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Alcohol Overdose: Signs and Symptoms, Treatment, and Prevention

People drink alcohol for many reasons: to celebrate an anniversary or birthday, to relax on vacation, or to unwind after a long week. But when someone continues to drink too much or too quickly despite being significantly intoxicated, it can result in an alcohol overdose.1

Alcohol overdose or toxicity can be fatal. Knowing the signs of an alcohol overdose is important to keep yourself and others safe. Learn the signs of an alcohol overdose and how to help someone struggling with alcohol misuse below.

Binge Drinking and Alcohol Overdose in the U.S.

Alcohol is one of the most used substances in the United States. Roughly 50% (138.5 million) of people aged 12 and older in the U.S. reported drinking alcohol in the past month according to the 2020 National Survey on Drug Use and Health (NSDUH).2

The same survey reported more than 44% of people aged 12 or older were past-month binge drinkers, which is defined as drinking 4 or more drinks at a time for women, or 5 or more drinks at a time for men.2 Of that group, almost 29% were past-month heavy drinkers, which is defined as binge drinking on 5 or more days out of the past month.2

Alcohol use is widely socially accepted and legal for people 21 and older, which is one reason a person may perceive drinking as harmless. The 2020 NSDUH found that only 69% of people perceived “great risk” from having 4 or 5 alcoholic drinks nearly every day.2

Unfortunately, binge drinking increases the risk of alcohol poisoning or overdose—a situation that can be extremely dangerous and potentially fatal.3 Between 2010-2012, an average of 6 people died every day from alcohol poisoning in the U.S.3

While anyone can be affected by an alcohol overdose, emergency departments treat adolescents and young adults for alcohol toxicity more than any other group. This group is also more likely to sustain traumatic injuries while drinking.4

What Is an Alcohol Overdose?

An alcohol overdose occurs when a person has such significant levels of alcohol in their bloodstream that areas of their brain responsible for controlling certain life-preserving functions start to shut down.1 This can negatively impact several physiological processes such as breathing, heart rate, and temperature control, which are essential to sustaining life.1

Binge drinking is dangerous because ingestion of large quantities of alcohol may lead to a sharp rise in blood alcohol at a rate that outstrips that which the body is able to break down alcohol and clear it from the bloodstream.1 This can lead to progressively worsening intoxication-related impairment and, ultimately, an alcohol overdose.1 The Centers for Disease Control and Prevention estimates that 1 in 6 adults in the U.S. engages in binge drinking, with 25% binge drinking at least once a week.5

Alcohol Overdose Signs & Symptoms

As a person’s blood alcohol content (BAC) increases, so does their risk of harm.1 A person’s BAC can continue to rise even after they have stopped drinking due to continued absorption of alcohol from their digestive tract.1

A person may exhibit different signs and symptoms of alcohol use as their BAC increases.6 A person with a BAC of 0.02 to 0.10, for example, may experience changes in behavior and mood and decreased coordination, whereas a person with a BAC of 0.20 to 0.30 may experience markedly diminished alertness in addition to nausea and vomiting, which could present the risk for aspiration or choking.6

Although variable depending on a person’s tolerance, coma is possible in people with a BAC between 0.40 and 0.60. A BAC between 0.60 and 0.80 is likely to be fatal.6

Knowing the signs of an alcohol overdose is important to keep yourself and others safe. Someone with a dangerous elevated and potentially lethal BAC may display any of the following signs and symptoms:1, 6

  • Confusion.
  • Excessive sleepiness.
  • Unconsciousness.
  • Vomiting.
  • Dulled responses (e.g., no gag reflex).
  • Urinary and bowel incontinence.
  • Significant decreases in blood pressure, pulse, temperature, and breath rate.
  • Blue or pale skin tone.
  • Clammy skin.
  • Seizures.
  • Coma.
  • Death.

Death and permanent brain damage from alcohol are possible.1 If you suspect a person is experiencing an alcohol overdose, call 911 immediately, even if they are not exhibiting all the signs and symptoms above.

How Much Alcohol Does It Take to Overdose?

Several factors influence how much alcohol it takes for an overdose to occur. These can include a person’s age, gender, how much they drink and how fast, medications they are taking, other recreational drugs they have been using, and how much food they have eaten.1

Another factor is a person’s tolerance to alcohol. Tolerance develops as the body adapts to repeated alcohol use over time, and a person may need to drink more to feel the desired intoxicating effects of alcohol.7

The rate at which the human body can process alcohol typically amounts to roughly 10 mg/dL to 30 mg/dL per hour.6 People who engage in regular binge drinking or heavy drinking tend to have a higher alcohol metabolism, but at some point, even these individuals, should they continue drinking, will have more alcohol in their system than their body can eliminate, resulting in dangerous levels of intoxication.8

Alcohol Overdose Treatment

If someone experiences an alcohol overdose, they may need lifesaving treatment immediately. Home remedies like cold showers, drinking hot coffee, or walking do not reverse the effects of an alcohol overdose and could just make the situation worse.1

In medical settings, the main goal of managing severe alcohol intoxication or overdose is to protect a person’s airway from aspiration and to minimize the risk of harm to a patient experiencing severe respiratory depression.9 Throughout the period of airway management, patients will be closely monitored, and in some cases may be administered intravenous fluids or glucose as additional supportive measures.4, 9

As patients with alcohol use disorder may present with thiamine deficiency, and alcohol itself may be associated with acute hypoglycemia, both intravenous thiamine and glucose may be administered in people with altered levels of consciousness.9

Treatment may differ for patients who have also ingested another substance, such as benzodiazepines or opioids.9

Once a patient is stabilized, medical staff may suggest ongoing alcohol addiction treatment such as inpatient or outpatient rehab to help them address a potential alcohol use disorder or substance use disorder.9

Preventing Alcohol Poisoning

Remember: anyone who drinks too much alcohol too quickly can be at risk of an alcohol overdose.1 The best way to prevent alcohol poisoning is to drink slowly, in smaller amounts, or not at all. Other points to consider:1, 3, 8

  • Drinking while pregnant, while having other significant health issues, or taking medications that may be impacted by alcohol use can be harmful and dangerous.
  • Caffeine can mask the effects of alcohol, potentially resulting in more drinking than people intended.
  • Drinking alcohol in combination with other drugs, like sleep aids, opioid pain medications, or anti-anxiety medications can increase your risk of overdose.
  • Drinking on an empty stomach may increase the risk of a rapid rise in BAC. When meals are eaten, the presence of fats and carbohydrates slow the emptying of your stomach contents and, consequently, the rate of alcohol absorption.

Getting Help

If you or someone you care about is struggling with binge drinking or alcohol misuse, help may be available at a rehab center near you or out of state. You can learn more about your treatment options by contacting your primary care physician (PHP) or a mental health practitioner. Because mental health and alcohol use disorders can sometimes go hand in hand, a treatment program that addresses both disorders may be recommended.

You can also contact American Addiction Centers (AAC) when you call . AAC has treatment facilities across the U.S. and is a leading provider of evidence-based addiction treatment. Our admissions navigators can answer questions you may have about treatment options, verify your insurance, and help you with the admissions process once you’re ready.

Alcohol Overdose FAQs

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