Alcohol Overdose: Signs, Risk Factors, and Treatment

Alcohol overdose, or alcohol poisoning, occurs when you drink too much alcohol for your body to handle, leading to life-threatening effects. There are approximately 2,200 alcohol overdose deaths in the United States every year, with the majority of deaths occurring in men between 35 and 64 years of age.¹ It’s important to know the key signs of an alcohol overdose, as well as how to treat it and transition into alcohol addiction treatment.

Key Signs of an Alcohol Overdose

Alcohol travels through the bloodstream to the brain and central nervous system, and within minutes you begin feeling the effects. All functioning, including speech, motor skills, and judgment, are altered. It takes the body between one and two hours to metabolize one standard drink, depending on factors like weight and gender. If you consume multiple drinks in a short time, such as when binge drinking, it overwhelms the central nervous system, shutting down the functioning of major organs, including the respiratory system and heart. Alcohol poisoning or overdose can occur when you drink a toxic amount of alcohol, leading to potentially fatal consequences.²

The key signs of an alcohol overdose include:³

• Seeming confused and disoriented
• Vomiting or dry heaving
• Seizing or convulsing
• Breathing is slow or stops
• Showing impaired motor skills and reactions
• Slowing or stopped heartbeat
• Going in and out of consciousness or losing consciousness completely
• Dropping body temperature that makes the skin clammy and cold to the touch
• Lacking gag reflexes, making it easier to choke on their vomit
• Showing signs of psychosis, including hallucinations, paranoia, or delusions

Call for 911 as soon as any of these signs appear. Taking cold showers, drinking coffee or water, and eating greasy foods will not help you sober up faster. There is no way to speed up alcohol metabolism.⁴

Risk Factors for Alcohol Overdose

Risk factors, such as mixing alcohol with medications and binge drinking, and being dependent on alcohol, can increase the likelihood that someone may experience an alcohol overdose.

Mixing Alcohol with Medications

Prescription and over-the-counter (OTC) medications consist of ingredients that can negatively interact with alcohol. You may experience alcohol toxicity, poisoning, or an overdose. This is especially true if you drink alcohol with a sedative medication, which can lead to significant respiratory depression.

Doctors may prescribe depressant medications for the following:⁵

• Allergies, colds, and cough
• Depression
• Anxiety
• Mood stabilizers
• Muscle relaxants
• Nausea
• Sleep disturbances
• Pain

Opioids are especially dangerous when mixed with alcohol, increasing the risk for emergency room department visits, injuries, and overdoses.⁶

Binge Drinking

Binge drinking refers to raising your blood alcohol concentration to .08 or higher in a short time. Binge drinking usually means drinking four or more standard drinks in two hours or less for women. For men, it means drinking five or more drinks in two hours. It only takes two to three drinks in a couple of hours for adolescents.⁷ The more you drink in one sitting, the higher your risk of overdosing on alcohol.

Further, research shows that millions of people, including adolescents and adults, misuse opioids in the U.S. It also shows that over half of that group binge drinks, putting themselves at an even higher risk of opioid and alcohol overdose.⁸

Extreme Binge Drinking

Many people go beyond binge drinking standards. A recent study claims 32 million people misusing alcohol consumed much higher levels than what is considered binge drinking. The name given to this problem is high-intensity drinking or extreme binge drinking, which includes three levels:⁹

• Level 1 for men means consuming five to nine alcoholic drinks, and for women, four to seven drinks on one occasion.
• Level 2 for men equals 10-14 drinks, whereas for women, it is 8-11 drinks.
• Level 3 for men means consuming 15 or more alcoholic beverages, while 12 or more drinks constitutes this level for women.

This group of extreme binge drinkers is more likely than non-binge drinkers to experience negative consequences of alcohol misuse. Each level of drinker is more likely to have an alcohol-related emergency room visit. Level one is 13 times, level two is 70 times, and level three is 93 times more likely to have an emergency room visit due to their drinking.⁹

Alcohol Dependence

According to research, alcohol dependence contributes to about 30% of alcohol overdose deaths.¹ Alcohol dependence is the body’s adaptation to the chronic presence of alcohol, which means that you need to continue drinking to function “normally” and prevent unpleasant and potentially dangerous alcohol withdrawal symptoms from emerging. Dependence and tolerance, although separate manifestations of drinking, are interconnected and affect one another—tolerance tends to increase as dependence develops, meaning that the person needs to drink in order to stave off withdrawal and needs higher amounts of alcohol to feel the effects. This can lead to drinking a larger number of drinks, which increases the likelihood of alcohol poisoning.

Treatment for an Alcohol Overdose

Alcohol overdose is a medical emergency. If you suspect you or someone else has overdosed on alcohol, call 911 immediately. Stay with the person until first responders arrive.

While waiting on emergency medical staff to arrive and transport someone to the hospital, you can take steps to ensure a person remains safe. For example, you should turn someone on their side so that they won’t choke if they vomit.¹⁰

Once at the emergency room, alcohol overdose is handled using many different techniques, including:¹⁰

• Stomach pumping to rid the body of toxins
• Breathing machines or tubes to get oxygen into the body
• Laboratory blood testing
• Heart monitoring
• Scans and x-rays to check for other problems
• IV therapies to treat dehydration
• Medicines to treat symptoms like nausea, vomiting, and headaches

Medical staff provides constant monitoring and medical care until you fully recover. As you stabilize from the alcohol overdose, you may experience withdrawal symptoms as alcohol leaves the body.

Could You Have Alcohol Use Disorder?

An alcohol overdose may be an indicator that someone is struggling with alcohol use disorder, or an alcohol addiction. Two criteria for alcohol use disorder include consuming more alcohol than intended and not stopping alcohol consumption despite adverse consequences. There are many more criteria, but you don’t have to meet them all to have alcohol use disorder. Be honest with yourself in thinking about your relationship with alcohol. Ask yourself questions like the following:¹¹

• Do I spend much of my time on alcohol-related activities? This may include borrowing money or rides to get alcohol, consuming alcohol, and recovering from a hangover.
• Do I keep misusing alcohol even though I know my physical or psychological health is worsening?
• Do I think about consuming alcohol a lot?
• Do I put myself in dangerous situations when I’m drinking? For example, drinking while driving.
• Do I give up activities I once enjoyed to consume alcohol?
• Do I continue to consume alcohol even though it causes problems in my personal, professional, or social relationships?

Answering yes to any of these questions is an excellent reason to consider seeking help. Call our helpline at 866-968-5444Who Answers? to jumpstart your recovery journey and find a rehab that’s right for you.

Transitioning to an Alcohol Rehab

While in the hospital receiving care for the overdose, you will likely be evaluated and given the option to enter alcohol rehab. Most hospitals have a treatment team consisting of substance use professionals who assess and refer you to the correct type of treatment program. The two main treatment settings are inpatient and outpatient, though there are several levels to outpatient, including partial hospitalization programs and intensive outpatient programs.

For many, alcohol rehab is the right choice. Benefits of alcohol addiction treatment include:¹²

• Individualized treatment plans based on your unique needs
• Alcohol detox services to help manage withdrawal and cravings
• Access to individual, group, and family therapy to teach relapse prevention, coping, and sober social skills as well as heal family wounds caused by alcohol use
• Access to peer support and meetings
• Mental health treatment for co-occurring disorders, such as depression, anxiety, eating disorders, and bipolar disorder
• Access to case managers and social services to assist in transitioning back home after treatment
• Aftercare planning

Contrary to popular belief, you don’t have to wait until you hit “rock bottom” to start making positive changes by entering alcohol rehab. You can do things now to prevent consequences, such as an alcohol overdose or injury related to alcohol misuse. Call our confidential helpline at 866-968-5444Who Answers? to speak to a knowledgeable treatment support specialist about rehab options near you.

Resources

1. Centers for Disease Control and Prevention. (2015). Alcohol Poisoning Deaths.
2. The Pennsylvania Department of Drug and Alcohol Programs. (2022). Overdose Overview.
3. National Institute of Alcohol Abuse and Alcoholism. (2021). Understanding the Dangers of Alcohol Overdose.
4. National Institute of Alcohol Abuse and Alcoholism. College Drinking: Changing the Culture: Alcohol Myths.
5. National Institute of Alcohol Abuse and Alcoholism. (2014). Harmful Interactions: Alcohol and Medicines.
6. Saunders, K. W., Von Korff, M., Campbell, C. I., Banta-Green, C. J., Sullivan, M. D., Merrill, J. O., & Weisner, C. (2012). Concurrent Use of Alcohol and Sedatives Among Persons Prescribed Chronic Opioid Therapy: Prevalence and Risk Factors. The Journal of Pain, 13(3), 266–275.
7. Esser, M. B., Guy, G. P., Jr, Zhang, K., & Brewer, R. D. (2019). Binge Drinking and Prescription Opioid Misuse in the U.S., 2012-2014. American Journal of Preventive Medicine, 57(2), 197-208.
8. Center for Disease Control and Prevention. (2019). More than half of People who Misuse Prescription Opioids Also Binge Drink: Millions of Americans at Increased Risk of Overdose and Death.
9. National Institute of Alcohol Abuse and Alcoholism. (2017). Study Finds Tens of Millions of Americans Drink Alcohol at Dangerously High Levels.
10. U.S. National Library of Medicine. (2021). Ethanol Poisoning.
11. National Institute of Alcohol Abuse and Alcoholism. (2020). Understanding Alcohol Use Disorder.
12. National Institute of Alcohol Abuse and Alcoholism. (2014). Treatment for Alcohol Problems: Finding and Getting Help.