Alcohol Overdose

Editor Dan Schimmel, LCSW, CAP
Updated On

The idea that you are at risk of an alcohol overdose or have recently experienced one may have you worried about whether you need to pursue a path to sobriety. If a loved one is currently in the midst of an event, addressing the most immediate medical concerns is more important than looking up recovery programs. Alcohol abuse taken to the point of overdose can have fatal ramifications. It’s important to be able to identify the signs of a potential alcohol overdose and understand how to address them as soon as possible. Let’s take a look at what you need to know right away and what you’ll have to address down the road.

Symptoms of an Alcohol Overdose

Many of the symptoms of an alcohol overdose overlap with the feelings we get when we’re buzzed or drunk. This is at least in part because alcohol poisoning begins occurring after surprisingly few drinks. While your liver can certainly run a bit of interference to protect your body, binge drinking, in particular, may get you to the stage of alcohol overdose within a couple hours.

A rough rule of thumb is that binge drinking constitutes consumption of five or more drinks within two hours by a male or four or more drinks in the same time frame by a female. By the time you get to 12 or more drinks, alcohol poisoning should be presumed. Smaller bodies are less likely to take excessive alcohol consumption as well, and this makes any consumption of alcohol by those with smaller frames especially concerning.

For reference, a standard drink is defined by the NIH as:

  • 12 ounces of regular beer, approximately 5 percent alcohol by volume
  • 5 ounces of wine, around 12 percent alcohol
  • 1.5 ounces of hard liquor, usually with a volume of at least 40 percent alcohol

Malt liquor and light beers often have higher volumes of alcohol than you might expect. When in doubt, always assume that the higher number is applicable. Cordials, liqueurs, and aperitifs usually land somewhere between beers and hard liquors in alcoholic volume. The same applies to fortified wines, ports, and Sherrys.

Some of the biggest indicators that an alcohol overdose is in progress are:

  • Feeling disoriented
  • Losing physical coordination
  • Vomiting
  • Being conscious or seemingly conscious while not able to respond
  • Passing out
  • Experiencing blurred vision
  • Speaking with a slur
  • Having reduced reaction times

Potential fatalities often arise from the fact that breathing can slow to as little as eight breathes per minute. Oxygen flow to the brain and the cardiovascular system may end up being diminished to the point that a person goes into a coma or experiences a seizure. The risk of death with either of those two events can be amplified by the fact that there may be vomit present in a person’s mouth or esophagus.

Not too surprisingly, the drop in oxygen in the bloodstream may lead to a person developing a blue skin tone. This may also be manifested as hypothermia as the body begins to lose heat due to it not being able to work properly with the lack of oxygen. Evidence of bluing usually occurs around the lips, the ears, the hands and the feet, so these are good spots to try to identify early signs of trouble.

The heart can also be strained at these moments, and there is a risk of a heart attack occurring. If the person shows any signs of clutching at their chest, that should be a source of concern. Some people may experience drops in their blood sugar levels, even if they’re not diabetic. This can also lead to stupor or coma.

Just because you haven’t passed out or gone into a coma does not mean you’re out of the woods regarding long-term risks. Severe dehydration from alcohol abuse may lead to organ failure, and brain damage can result even in cases where a person appears to remain conscious. If there’s any doubt that you may or may not have suffered alcohol poisoning, err on the side of caution and get medical help right away.

Addressing the Need for Immediate Attention

If you see that a friend appears to be in the midst of an alcohol overdose, you want to have them do a couple of things. When there are multiple friends present who are coherent enough to make an emergency call, have one dial 9-1-1 while at least one other person takes the following steps. You should:

  • Keep the intoxicated person awake and talking, if possible
  • Help them hydrate
  • Lay them on their side with their mouth pointed downward if they’ve passed out
  • Monitor them and help them if they’re in the process of vomiting, retching, gagging or dry heaving
  • Check to see that they’re still breathing at a reasonable pace
  • Identify any indications of alcohol poisoning, especially turning blue
  • Apply jackets or blankets to keep them warm, even if it feels like the weather is warm enough

It’s common to assume that someone who has been drinking heavily just needs to sleep it off. This is absolutely not what you should do. Blood alcohol levels will keep rising for at least a half hour after their last drink, and they won’t drop off to the point of sobriety for several more hours.

Avoid other myths, too. For example, a person who’s experiencing hypothermia should not be subjected to a cold shower in the hope of snapping them out of a stupor. Do not give them any more alcohol or coffee. Definitely do not give them any prescription or street drugs, such as stimulants or cocaine in an attempt to wake them. Providing a person with food is also a bad idea as pancreatic and glucose issues may affect digestion, and food can also make eventual vomit chunkier and more likely to cause choking.

If you are alone and suspect that you may be experiencing alcohol poisoning, the first thing you should do is contact 9-1-1 as soon as possible. Anyone who has been driving after drinking should pull over immediately at the first safe location they can find. If you’ve been walking, try to find a safe spot to sit down, preferably somewhere there isn’t concrete that you might strike your head on if you pass out.

Once you’re on the line with an operator from 9-1-1, stay on the line. Do not end the call, even if you want to contact a friend or family member. Many modern smartphones support texting while keeping calls on speaker, so you can try to get in touch with someone else while you’re still talking with a 9-1-1 operator. Do not hang up on the operator until a first responder is directly in physical contact with you at the scene and has instructed you to hang up.

How Medical Professionals Treat Alcohol Overdoses

First responders will administer some basic forms of treatment in the field before transporting you to a hospital. These include providing:

  • Oxygen, usually via a mask over the face or with a tube in the nose or throat if there are complications
  • Fluids or intravenous medications
  • Anti-convulsive medications to control any seizures that might be in progress
  • Nutrients, usually intravenously and with thiamine being the most common

Before departing the scene of treatment, ask the EMTs to tell any friends or family members who are present which hospital you’ll be going to.

Once you arrive at the emergency room, a professional will check your blood pressure, temperature, oxygen levels, heart rate, and blood alcohol levels. You may need to be catheterized in order to speed up the process of draining any alcohol in your bladder from your system as soon as possible. A doctor or nurse will also check your throat and nasal passages to ensure that there isn’t any vomit present or vomit-induced swelling occurring.

You should be prepared, if possible, to provide some details of what happened to the doctor treating you. This includes supplying information like:

  • Your age
  • Your current height and weight
  • Your biological sex
  • How many drinks you had
  • A list of any drugs, legal and illegal, you may have consumed in the last couple days
  • Whether you noticed any physical injuries or sustained any falls
  • If there is a history of substance abuse in your family

None of these questions should be seen as offensive. The doctor assisting you just needs to have a full picture of what’s going on. You should especially make note of any antidepressants, anti-anxiety medications or sedatives you’ve consumed as these can have interactions with some of the medications that are employed in treating an alcohol overdose.

The Days and Weeks After

Before you are discharged from the hospital, a doctor or a substance abuse counselor will likely visit you to discuss what happened. If you’re receptive to going into a recovery program, they can make arrangements for you to speak with a professional.

Once you get home, there’s a good chance you’ll continue to experience symptoms from your drinking episode. You may notice shifts in your glycemic levels as your body tries to level out blood sugar and water content in your system. It’s a good idea to keep water close at hand as you’ll likely need to hydrate in order to mitigate a hangover. A sense of grogginess may persist for up to 48 hours as your body begins to fully detox.

By the 72-hour mark after your last drink, there should be a marked improvement in how you feel. If this doesn’t occur, it might be a sign that you suffer from chemical dependency. You should keep an eye out for potential indications of withdrawal symptoms, including:

  • Seizures
  • Delusions, including visual or auditory hallucinations
  • Ketoacidosis, a spike in ketone and blood sugar levels that can trigger weakness and fatigue
  • Hyperpyrexia, a very high fever, potentially crossing the 106-degree Fahrenheit threshold

After a week, you’ll see improvements in your skin, including declining redness and a reduction in dandruff. By a month without alcohol, you’ll probably see a visible drop in belly fat as your liver loses fat levels attained due to alcohol abuse.

The Recovery Process

Do not assume that a first incident should be dismissed. Even one bad episode of alcohol abuse is a sign of bigger issues. Similarly, a lack of chemical dependency doesn’t presuppose the absence of other issues, such as self-medicating behaviors related to depression, anxiety or social phobias.

The intake process at a recovery center will help you figure out whether a particular location is right for you. Some topics worth discussing are:

  • Whether you need inpatient or outpatient care
  • If a detox might be necessary

It’s also a good idea to discuss special needs. These can include access to facilities that treat people who are older, those who are coping with mental illnesses and those who have multiple addictions. It’s prudent to discuss any physical disabilities or limitations you might have, and you definitely want to mention any concerns about being pregnant before you enter recovery. There also may be some patients who want to find facilities that are specifically aimed at treating transgender individuals or people with non-gender conforming identities. If you’d prefer to work with a facility that caters to a particular faith, that’s worth discussing upfront too.

Recovery is possible. The risk of relapse is also real, and you should go into the process with an attitude that places an emphasis on persistence rather than immediate success. In time and with help, you can learn how to get issues related to alcohol abuse under control.

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