Alcohol Overdose: Signs, Risks, and Treatment Options

Edmund Murphy
Dr. David Miles
Written by Edmund Murphy on 29 October 2024
Medically reviewed by Dr. David Miles on 07 November 2024

Alcohol overdose, also referred to as alcohol poisoning, occurs when an individual consumes large amounts of alcohol in a short span of time. It can cause symptoms such as confusion, uncoordinated movements, vomiting, urinary incontinence, and trouble breathing. Severe alcohol poisoning can be fatal and should be treated immediately.

In the event of alcohol poisoning, particularly if the person is struggling to breathe, experiences seizures, or loses consciousness, call 911 for emergency assistance.

Key takeaways:
  • Symptoms of alcohol overdose can include reductions in heart rate, breathing, and body temperature, vomiting, loss of bladder and bowel control, confusion, and impaired alertness.
  • To avoid alcohol overdose, people can follow guidelines for recommended weekly alcohol consumption, avoid binge drinking, or drink alcohol-free alternatives.
  • Treating alcohol overdose may require hospitalization to stabilize physical and mental well-being, ensure breathing and airways, and prevent serious cardiac issues.
Alcohol Overdose: Signs, Risks, and Treatment Options

Understanding alcohol overdose

Alcohol enters the bloodstream when it is consumed. The body metabolizes the alcohol through the liver, where it is recognized as a toxin and removed. When alcohol is consumed faster than the body can remove it, the level of alcohol in the bloodstream, known as Blood Alcohol Concentration (BAC), begins to rise.

When the BAC is very high, the individual experiences alcohol overdose, also referred to as alcohol poisoning. This begins to affect the brain and basic functioning, impairing breathing, heart rate, and temperature regulation. The impact of a high BAC can vary. It may cause mild impairments that reduce as the body metabolizes the alcohol or it may cause severe or even life-threatening effects.

Blood Alcohol Concentration (BAC)

Category BACDescription
Mild intoxication0.0-0.05% BAC
  • 0% BAC means that the individual is sober and not intoxicated at all.
  • As this rises, mild intoxication begins, causing some changes in speech, attention, memory, and coordination.
0.06-0.15% BAC
  • As intoxication increases, impairments also increase, impacting basic functioning, decision-making, and motor skills.
  • Risks of accidental harm increase and changes in mental state may emerge.
0.16-0.30% BAC
  • At this BAC, individuals may begin to experience signs of overdose, including severe impairments in memory, concentration, alertness, and coordination.
  • They may black out, lose consciousness, or vomit.
Life-threatening intoxication0.31-0.45% BAC
  • High levels of alcohol in the blood cause severe intoxication which can be life-threatening poisoning.
  • Vital functioning is severely impaired, causing serious risks associated with breathing, heart functioning, and temperature regulation.

Can you die from alcohol poisoning?

It is possible to die from alcohol poisoning. Statistics show that, in the US, around 61,000 people die per year from one occasion of binge drinking. This figure includes drug overdoses involving alcohol, alcohol poisoning, death by suicide, and accidental harm or crashes due to intoxication.

Signs of alcohol overdose

Signs of alcohol overdose or poisoning can include:

  • Difficulty speaking, such as slurred or incoherent speech
  • Trouble standing or uncoordinated movements
  • Confusion
  • Difficulty staying awake
  • Loss of bladder or bowel control
  • Pale or blue skin color
  • Slow or irregular breathing
  • Reduced body temperature
  • Slowed heart rate
  • Vomiting
  • Seizures
  • Unresponsiveness
  • Stopped breathing

If the individual is unable to breathe, has lost consciousness and cannot be woken, is experiencing seizures, or their skin has changed color, call 911 immediately.

First aid: What to do during an alcohol poisoning

Alcohol poisoning can be life-threatening. In the event of alcohol poisoning, contact a medical professional or 911 immediately.

While waiting for medical assistance, ensuring the individual’s safety is crucial. This can include:

  • Encouraging them to slowly sip water if they are conscious and can swallow
  • Keeping them sitting upright or in the recovery position
  • Checking that they are breathing
  • If they are vomiting, ensure that they do not choke
  • Keeping them warm with a jacket or blanket
  • Do not give them caffeine or any other substances

Risk factors for alcohol poisoning

How alcohol affects the body can vary from person to person. The risk factors for alcohol poisoning can depend on several factors, including:

  • Age of the individual: Young people may be more likely to engage in harmful binge drinking
  • Alcohol tolerance: People who regularly consume alcohol will have a higher tolerance to its effects, reducing the risk of poisoning
  • Amount consumed in one sitting: Binge drinking or consuming many drinks in one sitting can significantly increase the likelihood of alcohol poisoning
  • Alcohol strength: Drinks with high alcohol content are more likely to cause poisoning
  • Speed of consumption: Consuming drinks quickly increases the risk of poisoning as the alcohol cannot be metabolized fast enough

Avoiding alcohol overdose

People can use strategies to reduce the risk of alcohol overdose, such as:

  • Drinking lower-strength alcohol
  • Setting a limit for how much they will drink in one sitting
  • Eating a full meal before drinking
  • Drinking slowly
  • Replacing drinks with low-alcohol or alcohol-free alternatives
  • Not taking other substances or medications with alcohol

Safe alcohol consumption

Many people drink alcohol in small amounts, which is often unlikely to cause harm. By following guidelines on safe alcohol consumption, people can prevent alcohol poisoning and alcohol-related harm. Recommendations suggest that men can have two drinks per day and women one per day.

This can vary depending on the drink, as different drinks contain different alcohol levels or units. Drinking no more than 14 units per week is considered low-risk consumption. Examples of units include:

  • One pint of beer (568ml) is 3 units
  • One large glass of wine (250ml) is 3 units
  • One small shot of liquor (25ml) is 1 unit

Drinking more than 14 units per week or consuming large quantities of alcohol in one sitting can increase the risk of overdose and other harmful effects. People who regularly consume large quantities of alcohol may benefit from seeking professional support in reducing or stopping alcohol consumption.

Alcohol interactions

Alcohol is a central nervous system (CNS) depressant. Taking other CNS depressant substances while consuming alcohol can cause enhanced effects, such as respiratory depression and cardiac issues which can be life-threatening. This includes substances such as:

Taking CNS stimulant substances with alcohol can cause the effects of either substance to become masked by the other, which can lead to overconsumption of alcohol and increased risks. This includes illicit and prescribed substances such as:

Alcohol can also interact with various additional prescribed medications, causing changes in the effectiveness of the medication or increased risks of adverse effects. This includes:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), causing an increased risk of bleeding
  • Cardiovascular medications, causing impacts on heart functioning, increased risk of bleeding, or changes in blood pressure
  • Antidepressants, causing increased drowsiness, enhanced effects of alcohol, worsening depression symptoms

Treatment for alcohol overdose

There is no specific antidote for alcohol poisoning, although recent studies suggest that fomepizole can help reverse or reduce alcohol effects, particularly if it is administered within a short time frame.

Other treatments for alcohol overdose involve managing the presenting symptoms. For example:

  • Protecting airways
  • Reinstating normal breathing
  • Hydration and fluids
  • Replenishing vitamins
  • Stabilizing body temperature

Severe alcohol poisoning may require hospitalization and ongoing monitoring and treatment to ensure the individual’s safety and well-being. In severe cases, the stomach may be emptied to remove remaining alcohol and toxins.

Diagnosing alcohol overdose

When presenting with suspected alcohol overdose, professionals will require the following information to determine blood alcohol levels and the severity of the individual’s condition:

  • When, how much, and what was consumed
  • Additional substance use
  • Signs of alcohol poisoning
  • Vital signs, such as breathing, heart rate, and temperature
  • Blood alcohol content, using a breathalyzer or blood test
  • Electrolyte levels using a blood test
  • Liver and kidney functioning

FAQs

These are some of the most commonly asked questions about alcohol abuse and alcohol overodose.

1. What are the signs of alcohol poisoning?

Signs of alcohol poisoning include vomiting, slowed heart rate, trouble breathing, drop in body temperature, and confusion.

2. How long does alcohol poisoning last?

The duration of alcohol poisoning can depend on several factors, including the severity of poisoning, frequency and amount of alcohol consumption, associated injuries or health consequences, and treatments. Generally, with treatment, alcohol poisoning can be managed with a positive outcome.

3. How do you treat alcohol poisoning?

Alcohol poisoning is treated with professional medical assistance, including managing breathing and airways, stabilizing body temperature, and managing any changes in mental state.

4. What does alcohol poisoning feel like?

Alcohol poisoning can feel like being extremely intoxicated, to the point of becoming severely physically unwell, losing control of bodily functioning, becoming very confused or agitated, and struggling to stay awake.

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Resources:

  1. National Institute on Alcohol Abuse and Alcoholism. (Updated 2023). Alcohol’s Effects on Health: Understanding the Dangers of Alcohol Overdose. NIAAA. Retrieved from
  2. LaHood, A.J., & Kok, S.J. (Updated 2023). Ethanol Toxicity. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Retrieved from
  3. Centers for Disease Control and Prevention. (2024). Facts About U.S. Deaths From Excessive Alcohol Use. CDC. Retrieved from
  4. National Institute on Alcohol Abuse and Alcoholism. (Updated 2024). Drinking Levels and Patterns Defined. NIAAA. Retrieved from
  5. National Health Service. (Reviewed 2024). Alcohol Units. NHS. Retrieved from
  6. National Health Service. (Reviewed 2023). Alcohol Poisoning. NHS. Retrieved from
  7. National Institute on Alcohol Abuse and Alcoholism. (Updated 2023). Alcohol-Medication Interactions: Potentially Dangerous Mixes. NIAAA. Retrieved from
  8. National Institute on Alcohol Abuse and Alcoholism. (Revised 2014). Alcohol’s Effects on Health: Harmful Interactions. NIAAA. Retrieved from
  9. Mégarbane, B., Borron, S.W., & Baud, F.J. (2005). Current Recommendations for Treatment of Severe Toxic Alcohol Poisonings. Intensive Care Medicine, 31(2), 189–195. Retrieved from

Activity History - Last updated: 07 November 2024, Published date:


Reviewer

David is a seasoned Pharmacist, natural medicines expert, medical reviewer, and pastor. Earning his Doctorate from the Medical University of South Carolina, David received clinical training at several major hospital systems and has worked for various pharmacy chains over the years. His focus and passion has always been taking care of his patients by getting accurate information and thorough education to those who need it most. His motto: "Good Information = Good Outcomes".

Activity History - Medically Reviewed on 18 October 2024 and last checked on 07 November 2024

Medically reviewed by
Dr. David Miles

Dr. David Miles

PharmD

Reviewer

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