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What is Alcohol Intoxication?

Alcohol intoxication describes the physical and mental effects of drinking too much alcohol. These effects include slurred speech, reduced coordination, impaired judgment, blurred vision, and drowsiness. The level of intoxication depends on how much alcohol has been consumed. 

Acute alcohol intoxication, also known as alcohol poisoning, is a more severe form of intoxication. Effects here can include reduced body temperature, impaired breathing, and loss of consciousness. Acute intoxication is life-threatening. 

Most people either have experienced alcohol poisoning or know someone who has. 85.6% of adults drink alcohol at some point in their lives.7

Alcohol poisoning does not always involve traditional alcoholic beverages. Many household products contain alcohol. Consumption of these products can be a sign of drug dependence or alcohol addiction. 

When we talk about alcoholic drinks, we are referring to ethyl alcohol or ethanol. Ethanol is made from fermenting grains or fruits, and is mixed with other ingredients to provide flavor. Therefore, alcohol itself is just a fraction of the beverage. For example, beer typically contains only 5% alcohol, while hard liquors contain around 40%. Pure alcohol is dangerous to drink and is not generally available to buy. 

Many of those suffering from addiction drink isopropyl alcohol or rubbing alcohol to become intoxicated. Other substances such as cooking extracts and mouthwash can contain ethyl alcohol, leading to ethanol intoxication.

What is Acute Alcohol Intoxication? 

Acute alcohol intoxication is a state of extreme impairment from drinking too much alcohol. Effects of acute intoxication include nausea, vomiting, diarrhea, loss of control of bodily functions, and abdominal pain. 

In extreme cases, respiratory depression may occur, a life-threatening condition in which normal breathing is impaired.8 Other dangers include a higher risk for injury from violent altercations or trauma from accidents. 

A major cause of acute alcohol intoxication is binge drinking (drinking too many alcoholic beverages too quickly). According to the National Institutes of Health, 25.8% of Americans have engaged in binge drinking in the past.2  

What constitutes binge drinking depends on the sex of the drinker. For men, this is five or more standard drinks in two hours; for women, it is four or more. An example of a standard drink would be 12 fluid ounces of regular beer or 8-9 fluid ounces of malt liquor.

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What Causes Alcohol Intoxication?

When people drink alcohol, it passes through the stomach and into the small intestine, and from there it passes into the bloodstream. This raises their blood alcohol concentration

Blood alcohol concentration, also known as blood alcohol content (BAC), determines the amount of alcohol in the bloodstream. In every U.S. state (besides Utah—which is .05%), the legal definition of alcohol intoxication is a BAC of 0.08% or above.8  

The amount of alcohol consumed is not the only factor in determining BAC - weight also plays a role. For example, a male weighing 160 lbs who consumes three standard drinks may have a BAC of 0.11%. Meanwhile, the BAC of a 140 lb man who drinks that many might be closer to .13%.2 And if there is a man and woman of the same weight, a man will tend to have a lower BAC, even if they drink the same amount.2

Whether the person has eaten recently also matters. You absorb alcohol faster when you drink on an empty stomach. This is because the stomach sphincter muscle remains closed for digestion, slowing the absorption of alcohol.

A person’s medical history - particularly whether he or she is taking medication, is another important factor influencing intoxication. Drinking while taking some over the counter medications such as Benadryl can lead to extreme drowsiness. 

Alcohol poisoning does not always involve traditional alcoholic drinks. Many household products contain alcohol. Consumption of these products can be a sign of drug dependence or alcohol addiction. Many of those suffering from addiction drink isopropyl or rubbing alcohol to become intoxicated. Other substances such as cooking extracts and mouthwash can contain ethyl alcohol, leading to ethanol intoxication.

What are the Symptoms of Alcohol Intoxication?

Signs and symptoms of alcohol intoxication include:

  • Slurred speech 
  • Reduced coordination or balance
  • Vomiting
  • Inability to stay awake
  • Loss of consciousness
  • Low body temperature
  • Impaired memory or judgment
  • Slow or irregular breathing

If you are concerned about someone with these signs and symptoms you should seek immediate medical attention.

The 7 Stages of Alcohol Intoxication 

  1. Sobriety, or subclinical intoxication (0.01 - 0.05 BAC) — At this stage, a person may or may not appear intoxicated.
  2. Euphoria (0.01 - 0.12% BAC) The person is more confident, sociable, and impulsive, and has a shorter attention span. This person may or may not be legally intoxicated at this point.
  3. Excitement (0.09 - 0.25% BAC) — An intoxicated person at this stage may show slowed reaction times, reduced memory, blurred vision, and a lack of coordination. He will almost certainly appear intoxicated.
  4. Confusion (0.18 - 0.30% BAC) — This person is severely intoxicated. Signs and symptoms here include extreme drowsiness, highly impaired speech, increased aggression, and blurry vision. Significant impairments to balance and reflexes may also occur. Intoxication is obvious and apparent.
  5. Stupor (0.25 - 0.49% BAC) — A person at this stage can barely move or stand, is prone to vomiting, and may slip in and out of consciousness. The chance of an alcohol overdose is very high here, and medical help should be sought immediately. Death can occur over a BAC of .40%. 
  6. Coma (0.35 - 0.50% BAC) This is close to a fatal dose. The intoxicated person has lost consciousness. The body’s ability to regulate breathing is compromised, with breathing slower and more shallow. The person’s heart rate has likely slowed, and body temperature drops. This is a medical emergency.
  7. Death (+.50% BAC) When a person drinks this much, the body’s autonomic nervous system (ANS) shuts down. The ANS is responsible for breathing, heartbeat, circulation, digestion, and other vital functions. 

When to See a Doctor

If you believe someone is suffering from alcohol poisoning, you should seek immediate medical attention. While you wait, make sure the intoxicated person remains upright and awake. They should also be given water if possible and kept warm. 

How is Alcohol Intoxication Diagnosed?

A doctor can diagnose intoxication by checking the patient’s blood alcohol concentration levels. Low blood sugar is another sign of possible alcohol poisoning. Peer-reviewed studies indicate that alcohol can create an exaggerated insulin response, lowering blood sugar.4 BAC and blood sugar levels can both be checked with a simple blood or urine test.

How is Alcohol Intoxication Treated? 

Emergency medical attention for alcohol poisoning typically begins with a physical examination and careful observation. Those at risk of respiratory depression may receive oxygen therapy. This involves having a breathing tube inserted to assist with normal breathing. 

An intravenous drip may be inserted to restore fluid, electrolyte, and blood sugar to normal levels. Finally, a catheter may be fitted until the patient regains control of bodily functions.

Possible Complications of Alcohol Intoxication

Alcohol poisoning can lead to a variety of serious complications, including:

  • Gastritis (inflammation of stomach lining)
  • Diabetes complications
  • Respiratory failure
  • Hypothermia (dangerously low body temperature)
  • Arrhythmia (irregular heartbeat)
  • Diabetes complications
  • Brain damage 

What is the Outlook for Alcohol Intoxication?

After being treated and stabilized, patients should be carefully monitored as their vital functions return to normal. Symptoms of alcohol withdrawal are possible. 

Some signs and symptoms to watch for include decreased mood and appetite, memory problems, headache, and fatigue. Usually, full recovery takes only a couple days.

When is Alcohol Intoxication a Sign of Alcoholism?

Medical care professionals treating patients for alcohol poisoning should check for possible Alcohol Use Disorder (AUD). Those at risk of AUD: 

  • Are unable to quit drinking
  • Continue to drink despite it causing social or work problems
  • Crave alcohol and spend a lot of time acquiring and using it
  • Experience anxiety or depression and physical symptoms when alcohol wears off 

Another important sign of chronic alcohol abuse can occur during the detoxification process. An addicted person undergoing this process may exhibit serious withdrawal symptoms, such as seizures and delirium tremens. 

Diagnosis is based on interviews and questionnaires, not on lab tests. If this occurs, addiction treatment is required. 

Treatment Options for Alcohol Misuse & Addiction 

Alcohol addiction, left untreated, can have deadly consequences, including cancer, liver damage, and heart disease. Peer reviewed studies correlate drinking alcohol early in life to substance abuse involving other drugs, including marijuana and cocaine.11 

Over 95,000 Americans die each year from excessive alcohol consumption.Heavy alcohol use is a leading cause of death across all ages, accounting for 3.8% of all deaths worldwide.5 

The National Institute on Alcohol Abuse and Alcoholism recommends a variety of approaches for addressing alcohol misuse and addiction. The FDA has approved a number of drugs to help people reduce heavy drinking and promote abstinence. These include Naltrexone, Acamprosate, Metadoxine, and Disulfiram.8, 9

Behavioral therapy and mutual support groups such as Alcoholics Anonymous can offer long-term addiction support. These can be done in-person, but phone or video sessions are also possible. All these approaches can be used together to support a person’s addiction recovery journey.

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Resources

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1) Centers for Disease Control and Prevention. “Deaths from Excessive Alcohol Use in the U.S.” https://www.cdc.gov/, 2021.

2) Driving Laws Published by NOLO. “Blood Alcohol Level Chart: Are You Too Drunk to Legally Drive?

3) http://www2.courtinfo.ca.gov/. “Stages of Intoxication.” http://www2.courtinfo.ca.gov/.

4) Huang, Zhen, and Åke Sjöholm. “Ethanol Acutely Stimulates Islet Blood Flow, Amplifies Insulin Secretion, and Induces Hypoglycemia via Nitric Oxide and Vagally Mediated Mechanisms.” Endocrinology, vol. 149, no. 1, 2008, pp. 232-236.

5) Keyes, Katherine M., et al. “Alcohol consumption predicts incidence of depressive episodes across 10 years among older adults in 19 countries.” International Review of Neurobiology, vol. 148, 2019, pp. 1-38.

6) National Health Service. “Alcohol poisoning.” https://www.nhs.uk/,.

7) National Institute on Alcohol Abuse and Alcoholism. “Alcohol Facts and Statistics.” https://www.niaaa.nih.gov/.

8) Vonghia, Luisa, et al. “Acute alcohol intoxication.” European Journal of Internal Medicine, vol. 19, 2008, pp. 561-567. https://www.ejinme.com/.

9) National Institute on Alcohol Abuse and Alcoholism. “Treatment for Alcohol Problems: Finding and Getting Help.” https://www.niaaa.nih.gov/.

10) Centers for Disease Control and Prevention. “Deaths From Excessive Alcohol Use in the United States.” https://www.cdc.gov/.

11) Kandel, Denise and Yamaguchi, Kazuo. “From Beer to Crack: Developmental Patterns of Drug Involvement.” American Journal of Public Health, vol. 83, no. 6, 1993, pp. 851-855.

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