Alcohol is one of the most commonly used recreational substances in the United States, along with marijuana. However, excessive use can lead to both long-term issues and immediate dangers. Alcohol poisoning is a serious health threat among binge drinkers, and people that drink alcohol often have questions about what happens when you drink one too many. How much does it take to experience alcohol poisoning? How can you tell the difference between being very drunk and being alcohol poisoned?
Learn more about the signs and symptoms of alcohol poisoning and what you can do if you recognize those signs in yourself or someone else.
What is BAC?
To understand alcohol poisoning and how much alcohol it takes to have dangerous effects, it’s important to understand BAC, which is a common term used in both medicine and law enforcement when it comes to alcohol. BAC is shorthand for blood-alcohol concentration, which can be used as a metric to determine how much alcohol is affecting you. BAC is usually measured in decimal numbers, and higher numbers mean there is a greater amount of alcohol in your bloodstream. A BAC of 0.10 means there is one part alcohol per 1000 parts of blood in your bloodstream.
Why does alcohol in your bloodstream matter?
Any chemical substance that can have an effect on your body has to make it to your bloodstream first. Then it can be distributed to other parts of your body and make its way to your brain. When you drink alcohol, it goes to your stomach and intestines, where it’s absorbed into your bloodstream. Your liver will quickly go to work to filter out toxins like ethanol, the chemical name for drinking alcohol. However, your liver can only filter out about 0.015% per hour. One standard drink can elevate a person’s BAC from 0.02% to 0.03%. Drinking more than a single drink in an hour can cause ethanol to make it past your liver and into your brain.
What is a Standard Drink?
Since different drinks have different levels of alcohol content, there is no standard amount in ounces that works for beer, wine, and liquor. Instead, a standard drink is defined by the amount of pure alcohol it contains. A standard drink contains 0.6 fluid ounces or 14 grams of pure alcohol. But what does that mean for common alcoholic beverages, and how can you know? If you order a beer at a restaurant that’s 5% alcohol and the beer comes in a 12-ounce bottle, that means it’s 0.6% alcohol. Bottles of alcoholic beverages will display the ABV, or alcohol by volume. You may see the alcohol content displayed as “proof.” In the United States, proof is twice the alcohol content. That means an 80 proof liquor is 40% ABV.
However, if you don’t know the percentage, here’s a general look at the size of a standard drink across different kinds of beverages:
- 12 ounces of beer with 5% alcohol
- 8 to 9 ounces of malt liquor with 7% alcohol
- 5 ounces of wine with 12% alcohol
- 1.5 ounces of distilled liquor like rum, whiskey, tequila, or vodka with 40% alcohol
What are the Effects of Alcohol at Each BAC Level?
Alcohol poisoning is more likely once your BAC reaches a certain threshold, but the effects of alcohol can gradually escalate over time. Your BAC will rise with each drink in a short period of time. The faster you drink, the more your BAC will be affected. Here are the effects you might experience as your BAC rises:
- At 0.01 to 0.03, you may not feel any effects besides a slightly elevated mood.
- At 0.04 to 0.06, you can start to feel relaxed or warm. Your reasoning and memory may be slightly impaired.
- At 0.07 and 0.09, alcohol will start to impair your balance, vision, speech, and motor control. In most states, 0.08 is the legal driving limit.
- A BAC of .10 to .12 will cause significant motor control problems, impaired judgment, and slurred speech.
- At 0.13 to 0.15, your motor functions will be severely impaired, and you may have trouble walking normally. You may also experience anxiety and restlessness called dysphoria.
- From 0.16 to 0.18, your dysphoria will worsen, and you’ll start to experience nausea.
- When you reach 0.25 to 0.30, your risk of alcohol poisoning is significant. You may experience severe motor dysfunction, confusion, nausea, vomiting, and restlessness.
- At 0.35 to 0.40, you may pass out and go into a coma.
- At 0.40 and beyond, your risk of coma and death significantly increases. The most common deadly symptom is respiratory failure.
How Does Alcohol Affect Your Body?
Alcohol in the brain suppresses something called glutamate, which is an excitatory neurotransmitter. In other words, it’s a chemical messenger in your brain that increases activity. More specifically, glutamate helps to transfer information in the brain by sending signals between nerve cells. The suppression of glutamate is why alcohol can lower your ability to perceive things, make decisions, and remember things that happen around you. It also has an effect on another neurotransmitter called gamma-aminobutyric acid (GABA).
GABA is an important neurotransmitter in rest and relaxation. It opens channels to allow negative charges that slow down nervous system activity. GABA can help calm anxiety, relax muscles, and allow you to sleep. Alcohol increases the effectiveness of GABA by keeping those channels open for longer, causing more nervous system inhibition. This is why alcohol is in a larger category of chemicals called central nervous suppressants, along with sleep aids and anxiety medications. It’s also why alcohol can make you feel sleepy and sluggish.
But if alcohol is a depressant that slows down nervous system activity, why is it so popular at parties? First, alcohol has an effect on dopamine and serotonin, causing them to increase in the brain. These neurotransmitters are two of your brain’s “feel-good chemical,” which are tied to reward, motivations, and positive mood. While you drink, even though alcohol is a depressant, it may temporarily lift your mood. Alcohol’s effects as a depressant can also ease anxieties that would make you less social, which is why it’s often called a social lubricant.
Finally, alcohol has a strange effect when your BAC is rising versus when it’s falling. This is called the Mellanby effect, which basically refers to the fact that alcohol’s effects are more intense when your BAC is rising versus when it’s falling. For instance, you may have a few drinks in an hour, causing your BAC to rise to 0.03. At that moment, you feel increased comfort and bodily warmth. You have a few more drinks and get to 0.07 when you start to feel foggy-headed and dizzy and decide you’ve had enough. Your BAC starts to fall, but when you go back down to 0.03, you don’t experience the comfort and warmth again; you just feel tired and sluggish.
As your BAC rises, alcohol’s effects are more intense, even the positive effects. When it falls, it starts to feel more like depression. You may feel tired, sleepy, and your mood may drop, which isn’t ideal in a party setting. People often binge drink in an attempt to maintain positive feelings while staving off the fatigue that is likely to come when your BAC drops.
What Happens During Alcohol Poisoning?
Alcohol has multiple effects on the body when you drink it in excessive amounts. While humans have adapted to be able to consume alcohol in moderate amounts, your body treats the substance like poison. Your body isn’t able to store ethanol like it can with fats and sugars. As soon as you start drinking, your body will prioritize removing it from your system, so it doesn’t have any damaging effects.
The ability of a substance to damage your body is called its toxicity. When you drink more than your body is able to process in a short amount of time, alcohol can become toxic. As alcohol is sent through your liver to be metabolized, high amounts can damage your liver. When it gets past your liver, your bloodstream will send it throughout your body, where it can damage other organs. As your body becomes overwhelmed with the amount of alcohol you’re consuming, you’ll become nauseous and need to throw up.
The damage done to your organs can have long-term effects, especially if you binge drink frequently. However, the effects of alcohol poisoning on your brain can cause immediate life-threatening symptoms. As a depressant, alcohol slows down activity in your central nervous system. This can produce relaxing effects in moderate doses. But in high doses, alcohol can start to suppress important unconscious functions that your brain is responsible for.
Your breathing, heart rate, and blood pressure are just a few of these important functions. Alcohol poisoning can cause you to pass out or slip in and out of consciousness. It will also slow down your breathing to the point of respiratory depression or failure. This can cause brain damage, coma, and death.
What are the Symptoms of Alcohol Poisoning?
The symptoms of alcohol poisoning can change based on the amount of alcohol you’ve had and your current BAC level. It may be difficult to tell the difference between alcohol poisoning and heavy intoxication, especially since symptoms can increase gradually over a period of binge drinking. One of the first thresholds you may cross when escalating intoxication to alcohol poisoning is pushing past nausea. Nausea and vomiting are signs that your body is treating the alcohol as a harmful contaminant. Like when you eat bad food or get a virus, nausea signals that there’s something wrong, and vomiting may be a way to get rid of something that’s making you sick. Continuing to drink when you’re feeling nauseous can escalate your symptoms.
Mental symptoms can also point to some of the severe effects of alcohol. Alcohol can start to affect your ability to make judgments, decisions and form memories at relatively low BACs. However, alcohol can suppress your nervous system to the point of causing severe cognitive impairment. This can lead to severe and disturbing confusion. You may have trouble forming thoughts and words. You may forget what you were doing or where you were going. You may also get caught in mental loops where you keep coming back to a single thought or emotion.
Dysphoria is another psychological symptom of alcohol poisoning. Dysphoria is a vague sense that something is wrong or that you are unsatisfied. This may lead to physical or mental discomfort. Dysphoria can get worse as your BAC rises, and feelings of sadness or depression may linger as your BAC starts to fall.
At very high levels of intoxication, the depressing effects of the drug may cause you to pass out or fall asleep. Sleepiness is a common effect of alcoho,l but when you can’t maintain consciousness or if you pass out suddenly, it points to dangerous levels of intoxication. If someone else that’s drinking passes out and it’s difficult to wake them up, you should contact emergency services right away.
Other signs and symptoms of alcohol poisoning include:
- Severe motor dysfunction
- Loss of consciousness
- Difficulty waking up
- Slow breathing
- Irregular breathing
- Blue fingertips or lips
- Low body temperature
Alcohol Poisoning or Bad Hangover?
Alcohol poisoning can cause some dangerous and uncomfortable symptoms, but so can heavy alcohol use. How can you tell dangerous alcohol poisoning from a bad hangover?
It’s true that alcohol poisoning and hangovers are problems with the same cause. Alcohol causes you to dehydrate, which contributes to symptoms like headaches. It also irritates your gastrointestinal system to make you nauseous. It can affect your sleep. Even though it makes you tired, it can prevent you from getting restful sleep. While humans have adapted to be able to consume alcohol, your body will still react to it like it’s poison, especially in large amounts.
Hangovers and alcohol poisoning can share some common symptoms, including nausea, vomiting, sluggishness, sleepiness, restlessness, dizziness, and heart palpitations. You may also experience headaches and dehydration with both problems. The major difference between the two is that hangovers feel terrible but aren’t usually life-threatening and alcohol poisoning is. However, there are a few symptoms that are red flags for people that are navigating symptoms after a night of heavy drinking.
Again, confusion and disorientation is a sign that alcohol is affecting you in a way that’s not typical or harmless. Excessive vomiting can also be dangerous. Throwing up is a well-known consequence of binge drinking, but too much can lead to complications. If you can’t keep liquids down, you could experience extreme dehydration, which can be fatal.
Throwing up in your sleep can cause you to aspirate vomit, which can also be deadly.
Slow or irregular breathing is a sign of alcohol poisoning that’s not normal during a hangover. If breathing slows to six breaths per minute, it constitutes a medical emergency. Unconsciousness that’s difficult to come out of is another serious sign. While a hangover may make waking up uncomfortable, it’s usually possible to wake someone up while they have a hangover. Other dangerous signs that aren’t typical for hangovers are pale or blue skin, cold and clammy skin, a slow heart rate, or an irregular heartbeat. In some cases, alcohol poisoning can cause seizures.
Is Alcohol Poisoning an Overdose?
Yes, alcohol is often thought of as separate from other active substances like illicit and prescription drugs. But ethanol is a chemical that can affect your body and brain in ways that are similar to many drugs. Some prescription drugs like barbiturates and benzodiazepines can work in a way that’s similar to how ethanol affects the brain. Like other drugs, high amounts of ethanol in your body can disrupt your brain chemistry to the point of causing dangerous overdose symptoms.
In fact, alcohol poisoning can cause fatal consequences in the same way as other central nervous system depressants or opioids. Drugs that cause sedation and a slowing of activity in the central nervous system can slow down breathing. For that reason, alcohol poisoning is technically an ethanol overdose.
How Long Does Alcohol Poisoning Last?
Dangerous alcohol poisoning needs to be addressed as soon as possible, or it could become fatal. The most dangerous symptoms will happen as your BAC is rising, which can occur while you’re drinking or for some time after your last drink. Because alcohol can take time to absorb into your bloodstream through your stomach and intestines, your BAC can continue to rise over the course of several hours after you’ve stopped drinking. If your liver is healthy, it can process a little less than one standard drink every hour. After a night of binging, it could take several hours for the alcohol you drank to be processed. The chemical ethanol has a half-life between four and five hours. That means your body breaks down the chemical and reduces it to half of its concentration in your bloodstream in that time. However, you can still feel the effects of alcohol for longer than that.
What Should You Do If Someone Has Alcohol Poisoning?
When you’re in a setting in which people around you are binge drinking, the first step is to recognize the signs of alcohol poisoning. The telltale symptoms of passing out, slowed breathing, confusion, and seizures are the most obvious, but you should also look for excessive vomiting, difficulty waking up, and hyperthermia are other red flags. If you recognize the signs and symptoms of alcohol poisoning in another person, there are few things you can do:
- Call 911. Even if you see some signs, but you’re not sure, call emergency services and tell them about the situation. Calling for help and not needing it is better than not getting help in an emergency.
- Stay by the person. Don’t leave the person alone, and don’t assume someone else will take care of it. A person that’s unconscious is especially vulnerable to issues like vomiting.
- Keep them calm. If a person is conscious, keep them calm and let them know you’re there to help. After you’ve called 911, try to keep them where they are.
- Keep them awake. Try to keep the person awake with gentle means like giving them a sip of water. Don’t try to shock them awake or into sobriety. Things like a slap in the face or a splash of cold water can be jarring, sending a vulnerable person into shock.
- Sit them up. Have the person sit up to avoid aspirating vomit. If they can’t sit up, turn their body or head to one side. Don’t let them remain face up or face down.
- Cover them. Alcohol poisoning can cause hypothermia. If they feel cold or clammy, get them a blanket or sweater.
- Talk to paramedics. Paramedics will want to know home much they drank and if they took any other medications. If you don’t know, try to find someone that does.
How Can Alcohol Poisoning Be Treated?
When paramedics arrive, they’ll assess your condition. If you’re showing signs of alcohol poisoning, you’ll be taken to receive medical care. In the hospital, medical professionals will monitor your condition. You may just need to be monitored for complications until the alcohol wears off. If you’re having trouble breathing, you may be given oxygen, and a tube may be inserted into your windpipe to help you breathe without obstruction.
Since heavy alcohol use and vomiting can cause dehydration, you may be given an IV drip to help keep you hydrated as the alcohol wears off. Ensuring that you can breathe and that you stay hydrated should take care of the most dangerous complications that alcohol poisoning can cause. In cases of severe alcohol poisoning, medical professionals may need to pump your stomach. This removes alcohol from your digestive system that hasn’t yet been absorbed. It won’t stop alcohol in your bloodstream from having its effects, but it may shorten your symptoms and ideally prevent them from getting worse.