Alcohol: Poisoning

The image of a drunken individual may not immediately come to mind when one hears the term "drug overdose." Yet the sad reality is that 20,000 individuals die from alcohol-induced causes, and 30,000 young people require immediate medical treatment for acute alcohol poisoning each year in the United States.

How Does Alcohol Poisoning Occur?

Alcohol is a depressant of the central nervous system, which is made up of the brain and spinal cord. It produces different behaviors, emotions, and physical effects as it acts upon specific parts of the brain. First affected is the cerebrum, which controls such functions as recognition, vision, reasoning, and emotion. Low amounts of alcohol reduce inhibitions and affect judgment. For example, someone who is often quiet and reserved may become loud, outspoken, and more dramatic. Others may become depressed, withdrawn, even distressed and tearful. Later, as alcohol levels rise, vision, movement, and speech become impaired. When alcohol depresses the next brain area, the cerebellum, problems with coordination, reflexes, and balance occur.

The last portion of the brain to be affected is the medulla, which controls basic survival functions such as respiration (breathing) and heartbeat. When a person has consumed so much alcohol that the medulla is affected, his or her brain's ability to control respiration and heart rate becomes severely diminished. The heart rate can drop and breathing may stop, which will lead to a coma and then death.

How Much Alcohol is Lethal?

Most authorities agree that a lethal dose of alcohol is about 0.40 percent, or about five times the 0.08 legal limit of many states. Death from alcohol poisoning may occur at much lower levels, however, especially with inexperienced drinkers. For a 120-pound individual, it would only take about nine to ten drinks in an hour to reach the lethal level.

It is important to note that the liver can only oxidize or "clear" about one ounce (approximately one drink) of alcohol an hour. Depending on an individual's stomach contents, the amount consumed, and how quickly the individual drinks, it may be as much as thirty to ninety minutes after drinking ceases before an individual reaches his or her highest level of intoxication. Because this occurs whether the person is conscious or passed out, it is critical that someone who is semiconscious or unconscious be evaluated constantly.

Recognizing the Symptoms and Knowing How to Respond

The symptoms of alcohol poisoning include:

• vomiting
• passing out
• having difficulty waking up
• slow, shallow breathing
• cool, pale, or clammy skin

It is extremely dangerous to assume that someone showing the signs of alcohol poisoning will just sleep it off. These steps should be taken:

1. Check to see if the person can be awakened. Call his or her name or pinch the skin—he or she should have a reaction. (Remember, alcohol numbs the nerves so pinching the skin will help you gauge how far along in the overdose the person is.)
2. Turn the person onto his or her side so that the person does not choke on his or her own vomit.
3. Check skin color and temperature. If the skin is pale or bluish, or cold or clammy, call 911 immediately. The person is not getting enough oxygen.
4. Check the person's breathing. If the person is breathing less than twelve times per minute, or stops breathing for periods of ten seconds or more, call 911.

Remember that these are just some of the potential signs of acute alcohol poisoning. A person may have one or all of these signs. If the person cannot be awakened, the situation is serious. If you are at all concerned that someone has alcohol poisoning, do not hesitate to get help. You should not worry about whether it is a false alarm—remember that you are acting out of concern for your friend. Worrying about how your friend will respond tomorrow should not prevent you from getting help when needed. Make sure you and your friend have the next day to talk it over.

see also Accidents and Injuries from Alcohol; Alcohol: Chemistry; Alcohol: Complications of Problem Drinking.