Alcohol is the most popular recreational drug used in America. In spite of its popularity, alcohol is a potent toxin that can rapidly lead to an overdose (also known as alcohol poisoning) when consumed in excessive amounts. An alcohol overdose is a medical emergency that may be fatal if not promptly treated by medical professionals. Alcohol is involved with nearly 90,000 deaths in America every year, making it the third-leading cause of preventable death. Alcohol overdoses, either alone or in combination with other drugs, make up a substantial portion of these deaths. Signs Of Alcohol Overdose Alcohol use is extremely common and it is important for people to be aware of the signs and symptoms that can identify a potential overdose. Signs are objectively measurable by an observer. Key signs of an alcohol overdose include: Alcohol Overdose SignsVomiting Slow, irregular breathing (less than eight breaths per minute) Slow heart rate Clammy or blue skin Hypothermia (low body temperature) Dulled responses Unconsciousness Alcohol overdose symptoms are subjectively experienced by the person who is overdosing, and often include: Symptoms of Alcohol OverdoseNausea Confusion Memory loss Motor impairments Slurred speech Blackouts Causes Of Alcohol Overdose When you consume alcohol, it rapidly moves from the stomach into the bloodstream, where it remains until the liver can metabolize it. The liver metabolizes alcohol at a rate of approximately one drink per hour, so if you have three drinks in one hour, your liver needs an additional two hours to metabolize the alcohol you consumed. As alcohol levels build up in your bloodstream, the risk of an overdose increases rapidly. Binge Drinking Binge drinking is defined as consuming enough alcohol to bring your blood alcohol concentration (BAC) to 0.08 or higher. This typically occurs when a man has five alcoholic drinks or a woman has four drinks within a two-hour timeframe. Approximately 46% of American adults who consume alcohol have met the criteria for binge drinking at least once over the past year. As someone’s BAC increases, so does the risk of an overdose. Even moderate impairment (BAC of 0.08 to 0.15) increases the risk for potentially fatal complications of alcohol use. A BAC of over 0.15 is categorized as severe impairment, and a BAC of over 0.3 is considered life-threatening. Substance Interactions Alcohol is a central nervous system (CNS) depressant, meaning that it slows areas of the brain that are responsible for maintaining normal heart and respiration rates. When alcohol is taken with other CNS depressants, they act synergistically; that is, the combined effect of the drugs is stronger than expected based on the effect of each drug when it is taken alone. Thus, someone who can safely consume three drinks in an hour when they are not taking other drugs may put themselves at serious risk for an overdose if they mix alcohol with another CNS depressant. CNS stimulants like cocaine, methamphetamine and ADHD medications (Adderall, Ritalin) are also associated with an increased risk for alcohol overdose. When people combine these drugs they often feel like they are able to drink more without experiencing the intoxicating effects of alcohol, causing them to drink far more alcohol than they normally would. There are many drugs that interact with alcohol but the most dangerous drugs to mix with alcohol are prescription CNS depressants including opioids (OxyContin, Vicodin), benzodiazepines (Xanax, Valium) and sleeping pills (Ambien, Lunesta). Tolerance Alcohol tolerance develops as someone regularly consumes alcohol. Tolerance is defined as a state where greater amounts of alcohol are required to achieve the same effect that was experienced initially. Having a high alcohol tolerance may reduce the severity of intoxication signs and symptoms, but an alcohol overdose is a physiological response to a certain blood alcohol content and people with high tolerances may still experience an overdose. Moreover, high alcohol tolerance is associated with other negative health consequences, including liver and cardiovascular disease. Underage Drinking Underage alcohol use is a major risk factor for an overdose, and the consequences of underage drinking can be very serious. Alcohol overdoses are responsible for nearly 4,500 deaths and 119,000 emergency department visits by underage drinkers every year. Regular alcohol consumption by adolescents and young adults is associated with other serious short- and long-term consequences, including abnormal brain development and increased risk for developing substance use disorders and other psychological disorders. Alcohol Overdose Effects Effects of alcohol overdose include: Impaired motor coordination Confusion Respiratory depression (slow, irregular breathing) Slow heart rate Stupor Unconsciousness Coma Death Alcohol Overdose Statistics Alcohol-related deaths in the US have more than doubled since 1999, from 35,914 to 72,558 in 2017. It is likely that the number of alcohol overdose deaths is underreported since many alcohol-related deaths occur when people co-use alcohol with other drugs. Binge drinking is the most significant contributor to alcohol overdoses. According to the 2018 National Survey on Drug Use and Health, binge drinking was reported by 26.5% of adults, including 34.8% of people between the ages of 18-25 years. Alcohol Overdose Prevention The best way to prevent an alcohol overdose is by not drinking or by drinking only in moderation. According to the 2015-2020 Dietary Guidelines for Americans, recommended alcohol consumption for men is limited to two drinks per day, and one drink per day for women. Importantly, even people who drink in moderation are at risk for an overdose if they mix alcohol with other drugs that slow brain function (e.g. opioids, benzodiazepines). Key steps to prevent an overdose include: Steps to Prevent an Alcohol OverdoseDon’t drink on an empty stomach Drink in moderation Alternate between water and alcoholic drinks Choose low-alcohol content drinks Avoid drinking games Do not mix drugs with alcohol Although there is some evidence that healthy alcohol consumption may be possible for adults, not all research agrees that moderate alcohol use provides health benefits. A large study published in 2018 concluded that no alcohol consumption is the healthiest option. Treatment for Alcohol Overdose and Alcohol Abuse It is important to understand that alcohol overdose treatment should be done by medical professionals. If you suspect an overdose, call 911 immediately. If someone you are with experiences an alcohol overdose, there are steps you can take while you are waiting for medics to arrive: If the person is conscious, keep them sitting upright on the ground (not on a chair) If they are not conscious, make sure they are lying on their side to prevent them from choking if they vomit Cover them with a blanket to prevent hypothermia Do not try to get them to drink coffee, “walk it off” or put them in a cold shower. These could lead to choking, injuries related to falling or dangerous hypothermia. Many people struggle with alcohol use disorders without experiencing a life-threatening overdose. Alcohol abuse treatment can help you successfully quit using alcohol before a lethal overdose occurs. Alcohol use disorders can be challenging to overcome without professional help. The Recovery Village Palm Beach at Baptist Health is a high-quality rehab facility that has successfully helped numerous people achieve sobriety. Contact us today to learn more about our comprehensive rehab programs. SourcesNational Institute on Alcohol Abuse and Alcoholism. “Alcohol Facts and Statistics.” Updated December 2019. Accessed January 22, 2020. National Institute on Alcohol Abuse and Alcoholism. “Understanding the Dangers of Alcohol Overdose.” Updated November 2019. Accessed January 22, 2020. Hingson, RW.; Zha, W.; White, AM. “Drinking Beyond the Binge Threshold: Predictors, Consequences, and Changes in the U.S.” American Journal of Preventive Medicine, June 2017. Accessed January 22, 2020. National Institute on Alcohol Abuse and Alcoholism. “Harmful Interactions: Mixing Alcohol With Medicines.” Revised 2014. Accessed January 22, 2020. National Institute on Drug Abuse. “The Neurobiology of Drug Addiction: Definition of Tolerance.” Updated November 2019. Accessed January 22, 2020. Centers for Disease Control and Prevention. “Underage Drinking.” August 2018. Accessed January 22, 2020. Pfefferbaum, Adolf; et al. “Altered Brain Developmental Trajectories in Adolescents After Initiating Drinking.” The American Journal of Psychiatry, April 2018. Accessed January 22, 2020. Kyzar, Evan J.; Floreani, Christina; Teppen, Tara L.; Pandey, Subhash C. “Adolescent Alcohol Exposure: Burden of Epigenetic Reprogramming, Synaptic Remodeling, and Adult Psychopathology.” Frontiers in Neuroscience, May 2016. Accessed January 22, 2020. White, AM.; Castle, IJ.; Hingson, RW.; Powell, PA. “Using Death Certiﬁcates to Explore Changes in Alcohol-Related Mortality in the United States, 1999 to 2017.” Alcoholism: Clinical and Experimental Research, January 2020. Accessed January 22, 2020. The Substance Abuse and Mental Health Services Administration. “2018 National Survey on Drug Use and Health, Table 7.9B.” August 2019. Accessed January 22, 2020. Shmerling, Robert H. “Alcohol and your health: Is none better than a little?” Harvard Health Blog, September 2018. Accessed January 22, 2020. Griswold, MG.; et al. “Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016.” The Lancet, September 2018. Accessed January 22, 2020. U.S. Department of Health and Human Services. “2015-2020 Dietary Guidelines for Americans, 8th Edition – Appendix 9: Alcohol.” December 2015. Accessed January 22, 2020. Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.