Despite being a legal substance, alcohol is very much a drug—and one that has very real and potentially fatal consequences. Alcohol poisoning is the most severe side effect of intoxication that can occur. The CDC estimates that it results in an average of 2,200 deaths each year. What makes alcohol poison particularly worrisome is that it can be difficult to distinguish from typical drunken behavior in its early stages. Being able to recognize the signs of alcohol poisoning can quite literally mean the difference between life and death.
What is Alcohol Poisoning?
Alcohol poisoning is a life-threatening condition that is also sometimes referred to as an alcohol overdose. It occurs when there is too much alcohol in the bloodstream and the brainstem, a critical structure that connects your brain and the rest of your body, begins to feel its effects. At this stage of alcohol consumption, all the parts of the brain—as well as their specific functions—have been impaired and the brain has effectively shut down.
However, it is not the loss of brain function in and of itself that makes alcohol poisoning so deadly. It is particularly due to the brainstem and its role of regulating the central nervous system. The loss of which causes a disruption of vital life functions such as the heartbeat, blood pressure, and breathing. It goes without saying that alcohol poisoning is much more severe than a “bad hangover”. It’s not something that can just be slept off or fixed with a cup of coffee. It is a serious medical condition that requires emergency medical attention.
Symptoms & Signs of Alcohol Poisoning
Alcohol poisoning is the culmination of the brain’s deteriorating functionality as more and more alcohol enters the bloodstream. A person will go through the typical stages of intoxication and exhibit the usual drunken behaviors until suddenly, they’ve gone too far.
Alcohol’s depressant effects on the central nervous system reach their most intense at this stage, the evidence of which is displayed in the nature of alcohol poisoning symptoms. Confusion and disorientation, slurred speech, stumbling, and damp, clammy skin are some of the mild signs of alcohol poisoning. These can be difficult to distinguish from severe—but not yet deadly—levels of impairment. The more severe symptoms are much more noticeable:
- Bluish or pale skin
- Low body temperature
- Very slow heartbeat
- Going in and out of consciousness/trouble staying awake
- Slow breathing (fewer than 8 breaths a minute or with long pauses of 10+ seconds between each breath)
- Slow responses
These side effects can compound upon one another, resulting in numerous complications which is where the primary danger lies. These severe side effects include:
- Brain damage
- Choking on vomit (due to lack of gag reflex)
- Difficulty breathing because of vomit in lungs
- Heart attack
- Severe dehydration
Long-term damage from alcohol poisoning can affect the pancreas and brain, although alcohol does quite a number on the body well before it gets to that stage.
What Causes Alcohol Poisoning?
There is no set formula of what will bring the onset of alcohol poisoning. It’s not a matter of mixing different types of liquor, eating enough food beforehand, or even how many shots you take. While those certainly are contributing factors, the cause of alcohol poisoning and its detrimental effects on the brain, lies in blood alcohol concentration (BAC) levels.
What is BAC?
BAC is a measurement of the amount of alcohol (ethanol) in the bloodstream. Blood alcohol concentration is a ratio and as such, varies with the many physiological and behavioral factors that affect it. These include:
- Body fat percentage/Muscle mass
- Hydration levels
- Food consumption
- Emotional state
- Drink strength
- Alcohol tolerance
- Rate of drink consumption
It quickly becomes apparent how impossible it is to try and apply a uniform scale of how many drinks it takes for alcohol poisoning to happen. (Source)
Alcohol Poisoning BAC Level
Alcohol poisoning occurs when BAC levels exceed 0.25. Unfortunately, trying to determine precisely how many drinks it takes for that to happen is not as straightforward. Drink-to-BAC ratios are highly individualized since the factors that affect BAC vary so greatly from person-to-person.
For example: A 100-pound woman will have a much higher BAC (~0.05) after 1 drink than a 200-pound woman would (~0.02). But one must also consider the differences in their muscle composition, metabolisms, and how hydrated they are – just to name a few factors.
Another factor to consider is that every hour, 0.15 BAC is reduced from the bloodstream due to the body’s basic metabolizing function. This means that someone who has 5 drinks over the course of an evening will be far less intoxicated than someone who has 5 drinks within an hour.
Getting Help for an Alcohol Overdose
As with any kind of overdose, getting medical attention as quickly as possible is important for increasing the odds of survival. Most instances of alcohol poisoning result in a trip to the emergency room but there are currently no medications available for reversing the effects of an overdose like there is with opioids. Long-term recovery will likely require treatment for alcohol abuse disorder to prevent a level of drinking from occurring again, and the best way to prevent alcohol poisoning will always be to abstain from drinking alcohol altogether.