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What is an Alcohol Overdose?

Alcohol overdose, also known as alcohol poisoning (intoxication), is a serious and potentially life-threatening condition. It occurs from drinking large amounts of alcohol over a short period. Ingesting more alcohol than the body is able to process can cause: 

  • Breathing problems
  • Black out or unconciousness
  • Elevated heart rate
  • Interruption of the gag reflex, which can lead to coma and death

Regardless of severity, a person experiencing an alcohol overdose requires immediate medical attention. If there is any indication that someone has alcohol poisoning, emergency medical help should be contacted immediately.

What Causes an Alcohol Overdose? 

Alcohol not only affects the central nervous system (CNS) as a depressant, but it also affects internal organs. An alcohol overdose is essentially when more alcohol is consumed than the body can process.

The small intestine absorbs alcohol as it passes from the stomach, sending it into the bloodstream as quickly as it is absorbed. This rapidly increases the blood alcohol level, also known as blood alcohol concentration (BAC), which the body must process.

The liver is critical for breaking down alcohol. However, it is only capable of metabolizing a limited amount at a time. What is unable to be broken down is sent back through the rest of the body.

While everybody metabolizes alcohol at different rates, the typical benchmark for a safe amount of alcohol is around one-third of one ounce per hour. This is roughly equivalent to a shot of liquor, one beer, or one small glass of wine. Any more than this will likely be too much for the body to break down, leading to an accumulation in the body.

An alcohol overdose occurs when an accumulation of alcohol in the body leads to the shutdown of certain areas of the brain, particularly the ones that control essential life-support functions. 

Several factors can lead to an overdose, such as age, alcohol tolerance levels, gender, and even the amount of food eaten. But three particular factors are the most problematic when it comes to experiencing an alcohol overdose. These include:

Binge Drinking

Binge drinking is the most common reason for alcohol intoxication. It is a pattern of heavy drinking that involves consuming five or more alcoholic drinks for males or four drinks for females within two hours. 

Binge drinking is especially problematic because it is possible to consume a fatal dose of alcohol before losing consciousness. This is because alcohol continues to be released from the stomach into the bloodstream after drinking has stopped, raising the BAC even while unconscious.

Alcohol binges can happen over just a few hours or go on for several days, both of which can be deadly. The length of time that binge drinking covers is less consequential as how much alcohol is consumed over any given period. Alcohol intoxication is more likely to occur after ingesting multiple drinks over a short time frame. Constant, sustained drinking over a longer period of time has negative health effects, but is less likely to result in an alcohol overdose. 

Mixing Alcohol with Other Drugs or Medications

While taking other drugs, such as sleep aids or anti-anxiety medications, alcohol use can greatly increase the risk of alcohol overdose. Drinking alcohol can even be dangerous while taking over-the-counter (OTC) drugs such as antihistamines. 

Using alcohol with opioid pain relievers, however, is a particularly dangerous combination. This is because these drugs suppress vital control areas in the brain that are also adversely affected by excess amounts of alcohol. Taking these substances together intensifies each of their effects and could even cause an overdose with a moderate amount of alcohol.

Accidental Ingestion

An alcohol overdose is also possible when children or adults accidentally ingest household products that contain alcohol. It is important to label products accordingly and keep all types of alcoholic beverages out of reach from children. For older children and young adults, it is imperative to lock alcohol in a place where it cannot be accessed, as teens are more susceptible to an alcohol overdose. 

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Signs of an Alcohol Overdose (Intoxication) 

Critical signs of alcohol poisoning (intoxication) include:

  • Noticeable changes in mental state
  • Mental confusion
  • Difficulty staying awake or waking up
  • Significant vomiting
  • Seizures
  • Slow and irregular breathing
  • Significantly slowed heart rate
  • Clammy or pale skin
  • Blue-tinted or altered skin tone
  • Dulled responses
  • Extremely low body temperature

It is not necessary to have all the symptoms listed above to experience an alcohol overdose. If more than one of these symptoms are present, it is important to seek immediate medical attention.

How Does an Alcohol Overdose Affect the Body? 

In addition to the symptoms that accompany an alcohol overdose, serious complications can arise from drinking more than the liver can process. Some of these complications and risks of alcohol intoxication include:

  • Slowed breathing, slowed heart rate, and loss of gag reflex — all of which are regulated by the nervous system
  • Loss of the gag reflex can result in a person choking on their own vomit after passing out
  • Cardiac arrest can follow hypothermia (a significant decrease in body temperature)
  • Seizures, as a result of hypoglycemia (low blood sugar levels)
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How is an Alcohol Overdose Diagnosed?

An alcohol overdose can be diagnosed by doctors and other healthcare professionals based on the presence of a variety of symptoms listed above. However, several additional factors are often included when diagnosing alcohol intoxication. Some of these factors include:

  • Assessing the patient’s regular drinking habits
  • Presence of other health conditions 
  • Other health information
  • Additional tests such as blood and urine analysis to check alcohol and glucose levels

Treatment Options/Resources for an Alcohol Overdose

Alcohol poisoning (intoxication) is usually treated in a hospital emergency room. The attending physician will typically monitor symptoms and provide the following treatments if the patient’s condition worsens:

  • Intravenous fluids (IV) or medications
  • Supplemental oxygen through nasal tube or mask
  • Supplemental nutrients to prevent additional complications, such as brain damage
  • Specific medications to stop seizures, if needed

How Can I Prevent an Alcohol Overdose?

The best way to prevent an alcohol overdose is by abstaining from alcohol altogether. If you would like to drink alcoholic beverages without overdosing, enjoy them slowly and limit intake to one or two drinks per day. Also, avoid consuming more than one drink per hour at any time. 

Never drink without food in your system. Drinking on an empty stomach can lead to excess alcohol absorption, while having even a little bit of food may help slow absorption to a limited degree. Although having food in your stomach cannot prevent an alcohol overdose, it will help mitigate some of the effects of mild to moderate drinking.

It is also important to safely store products that contain alcohol to avoid accidental overdose. Ensure all alcohol-containing products, most notably mouthwashes and certain medications, are kept out of the reach of children.

If you or a loved one are experiencing problems related to alcohol use or misuse, seek help from a medical practitioner or healthcare professional. If either of you has already been treated for alcohol intoxication (poisoning), seek follow-up care to help prevent a future alcohol overdose.

Resources

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Hingson, R.W.; Zha, W.; and White, A.M. Drinking beyond the binge threshold: Predictors, consequences, and changes in the U.S. American Journal of Preventive Medicine 52(6):717–727, 2017. PMID: 28526355 https://www.pubs.niaaa.nih.gov.

National Institute on Alcohol Abuse and Alcoholism. Understanding the Dangers of Alcohol Overdose. NIAAA https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-dangers-of-alcohol-overdose.

National Health Service. Alcohol Poisoning. NHS. https://www.nhs.uk/conditions/alcohol-poisoning/.

Centers for Disease Control and Prevention. Alcohol Use and Your Health. CDC. https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm.

National Institute on Alcohol Abuse and Alcoholism. Alcohol Overdose: The Dangers of Drinking Too Much. NIAAA. https://www.niaaa.nih.gov/sites/default/files/publications/overdoseFact.pdf.

LaHood AJ, Kok SJ. Ethanol Toxicity. [Updated 2020 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557381/.

Willmore, J., Marko, T. L., Taing, D., & Sampasa-Kanyinga, H. (2017). The burden of alcohol-related morbidity and mortality in Ottawa, Canada. PloS one, 12(9), e0185457. https://doi.org/10.1371/journal.pone.0185457.

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