcohol poisoning is when the percentage of alcohol in your blood is so high that it is toxic. This can cause a wide range of symptoms and complications, from clammy skin to blacking out, vomiting to seizures, breathing trouble to coma. Alcohol poisoning is usually recognized at a critical stage when urgent medical attention is needed. Survival is possible if immediate medical care is provided, but death or permanent disability can result without treatment.

Alcohol Poisoning Symptoms

Alcohol affects many physical functions, including blood pressure, breathing, and a person's level of awareness.

Signs of potential alcohol poisoning include:

  • Slurred speech
  • Instability when walking
  • Confusion
  • Nausea

These are often overlooked, perhaps because people just consider them indications of being "drunk" (i.e., they perceive the condition as impaired, but not serious). But it's important to know that, at this stage, the situation can progress rapidly.

Someone who is drunk can experience worsening symptoms within a few hours. When alcohol poisoning occurs, the effects can be dramatic.

Signs of alcohol poisoning, which warrant immediate medical attention, include:

Don't Hesitate—Call 911

Call 911 or go to the nearest hospital if you notice signs of alcohol poisoning. Then, do what you can to keep the person safe until help arrives. Never leave someone who is drunk alone, whether they are asleep or awake. If you are concerned that they could hurt you, maintain a safe distance while waiting for professional help.

Why They Occur and Possible Complications

Symptoms and potential risks and complications of ingesting too much alcohol largely stem from the effect on the brain and blood vessels. Rapid fluid ingestion can be harmful in and of itself, as it can alters the fluid concentration in the body, potentially disrupting fluid and electrolyte balance.

Brain Impairment

Alcohol poisoning can make a person black out, causing loss of consciousness and often an inability to remember many of the events that occurred.

Alcohol also disrupts a person's balance due to its effects on the brainstem and cerebellum. Not only does this cause a lack of physical coordination, which can cause falls or other accidents, but it also contributes to alcohol-induced nausea and vomiting.

Alcohol is a central nervous system (CNS) depressant, which means that it acts to decrease your response time and level of consciousness. This effect decreases the gag reflex, which can make you choke on your own vomit while passed out or sleeping, causing potentially fatal consequences.

As a CNS depressant, a high blood concentration of alcohol can also inhibit respiration, usually resulting in a slow, shallow breathing pattern.

In severe cases, alcohol poisoning can result in coma.

Vasodilation

When you have alcohol in your system, you may also experience vasodilation (widening of the blood vessels), which decreases blood pressure. Vasodilation also causes blood to rush to the skin, potentially leading to hypothermia.

Vasodilation also interferes with the body's ability to compensate for bleeding and shock. This is particularly important to consider as alcohol weakens the walls of blood vessels and makes them more susceptible to rupture and bleeding.

These factors combined with the increased likelihood of becoming injured while drunk means alcohol poisoning increases the risk of hemorrhage (bleeding) in the brain and elsewhere in the body, which can be profuse.

Causes

Most people can physically manage moderate amounts of alcohol, but everyone's ability to metabolize alcohol is different. As such, the amount of alcohol that needs to be consumed to reach a state of alcohol poisoning varies from person to person.

In some, that amount may be lower than anticipated. But being able to tolerate more and more alcohol does not mean that you are less likely to experience alcohol poisoning: Many heavy drinkers believe that they have learned to 'hold their alcohol," but the changes going on inside the body make chronic drinkers susceptible to this condition.

The liver, which normally metabolizes and detoxifies alcohol, is damaged by chronic alcohol use. When you can't metabolize alcohol efficiently, the harmful effects on your body occur quickly, have a more dramatic effect, and last longer.

While alcohol poisoning is certainly a concern for people with alcohol use disorder, alcohol poisoning is more common than most people realize and can happen to anyone who drinks.

Diagnosis

Diagnosis of alcohol poisoning is complex, requiring a physical examination, assessment of vital signs, and possibly diagnostic tests. There are a number of issues that interfere with the timely diagnosis of alcohol poisoning, and delays can worsen the consequences.

Reasons for Diagnostic Delays

Alcohol poisoning can appear similar to many life-threatening conditions. For example, hypoglycemia (low blood sugar), a stroke, or a seizure can cause problems with speech and level of consciousness that may be confused with alcohol consumption.

A person experiencing alcohol poisoning may also have other medical issues, such as a head injury or a drug overdose. These other conditions can complicate the symptoms, making it more challenging to recognize alcohol poisoning.

Friends and acquaintances may have a tendency to overlook intoxicated victims, believing that the alcohol will wear off. Severely intoxicated people often smell of alcohol and may experience issues like incontinence, which can be indicators that they are more than drunk.

Underage drinkers, or even adults who are concerned about their reputations, may avoid seeking medication attention for fear of getting into trouble with authorities, parents, or work colleagues. This often delays the diagnosis of alcohol poisoning, worsening the outcome.

Diagnostic Assessment

Accurate diagnosis of alcohol poisoning relies on a clinical examination and diagnostic tests.

Blood pressure, breathing rate, pupil size, and responsiveness are all considered in the assessment.

Blood and urine tests can measure alcohol concentration, providing helpful clues about whether alcohol poisoning is the cause of symptoms. Sometimes, however, alcohol may not be present in blood and urine even when the impact of alcohol poisoning is still quite evident.

In some situations, a medical team may order imaging studies such as a brain computerized tomography (CT) scan to see if there is head trauma or bleeding.

And sometimes, electroencephalography (EEG) is needed to differentiate between alcohol poisoning and a seizure.

Treatment

Once at the hospital, and sometimes on the way to the hospital, a person who is experiencing alcohol poisoning generally receives intravenous (IV) fluids to replace the fluid loss from vomiting and to correct the alcohol-induced fluid and electrolyte disruption in the body.

In some instances, oxygen may be administered by placing a mask on the face. Mechanical ventilation may be necessary for respiratory support if breathing is not self-controlled. Medications to maintain adequate blood pressure may also be needed.

Removal of alcohol and toxins directly via a tube placed in the stomach (a process referred to as stomach pumping) can prevent further absorption of alcohol. Dialysis, a process by which blood is filtered of waste and toxins, may be necessary in severe circumstances.

If seizures are occurring, a short-term anticonvulsant medication can help stop them. Treatment for any injuries, such as head trauma or bone fractures, is often necessary as well.

There are several common myths about treating alcohol poisoning. For example, some people suggest drinking coffee or taking a cold shower. These methods cannot remove excess alcohol from the body and, therefore, cannot reduce the effects of alcohol poisoning.

Consent

Intoxication affects the way consent works in emergency medical situations. Normally, anyone experiencing a medical emergency must give permission to receive professional help. This requires understanding the necessity of treatment, knowing the possible side effects of treatment, and being informed of the consequences of refusing help.

That's a lot of information, particularly if one's ability to think is impaired by alcohol.

Because of alcohol-induced impairment, it is often assumed that someone who is intoxicated would accept help if able to do so. This form of permission is called implied consent.

A Word From Verywell

Alcohol poisoning is a serious matter. It can affect anyone at any age. One of the biggest dangers is the belief that you can tolerate a large amount of alcohol just because you have consumed that amount in the past. Your health can change, the pace of your drinking or the alcohol concentration of a favorite drink may vary, and even your ability to metabolize alcohol can change from one day to another.

The bottom line is that if you suspect alcohol poisoning in yourself or someone else, you should call for medical attention immediately rather than waiting to see if things get better on their own. Moments matter.

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Article Sources
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