Alcohol Overdose: Causes, Risk, Signs and How to Prevent It

Alcohol overdose, also known as alcohol poisoning, happens when a person consumes a toxic amount of alcohol, leading to severe impairment of bodily functions. As the CDC reports, approximately 178,000 people in the United States died annually from alcohol use during the years 2020–2021.

The primary cause of alcohol overdose is consuming large amounts of alcohol in a short period. Binge drinking, where individuals drink excessively over a few hours, significantly increases the risk of overdose.

Signs of alcohol overdose include confusion, vomiting, seizures, slow or irregular breathing, and a blue-tinged or pale skin tone. In severe cases, the person becomes unconscious and unresponsive.

The effects of alcohol overdose are fatal if not treated promptly. It leads to severe dehydration, brain damage, hypothermia, irregular heartbeats, and respiratory failure.

Treatment for alcohol overdose involves administering oxygen, intravenous fluids, and medications to manage symptoms. In severe cases, the patient might require intubation and mechanical ventilation.

Preventive measures for alcohol overdose include drinking in moderation, avoiding binge drinking, and knowing your limits. It’s essential to stay hydrated, eat before and while drinking, and never mix alcohol with other substances.

What is an Alcohol Overdose?

Alcohol overdose, also known as alcohol poisoning, happens when an individual consumes a huge amount of alcohol in a short period, leading to severe impairment of bodily functions. It is considered a medical emergency and needs immediate attention. 

As the Minnesota Department of Health put it, alcohol poisoning, or alcohol overdose, occurs when a person consumes alcohol faster than their liver can process it. Once the liver is overwhelmed, it can no longer metabolize alcohol as it should.  The symptoms of an alcohol overdose can include severe confusion, vomiting, seizures, slow and irregular breathing, hypothermia, unconsciousness, and, in extreme cases, death.

According to the CDC, there are 2,200 alcohol poisoning deaths each year in the US. These alarming numbers reflect the urgent need for increased awareness and education on the dangers of excessive alcohol consumption, as well as stronger support systems to prevent such tragedies.

What Causes an Alcohol Overdose?

An alcohol overdose, or alcohol poisoning, is caused by an excessive consumption of alcohol within a short time, which results in an increased Blood Alcohol Concentration and, subsequently, liver damage. 

The body only processes a certain amount of alcohol per hour, typically about one standard drink. The liver uses an enzyme called alcohol dehydrogenase to convert alcohol into acetaldehyde, a toxic chemical and known carcinogen. Another enzyme quickly converts acetaldehyde into acetate, which is eventually turned into water and carbon dioxide for the body to eliminate.

However, the liver can only process a limited amount of alcohol at a time. Consuming more alcohol than the liver can handle raises the individual’s Blood Alcohol Concentration, BAC, leading to a buildup of acetaldehyde. 

High BAC levels overwhelm the body’s ability to function correctly, leading to symptoms of alcohol poisoning. These symptoms include confusion, vomiting, seizures, slow or irregular breathing, hypothermia, and unconsciousness. Without prompt medical treatment, alcohol overdose causes permanent brain damage or death.

Blood Alcohol Concentration (BAC) is a measure of the amount of alcohol present in a person’s bloodstream and is expressed in percentages. According to the Cleveland Clinic, a BAC of 0.30% to 0.40% means the individual is at risk of alcohol poisoning. 

What Increases the Risk of Alcohol Poisoning?

According to the American Addiction Center, factors that increase the risk of alcohol poisoning include binge drinking, mixing alcohol with other substances, and age. Each contributes to the body’s inability to metabolize alcohol efficiently and safely.

1. Binge Drinking: drinking plenty of alcohol in a short period significantly raises blood alcohol concentration (BAC). This rapid intake overwhelms the liver’s ability to process alcohol, leading to toxic levels in the bloodstream. Binge drinking is a huge risk factor for alcohol poisoning, especially among young adults and college students.
2. Mixing Alcohol with Other Substances: taking alcohol with drugs, especially depressants like opioids, benzodiazepines, or sedatives, amplifies the effects of alcohol. This combination severely depresss respiratory and cardiovascular functions, increasing the risk of poisoning and fatal outcomes.
3. Drinking on an Empty Stomach: When alcohol is consumed without food, it is absorbed more quickly into the bloodstream. Food slows down the absorption process, giving the liver more time to metabolize alcohol. Drinking alcohol on an empty stomach leads to a faster and higher spike in BAC, heightening the risk of alcohol poisoning.
4. High-Alcohol Content Beverages: Drinks with a high concentration of alcohol, such as spirits and liquors, result in a larger amount of alcohol entering the bloodstream rapidly. This quick influx leads to dangerously high BAC levels, increasing the likelihood of poisoning.
5. Body Size and Composition: Individuals with smaller body sizes and lower body water content are more susceptible to alcohol poisoning. Women generally have less body water than men, leading to higher BAC levels even with the same amount of alcohol consumption.
6. Age: age influences the risk of alcohol overdose due to differences in metabolism and tolerance. Younger individuals, particularly adolescents and young adults, often have lower alcohol tolerance and may engage in binge drinking behaviors, increasing the risk of overdose. Older adults metabolize alcohol more slowly and have existing health conditions or take medications that interact negatively with alcohol, heightening the risk.
7. Gender: gender affects the risk of alcohol overdose because women have lower body water content and different alcohol metabolism rates than men. These physiological differences result in higher blood alcohol concentrations in women, even when consuming the same amount of alcohol as men. 
8. Tolerance Levels: People with low alcohol tolerance are at a higher risk of alcohol poisoning. Their bodies are less accustomed to processing large amounts of alcohol, making them more vulnerable to its toxic effects.
9. Pre-existing Health Conditions: Certain medical conditions, such as liver disease, diabetes, or metabolic disorders, impair the body’s ability to metabolize alcohol effectively. Individuals with these conditions face a higher risk of alcohol poisoning because their bodies cannot process alcohol as efficiently as healthy individuals.

Who is Most at Risk for Alcohol Poisoning?

Individuals most at risk for alcohol poisoning include young adults, women, and people mixing alcohol with drugs and other substances, especially those who engage in binge drinking. This group often consumes large quantities of alcohol in short periods, overwhelming their bodies’ ability to metabolize it safely.

According to the Minnesota Department of Health, one of the greatest risk factors for alcohol poisoning is binge drinking. It contributed to 429 deaths in Minnesota in 2021. Binge drinking refers to the consumption of four or more drinks for females or five or more drinks for males on an occasion.

Women, due to physiological differences, tend to have higher blood alcohol concentrations. Bodies of individuals with pre-existing health conditions such as liver disease or metabolic disorders also find it difficult to metabolize the alcohol and dispose of it properly. 

Additionally, people mixing alcohol with other substances, including prescription medications or recreational drugs, face a significantly increased risk of alcohol poisoning.

What are the Critical Signs and Symptoms of Alcohol Overdose?

The Institute of Alcohol Abuse and Alcoholism says that symptoms of alcohol overdose include mental confusion, difficulty remaining conscious, vomiting, seizures, trouble breathing, slow heart rate, clammy skin, dulled responses (such as no gag reflex, which prevents choking), and extremely low body temperature.

The critical symptoms of an alcohol overdose include:

• Confusion
• Vomiting
• Seizures
• Slow or irregular breathing
• Hypothermia (low body temperature)
• Blue-tinged or pale skin
• Unconsciousness
• Unresponsiveness

What Should I Do if I See Someone Who May Have Alcohol Poisoning?

If you see someone who may have alcohol poisoning, call emergency services, keep the person awake, monitor breathing, and do not leave them alone. The following are steps to take when someone has alcohol poisoning:

• Call Emergency Services: Immediately dial 911 or your local emergency number. Describe the symptoms and provide any relevant information about the person’s condition and the amount of alcohol consumed.
• Keep the Person Awake and Sitting Up: If the person is conscious, try to keep them awake and in a sitting position to prevent choking on vomit. Engage them in conversation to maintain their alertness.
• Turn Them on Their Side: If the person is unconscious or semi-conscious, place them in the recovery position (on their side) with their head turned to one side. The side position helps keep the airway clear and reduces the risk of choking on vomit.

• Monitor Breathing and Heart Rate: Regularly check their breathing and pulse. If breathing becomes slow, irregular, or stops, perform CPR if you are trained, and continue monitoring until emergency personnel arrive.
• Do Not Leave Them Alone: Stay with the person until help arrives. Constantly monitor their condition and be prepared to provide additional information to emergency responders.
• Do Not Give Them Food, Drink, or Medication: Avoid giving the person food, water, coffee, or any other substance, as these can worsen their condition. Do not attempt to induce vomiting.
• Provide Relevant Information: When emergency personnel arrive, inform them about the person’s symptoms, the amount of alcohol consumed, any other substances taken, and any known medical conditions.

The World Health Organization states that around the world, 3 million deaths every year result from the harmful use of alcohol, which represents 5.3% of all deaths. Prompt action and continuous monitoring significantly increase the chances of survival and recovery for someone experiencing alcohol poisoning.

How is an Alcohol Overdose Treated?

The American Addiction Center states that treatment for alcohol poisoning may involve observation, monitoring, glucose administration, administering medications, fluid hydration via IV, and frequent assessment of breathing. 

Intravenous (IV) fluids are administered to help rehydrate the body, maintain blood pressure, and support the liver in processing and eliminating alcohol from the bloodstream. Oxygen therapy is often provided if the patient is experiencing respiratory distress. In severe cases, if the patient has stopped breathing or has a depressed respiratory rate, mechanical ventilation is necessary to assist with breathing.

Activated charcoal is sometimes administered to bind any remaining alcohol in the stomach, preventing further absorption into the bloodstream. Continuous monitoring is essential to track the patient’s progress and address any complications that arise, such as hypothermia or irregular heartbeats.

In cases where the overdose is accompanied by a coma or unresponsiveness, gastric lavage (stomach pumping) is performed to remove alcohol from the stomach. The overall goal of treatment is to stabilize the patient’s condition, prevent complications, and support the body in eliminating the toxic levels of alcohol.

What is the Long-Term Outlook for an Alcohol Overdose?

The long-term outlook for an individual who has experienced an alcohol overdose depends on several factors, including the severity of the overdose, the speed and effectiveness of medical treatment received, and the person’s overall health and drinking habits.

According to an article reviewed by Timothy J. Legg, PhD, and written by Darla Burke for Healthline on “Alcohol Overdose,” prompt treatment of an alcohol overdose can prevent life-threatening health problems. 

However, repeated episodes of alcohol overdose can lead to more severe health issues, including persistent brain damage, neurological impairments, and liver disease. 

Chronic misuse of alcohol that leads to repeated overdoses significantly increases the risk of developing lasting conditions such as alcoholic hepatitis, fibrosis, or cirrhosis of the liver, which can be life-threatening.

Can an Alcohol Overdose Lead to Death?

According to the NIAAA, alcohol overdose can lead to death. Severe alcohol poisoning causes respiratory failure, choking, heart arrhythmias, and coma, all of which are fatal without immediate medical intervention.

How Can You Prevent an Alcohol Overdose?

To prevent an alcohol overdose, drink in moderation, avoid binge drinking, and know your limits. Additionally, never mix alcohol with other drugs, and ensure you eat before and while drinking to slow alcohol absorption.

Can Alcohol Overdose Occur from Drinking Beer Only?

Yes, alcohol overdose can occur from drinking beer if consumed in large quantities over a short period. Any alcoholic beverage can lead to overdose if enough is consumed quickly.

Does Eating While Drinking Prevent Alcohol Overdose?

Yes, eating while drinking slows the absorption of alcohol and reduces the risk of overdose, but it does not eliminate the risk. The California Department of Alcoholic Beverage Control explains that food slows the rate of alcohol intoxication by causing the pyloric valve at the stomach’s bottom to close during digestion. This action prevents alcohol from entering the small intestine, where most of it is absorbed.

Can Alcohol Overdose Happen the First Time You Drink?

Yes, alcohol overdose can happen the first time someone drinks, especially if they consume a large amount quickly. Lack of tolerance and experience with alcohol increases the risk.

Is It Safe to Let Someone Sleep Off Alcohol Poisoning?

No, it is not safe to let someone “sleep off” alcohol poisoning, as the National Institute on Alcohol Abuse and Alcoholism explains. If someone shows signs of alcohol overdose, they need immediate medical attention to prevent potentially fatal complications.

What Should You Do if You See Someone Who May Have Alcohol Poisoning?

If you see someone who may have alcohol poisoning, it is crucial to call emergency services immediately and keep the person awake and sitting up. Describing the symptoms to emergency responders can ensure timely and appropriate medical intervention. For more detailed information on managing alcohol overdose, you can explore topics related to binge drinking.

Turn the person on their side if they are unconscious to prevent choking and monitor their breathing and heart rate. Do not leave them alone until help arrives. Providing relevant information to emergency personnel about the person’s condition and alcohol consumption can be lifesaving. Seeking further support through programs like drug & alcohol rehab for veterans can help address underlying alcohol use issues.