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Alcohol Poisoning Symptoms: How To Recognize the Signs

Written by Theresa Valenzky

& Medically Reviewed by Benjamin Caleb Williams, RN

Medically Reviewed

Up to Date

This article was reviewed by a medical professional to guarantee the delivery of accurate and up-to- date information. View our research policy.

Last Updated - 6/17/2022

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When someone drinks excessive amounts of alcohol, they may experience alcohol poisoning, which can cause permanent injury and even be fatal. Six people die every day in the U.S. because of alcohol poisoning. People who binge drink should be aware of the signs of alcohol poisoning (such as choking, passing out and difficulty breathing) so they know when to seek help for themselves or those around them.

The liver processes alcohol. When people drink ethanol (alcohol) faster than their liver can metabolize it, it builds up in the bloodstream. As it reaches dangerous levels, alcohol quickly starts to affect multiple organs in the body, including the brain, leading to typical signs of drunkenness. When people continue drinking excessive amounts of alcohol, ethanol will start to damage the brain seriously, and organs may begin to shut down, leading to alcohol poisoning signs.

Early Symptoms of Alcohol Poisoning

Anyone who binge drinks, or spends time around others who drink heavily, should be aware of alcohol poisoning warning signs. Initial symptoms will occur once the alcohol starts causing damage to organs like the brain and heart. Earlier signs of alcohol poisoning include:

  • Feeling confused or disoriented
  • Vomiting
  • Difficulty breathing
  • Irregular or fast heartbeat
  • Severe dehydration
  • Clammy skin
  • Choking
  • Passing out

If someone exhibits these signs, especially signs relating to breathing or unconsciousness, others near that person should get help as soon as possible. It can take some time for alcohol to enter the bloodstream after a person takes a drink, so if someone starts experiencing these side effects while drinking or shortly after, there is a good chance that their blood alcohol levels will continue to rise and their symptoms will become more severe. This can quickly lead to death if not addressed correctly.

Late Signs of Alcohol Poisoning

Signs of alcohol poisoning may become visible once a person’s blood alcohol concentration (BAC) ranges from 0.16–0.30%. At levels higher than this, the person’s risk of death is greatly increased. If early alcohol poisoning symptoms are left untreated, a person who is overdosing on alcohol may experience:

  • Dangerously low body temperature, which may include blue-tinged lips or skin
  • Respiratory failure
  • Heart attack
  • Seizures
  • Permanent brain damage

These signs all indicate that someone is at risk of death from alcohol poisoning. People should seek emergency medical care by calling 9-1-1 if these symptoms are observed. People can also get more information about alcohol poisoning by calling:

  • National Poison Control Center (800-222-1222)
  • The Substance Abuse and Mental Health Services Administration (800-662-4357).

Some of these symptoms are hard to observe because the person may have passed out. If the person is completely unresponsive and won’t wake up after falling unconscious, this is a sign they are likely experiencing alcohol poisoning. You can also monitor a person’s breathing. If the person has 10 seconds or more between breaths or breathes less than eight times per minute, they are likely in respiratory arrest.

Summary of Alcohol Poisoning Symptoms

Alcohol poisoning can be fatal, and anyone who exhibits signs of alcohol poisoning should seek immediate medical attention. The most serious signs of alcohol poisoning are any symptoms affecting breathing. This can include labored breathing, slower breathing or choking. The other most serious sign to be aware of is decreased levels of consciousness. Someone unconscious can easily choke or be in danger in other ways.

Cognitive and Behavioral Symptoms

Cognitive and behavioral symptoms of alcohol poisoning occur because alcohol slows signals in the brain. These symptoms can include:

  • Confusion
  • Memory loss or blackouts
  • Difficulty staying conscious
  • Impaired judgment
  • Decreased awareness of danger
  • Loss of coordination
  • Slurred speech
  • Aggressiveness or belligerence

Some of these symptoms may be related to intoxication instead of true alcohol poisoning. However, if this is the case, they will worsen as alcohol poisoning develops.

Physical Symptoms

Physical symptoms of alcohol poisoning are typically the most noticeable way to determine that someone is overdosing on alcohol. While some physical symptoms of alcohol poisoning can also occur solely with intoxication, they should alert you that alcohol poisoning may be occurring. These symptoms include:

  • Vomiting
  • Slow or irregular breathing
  • Pale or bluish skin
  • Hypothermia
  • Seizures
  • Loss of consciousness

Long-Term Effects and Complications

Most of the long-term effects and complications of alcohol poisoning are due to complications that occur during the episode of overdosing on alcohol. Prolonged periods without oxygen due to slow breathing or respiratory arrest can result in permanent brain damage. Injuries can also occur while overdosing on alcohol, which can have irreversible implications.

What Causes Alcohol Poisoning?

Alcohol poisoning occurs when you drink so much alcohol that it affects signals in your brain responsible for keeping you alive. This can result in impaired breathing and abnormal heart activity that can ultimately be fatal. For alcohol poisoning to occur, you must drink a large amount of alcohol in a short period.

Binge Drinking

Binge drinking is almost always involved when alcohol poisoning occurs, making it much more likely to happen. Binge drinking occurs when men have had five drinks or women have had four drinks within two hours. This pattern of drinking is especially common in teens and young adults.

In 2017, 13.5% of high schoolers reported binge drinking within the past month. However, while young people are more likely to binge drink, over three-quarters of those who die from alcohol poisoning are adults aged 35–64. Drinking more slowly or having fewer drinks in one sitting lowers the chance that someone will have alcohol poisoning.

Rapid Consumption

When you drink alcohol, your body begins processing it as soon as it enters your bloodstream. A healthy person takes about an hour and a half to process the alcohol in a single drink. When you drink a large amount in a short period, your body cannot eliminate alcohol from your bloodstream any faster. This means alcohol will quickly build up as the body slowly metabolizes it. Rapid drinking will lead to high levels of alcohol, increasing the risk of alcohol poisoning.

Underlying Health Conditions

Rapid drinking can cause alcohol poisoning, and underlying health factors can also play a significant role. Health conditions that affect your liver or require medications that can affect your liver can slow how quickly your body processes alcohol. This means that even if you drink alcohol more slowly, alcohol can build up in your bloodstream, increasing the risk of alcohol poisoning.

Risk Factors for Alcohol Poisoning

Several factors can increase your risk of developing alcohol poisoning. Most are due to the effect they have on how your body reacts to alcohol or how it processes it.

Age

As we age, our bodies process alcohol differently. Slowing metabolisms slow how rapidly your body can process alcohol. This means that you may be more likely to experience alcohol poisoning from a smaller amount of alcohol or from drinking alcohol over a longer period. While being older increases your risk of alcohol poisoning in one way, it also decreases your risk in another. This is because older people are less likely to engage in binge drinking behaviors that cause alcohol poisoning than their younger counterparts.

Gender

Females process alcohol more slowly than males, making them more at risk for alcohol poisoning from a smaller amount. While females are more at risk for overdosing on a smaller amount of alcohol, males are more likely to engage in the behaviors that cause alcohol poisoning. Over 3 in 4 people who die from alcohol poisoning are males.  

Tolerance Level

When someone uses alcohol regularly, their body gradually adapts to it. Over time, this enables them to tolerate higher doses as the brain becomes less responsive to the effects of alcohol. This makes alcohol poisoning less likely; however, it increases the risk of alcohol poisoning when someone resumes drinking after a period of abstinence. During abstinence, the brain readjusts, and tolerance disappears. Someone who resumes drinking like they did when they had tolerance may be at a higher risk of overdosing on alcohol.

Mixing Alcohol With Other Substances

Mixing alcohol with other drugs, whether for recreational or medical purposes, can increase the risk of alcohol poisoning. If alcohol and another drug that suppresses brain activity are combined, they can augment each other, increasing the risk of overdose. Additionally, using medications or drugs can slow how quickly the liver removes alcohol, causing alcohol levels to remain higher for longer.

How Much Alcohol Is Too Much?

One drink is defined as 12 ounces of beer, five ounces of wine or 1.5 ounces of spirits such as rum, whiskey or vodka. However, it’s important to remember that some types of drinks within each category have higher levels of alcohol.

For example, craft beer often contains more ethanol than light beer, and a higher-proof liquor has more alcohol than a lower-proof one. With each drink a person has, the amount of alcohol in their system will rise. It will also rise faster if they haven’t eaten in a while or are mixing alcohol with other substances.

A person’s age, weight, sex and genetics will also affect how quickly their liver metabolizes alcohol. Even when two people have had the same amount to drink, one person may be more likely than the other to get drunk faster and start displaying signs and symptoms of alcohol poisoning.

Prevention of Alcohol Poisoning

The only way to completely avoid the risk of alcohol poisoning is not to use alcohol at all. However, the risk of alcohol poisoning is very remote if you use alcohol responsibly. You can use several strategies to help moderate your alcohol intake and avoid the dangers of alcohol poisoning.

Knowing Your Limits

A big part of alcohol poisoning is knowing and abiding by your limits. This requires self-control, as it can be very easy to make exceptions when you’re having fun and already feeling buzzed. Knowing your limits and abiding by them when it matters can help to reduce your risk of alcohol poisoning. One good strategy is to tell a friend your limits beforehand and have them keep you accountable while drinking.

Pacing Your Drinking

Your body metabolizes alcohol at a fixed rate. If you pace your drinking, allowing time between each drink, you will reduce your overall risk of alcohol poisoning. Slowly drinking a certain amount will have a lower risk of causing alcohol poisoning than the same amount used all at once. You can pace your drinking by setting an alarm or timer on your phone that helps you to keep track of how much alcohol you’ve used and how much time you’re keeping between drinks.

Eating With Alcohol Consumption

Drinking on an empty stomach makes it so your body absorbs only alcohol. If you have eaten, your body will absorb alcohol more slowly, decreasing your overall risk of developing alcohol poisoning. Eating a full meal before a night of drinking and avoiding drinking if you’ve vomited can help reduce the risk of alcohol poisoning.

Avoiding Mixing Alcohol and Other Substances

You should avoid drinking if you use other substances. This could be a recreational drug but could also be a medication. Mixing substances and alcohol increases your risk of alcohol poisoning. Before drinking, you should check with your doctor if you’re using any medication, even if it’s over the counter. You should also ensure ample time between using another substance and drinking, typically at least 24 hours.

Treatment for Alcohol Poisoning

If someone is showing signs of an alcohol overdose, call 9-1-1 right away. Alcohol poisoning is potentially fatal, but emergency medical services can provide people with life-saving support. “Sleeping it off” is not a cure for alcohol poisoning because people’s BAC levels may continue to rise even after they pass out. Serious symptoms like a heart attack or seizures can still occur.

People with alcohol poisoning should not be left alone. Someone should stay with them and try to keep them awake if possible. A big potential danger for people who have alcohol poisoning is choking on their vomit. They should stay sitting up if they are awake or be rolled over onto their side if they are passed out. Wait until medical help arrives.

Emergency responders usually give people fluids to help quickly rehydrate them while monitoring and treating alcohol poisoning symptoms. Someone having respiratory difficulties may be put on breathing support. Their heart will also probably be continuously monitored to address any cardiac symptoms immediately.

Alcohol poisoning is a sign that someone is misusing alcohol. If you or someone you care about is having trouble managing their alcohol use, professional help may be needed to prevent future harm from alcohol overdoses. Alcohol treatment centers can help you learn how to take control of your drinking. Contact The Recovery Village Ridgefield today to learn about options for alcohol detox, treatment and recovery.

Sources

U.S. Centers for Disease Control and Prevention. “Alcohol Poisoning Deaths.” January 6, 2015. Accessed June 16, 2023.

National Institute on Alcohol Abuse and Alcoholism. “Alcohol’s Effects on Health.” January 2023. Accessed June 16, 2023.

Pennsylvania Department of Drug and Alcohol Programs. “Alcohol poisoning or overdose.” 2023. Accessed June 16, 2023.

NHS. “Alcohol poisoning.” January 11, 2023. Accessed June 16, 2023.

View Sources

U.S. Centers for Disease Control and Prevention. “Alcohol Poisoning Deaths.” January 6, 2015. Accessed June 16, 2023.

National Institute on Alcohol Abuse and Alcoholism. “Alcohol’s Effects on Health.” January 2023. Accessed June 16, 2023.

Pennsylvania Department of Drug and Alcohol Programs. “Alcohol poisoning or overdose.” 2023. Accessed June 16, 2023.

NHS. “Alcohol poisoning.” January 11, 2023. Accessed June 16, 2023.

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