How Can You Tell If Someone Has Alcohol Poisoning?

Drinking alcohol occasionally is usually no cause for concern. However, if you or those you know are frequently binge drinking or drinking hard alcohol, it can sometimes lead to an alcohol overdose or alcohol poisoning.  

Alcohol poisoning is NOT the same as being drunk or tipsy. Alcohol poisoning can be life-threatening, and anyone drinking too much alcohol is at risk. 

Alcohol poisoning typically occurs when a person consumes a significant amount of alcoholic beverages such as beer, wine, or cocktails. However, it can also happen due to the intentional or unintentional ingestion of products that contain alcohol, including household items like mouthwash and cough syrup.

If you think someone is overdosing on alcohol, call 911 (or your local emergency response number) or take them to the nearest hospital or doctor immediately. 

What is Alcohol Poisoning?

Alcohol poisoning, or alcohol overdose/alcohol toxicity, happens when you drink so much alcohol over a short period that your liver can’t keep up. The brain then starts shutting down essential functions. These can include controlling the heartbeat, helping you breathe, and regulating your body temperature. 

The Alcohol-Related Disease Impact (ARDI) application estimates that each year, there are more than 178,000 alcohol related deaths (approximately 120,000 male deaths and 59,000 female deaths) caused by alcohol poisoning. 

What Are the Symptoms of Alcohol Poisoning? 

Alcohol poisoning is not simply binge drinking, getting drunk, and waking up with a bad hangover. Here are the symptoms of being intoxicated vs. alcohol poisoning symptoms. 

Is Alcohol Poisoning an Emergency?

Alcohol poisoning is always a medical emergency. If you’re with someone showing signs of an alcohol overdose, take the following steps:

1. Call 911 (or your local emergency response number). Never assume the person will simply sleep off alcohol poisoning.

2. Don't leave an unconscious person alone. Because alcohol poisoning affects the gag reflex, someone with alcohol poisoning might choke on their vomit and have trouble breathing. Don’t try to induce (force) vomiting. 

3. Be prepared to give information. Let emergency staff know the kind and amount of alcohol the person drank. Once they have this information, they can get a better idea of their blood alcohol concentration (BAC) and how to provide proper treatment. 

4. Help someone who is vomiting. Try to keep the person sitting upright. If they have to lie down, turn their head sideways to prevent choking and keep them awake.

The most important thing is to stay calm and ask for help. Sometimes it can be difficult to know when someone is drunk enough to need emergency treatment. 

Remember, it’s better to act right away. You may worry about what will happen to you or a friend or family member, especially if underage. However, many states have Good Samaritan laws that allow people to call 911 and get immediate medical care without fear of arrest if they're having a drug or alcohol overdose or see someone overdosing. 

What Causes Alcohol Poisoning?

All alcoholic beverages, such as beers, wine, and cocktails, contain a form of alcohol called ethyl alcohol or ethanol. Besides alcoholic beverages, this type of alcohol is also found in many household products like mouthwash, medicines (such as cough syrups), and cleaning supplies. 

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, and methanol or ethylene glycol, which is a common ingredient in antifreeze, paints, and solvents.

Poisoning happens when you drink too much at once. The exact number of drinks to cause someone to have alcohol poisoning depends on their alcohol tolerance, age, sex, and overall health. 

What counts as binge drinking?

Binge drinking is the most common cause of alcohol poisoning. To count as binge drinking, the blood alcohol concentration (BAC) must reach .08% or higher.

The amount of alcohol this translates to is approximately five or more drinks for men and four or more drinks for women within two hours. 

How much alcohol is too much? 

Unlike food, which digests over a few hours, alcohol enters the bloodstream quickly and takes longer to metabolize. Here's the breakdown for different types of alcoholic beverages:

• 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.

• Hard alcohol like gin, rum, vodka, or whiskey: 1.5 fluid ounces (45 milliliters) of an 80-proof drink, which has about 40% alcohol.

However, this is not an exact science. For example, mixed drinks may contain more than one serving of alcohol. Alcohol content is required to be on the label, but if you’re ever unsure, ask your bartender or server. 

Are There Any Risk Factors for Alcohol Poisoning? 

While anyone can experience alcohol poisoning, the risk significantly increases in those who engage in binge drinking. Per the CDC, deaths from alcohol poisoning usually involve men between the ages of 35 and 64. Middle-aged people are more likely to take prescription drugs, which can increase the severity of alcohol poisoning. 

Besides frequent heavy drinking, several factors can increase your risk, including: 

• Drinking on an empty stomach

• Combining alcohol with certain medications (antihistamines, anti-anxiety medications, opioid pain medicines, and sedative hypnotics) 

• Sex: Women process alcohol more slowly than men.

• Age: Younger adults and teens are at higher risk due to several factors, including peer pressure and low alcohol tolerance.

• Small body size and low body weight

• Overall health

• Certain medical conditions, like liver disease, can affect how your body processes alcohol, as damage to the liver affects its ability to process alcohol.

• Alcohol can worsen symptoms of certain health conditions, such as Hodgkin's lymphoma and Crohn’s disease. Consuming alcoholic beverages that are not gluten-free can also worsen symptoms of celiac disease.  

How Do Doctors Diagnose Alcohol Poisoning?

Doctors can diagnose alcohol poisoning based on the person’s symptoms. Besides doing a physical exam, a healthcare professional will typically order several tests to confirm an alcohol poisoning diagnosis. These may include:

• Blood or breathalyzer test to check blood alcohol content (BAC)

• Other blood work for blood electrolyte levels, kidney function, blood counts, and liver function tests 

• Urine tests

• Electrocardiogram (EKG)   

How Is Alcohol Poisoning Treated & Managed?

At the hospital, there are many alcohol poisoning treatments that the staff will use right away to stabilize patients. These include:

1. IV fluids. Your care team will give you intravenous (IV or into a vein) fluids to treat dehydration. IV drips containing glucose (sugar) or electrolytes can also be administered to increase blood sugar levels and address electrolyte imbalances. 

2. Stomach pumping. At the hospital, staff might pump your stomach to flush the toxins out. 

3. Oxygen therapy. Providers can give oxygen using a nasal cannula (a flexible tube clipped to your nose). In more severe cases, when you experience significant difficulty breathing, intubation may be necessary. This involves placing a small tube through your mouth and into your windpipe (airway) to provide mechanical ventilation and ensure that your airway remains open.

4. Blood filtration. If your kidneys are failing, doctors may start dialysis to filter alcohol from your blood.

How to manage alcohol poisoning in the long term? 

The long-term management of alcohol poisoning prioritizes recovery, preventing recurrence, and addressing underlying causes. A medical follow-up appointment may be needed to monitor organ function and treat any complications. 

Additionally, therapy or substance use disorder treatment programs can help manage addiction and mental health concerns. For those suffering from alcohol withdrawal, doctors might prescribe acamprosate, disulfiram, or chlordiazepoxide to curb the desire to drink. 

Lastly, avoiding triggers, building a support system, and developing coping skills are critical to successful alcohol abuse recovery. Educate yourself and others on the risks of alcohol use disorder to prevent relapses. 

How to Prevent Alcohol Poisoning

The best way to prevent alcohol poisoning is to limit your alcohol consumption. If you’re drinking with friends, pay attention to the type of alcoholic drinks you’re consuming and how fast. Drinking in moderation is key for you and those around you. Keep it to one drink per hour. 

Other ways to avoid alcohol poisoning include:

• Opt out of drinking games. Beer pong, funnels, and other drinking games can pressure participants to binge drink.  

• Stay hydrated. Drink plenty of water alongside each alcoholic beverage. 

• Eat before drinking alcohol. Alcohol is more dangerous on an empty stomach; eat plenty of starchy, carb-heavy food beforehand. 

• Do not mix medicine and alcohol. Never drink alcohol when on certain medications, especially Tylenol (acetaminophen). 

• Stay alert. Avoid a drink if you’re unsure of what’s in it or if it’s mixed with energy drinks. 

• Know your limits and stick to them.

If you think you or someone else might have alcohol use disorder, don’t be scared to reach out for help. Talk to your doctor or call the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-HELP (4357). 

SAMHSA also provides valuable resources on various mental health conditions that can help you and your loved ones better understand and navigate your journey. You're not alone in this, and there are tools available to support you.

5 Alcohol Poisoning Myths Debunked

The most effective way to treat alcohol poisoning is through evidence-based treatment managed by a team of healthcare professionals. If you suspect someone may have alcohol poisoning, it's crucial to seek emergency medical assistance. That said, contrary to popular belief, these popular alcohol intoxication myths are simply untrue and may even worsen the situation. 

1. Taking a cold shower to lower body temperature

2. Trying to throw up the alcohol

3. Eating food to “soak up” the alcohol 

4. Going on a walk to burn it off 

5. Drinking coffee or other caffeinated beverages to feel more alert