Alcohol poisoning is a result of drinking too much alcohol. It is important to know the signs and what to do.

The misperception that someone has ‘just passed out’ and ‘let him/her sleep it off’ is a belief that sometimes leads to death. Rapid binge drinking is especially dangerous, because of the possibility of drinking a fatal dose before becoming unconscious.

• Know the danger signals.
• Do not wait for all symptoms to be present.
• Be aware that a person who has passed out may die.
• If there is any suspicion of alcohol overdose, call 911 or the emergency number for help. Don’t try to guess the level of drunkeness.

Don't be afraid to seek medical help for someone who has had too much to drink. Don't worry that they may become angry or embarrassed - remember, you cared enough to help.

Signs of alcohol poisoning:

• Confused
• Irregular, slow or shallow breathing
• Vomiting or choking while sleeping
• Cold, pale or bluish skin
• Cannot be awakened
• No response to pinching the skin
• Seizures

A person with any of the following symptoms is not simply ‘really drunk.’ These are early signs of possible alcohol poisoning:

• Slurred speech
• Difficulty walking or standing up
• Erratic behavior
• Unable to make eye contact or hold a conversation
• Feeling very ill or vomiting

If you notice any of these signs, intervene BEFORE the situation becomes life-threatening. Have sober friends stay with the person, and try to keep them from consuming more alcohol or other substances.

If the person is not in need of medical help, be sure to position the person on his/her side placing a pillow behind him/her to help prevent them from rolling on their back. Stay with the person and wake them frequently. Even though the person is sleeping, alcohol levels may continue to rise, causing the person to become unconscious, rather than asleep. If at any time you cannot wake the person, CALL 9-1-1. DO NOT ASSUME that they will stay in the position you placed them and be safe the next morning.

If someone shows any of the signs of alcohol poisoning, help is required immediately.

• Call 911 or the emergency medical number.
• Identify sober people to help.
• Stay with the person.
• Use the recovery position: Prop the person on his/her side to prevent choking.
• Tell emergency medical technicians the symptoms and how much alcohol the person drank or if they had other substances.

There are common myths about sobering which, in reality, don't work or could put the person in more danger.

• Don't believe that giving the person black coffee or other liquids will help them sober up. Neither will 'walking it off.'
• Don't have the person take a bath or shower - this could result in injury or hypothermia.
• Don't just have the person sleep it off - they should be awake (or awakened frequently) so that they can be assessed for consciousness.

The only thing that reverses the effects of alcohol is time - something that is not available if you are suffering from alcohol poisoning. And many different factors affect the level of intoxication of an individual, so it's difficult to gauge exactly how much is too much.

Alcohol depresses nerves that control involuntary actions such as breathing, the heart beat, and the gag reflex (prevents choking). A fatal dose of alcohol will eventually stop these functions.

It is common for someone who drank excessive alcohol to vomit since alcohol is an irritant to the stomach. There is then the danger of choking on vomit, which could cause death by asphyxiation in a person who is not conscious because of intoxication.

After a person stops drinking, alcohol in the stomach and intestine continues to enter the bloodstream and circulate throughout the body. A person's blood alcohol concentration (BAC) can continue to rise even while he or she is passed out. As a result, breathing and heart beat can slow, become irregular, then stop; hypothermia (low body temperature) can lead to cardiac; and hypoglycemia (too little blood sugar) can lead to seizures.

Even if the victim lives, alcohol overdose can lead to irreversible brain damage.

For many people, a night of drinking can lead to a painful morning after and the dreaded effects of a hangover. What does science tell us about this phenomenon? What causes the typical symptoms of a hangover? And the question perhaps as old as hangovers themselves—are there any real remedies?

What Is a Hangover?

A hangover refers to a set of symptoms that occur as a consequence of excessive alcohol use. Typical symptoms include fatigue, weakness, thirst, headache, muscle aches, nausea, stomach pain, vertigo, sensitivity to light and sound, anxiety, irritability, sweating, and increased blood pressure. A hangover can vary from person to person.

Other Substances That Contribute to Hangover Symptoms

Alcohol is the main culprit in a hangover, but other components of alcoholic beverages might contribute to hangover symptoms or make a hangover worse.

• Congeners are compounds, other than ethyl alcohol, that are produced during fermentation. These substances contribute to the taste and smell of alcoholic beverages. Darker spirits, such as bourbon, which tend to have higher levels of congeners than clear spirits, could worsen hangover symptoms for some people.
• Sulfites are compounds that are added to wine as preservatives. People who have a sensitivity to sulfites may experience a headache after drinking wine.

What Causes Hangover Symptoms?

A number of factors can contribute to hangovers:

• Mild dehydration: Alcohol suppresses the release of vasopressin, a hormone produced by the brain that sends signals to the kidneys causing them to retain fluid. As a result, alcohol increases urination and excess loss of fluids. The mild dehydration that results likely contributes to hangover symptoms such as thirst, fatigue, and a headache.
• Disrupted sleep: People may fall asleep faster after drinking alcohol, but their sleep is fragmented, and they tend to wake up earlier. This contributes to fatigue, as well as lost productivity.
• Gastrointestinal irritation: Alcohol directly irritates the lining of the stomach and increases acid release. This can lead to nausea and stomach discomfort.
• Inflammation: Alcohol increases inflammation in the body. Inflammation contributes to the malaise that people feel when they are sick, so it may play a role in hangover symptoms as well.
• Acetaldehyde exposure: Alcohol metabolism, primarily by the liver, creates the compound acetaldehyde, a toxic, short-lived byproduct, which contributes to inflammation in the liver, pancreas, brain, gastrointestinal tract, and other organs.
• Mini-withdrawal: While drinking, individuals may feel calmer, more relaxed, and even euphoric, but the brain quickly adjusts to those positive effects as it tries to maintain balance. As a result, when the buzz wears off, people can feel more restless and anxious than before they drank.

Because individuals are so different, it is difficult to predict how many drinks will cause a hangover. Any time pe ople drink to intoxication, there is a chance they could have a hangover the next day.

When Does a Hangover Peak and How Long Does It Last?

Hangover symptoms peak when the blood alcohol concentration in the body returns to about zero. The symptoms can last 24 hours or longer.

Are Hangovers Dangerous or Just Painful?

Hangovers can be both painful and dangerous. During a hangover, a person’s attention, decision-making, and muscle coordination can all be impaired. Also, the ability to perform important tasks, such as driving, operating machinery, or caring for others can be negatively affected.

Common Myths About Hangovers

Myth: Certain actions, such as drinking coffee or taking a shower, can prevent or cure a hangover.

Fact: The only way to completely avoid a hangover is to not drink alcohol at all or to keep alcohol intake to a minimum. There is no cure for a hangover other than time.

Myth: The order of drinks will affect a hangover—as captured in the expression, “beer before liquor, never sicker.”

Fact: In general, the more alcohol a person drinks, the worse the hangover will be. This is true regardless of whether a person drinks beer, wine, distilled spirits, or a combination of these.

Myth: Having an alcoholic drink in the morning after a night of drinking will help avoid a hangover—a practice known colloquially as “a hair of the dog that bit you.”

Fact: While this might temporarily minimize some symptoms, it could contribute to and prolong the malaise and other symptoms of the hangover.

Are There Any Remedies for a Hangover?

Although many remedies for alleviating hangovers are mentioned on the web and in social media, none have been scientifically proven to be effective. There is no magic potion for beating hangovers—and only time can help. A person must wait for the body to finish clearing the toxic byproducts of alcohol metabolism, to rehydrate, to heal irritated tissue, and to restore immune and brain activity to normal. There is no way to speed up the brain’s recovery from alcohol use—drinking coffee, taking a shower, or having an alcoholic beverage the next morning will not cure a hangover.

Some people take over-the-counter pain relievers (often acetaminophen) before going to bed to minimize hangovers. It is important to recognize that the combination of alcohol and acetaminophen can be toxic to the liver. Like alcohol, certain over-the-counter pain relievers, including aspirin and ibuprofen, can increase acid release and irritate the lining of the stomach. Proceed with caution when using these medications before or after consuming alcohol.

To help ease their hangover symptoms, some people turn to electrolyte-rich sports drinks or other products, or even intravenous (IV) treatments, in an effort to treat electrolyte imbalance caused by increased urination and fluid loss as a result of drinking. Research has not found a correlation between the extent of electrolyte disruptions and the severity of hangovers, or the impact of added electrolytes on hangover severity. In most people, the body will quickly restore electrolyte balance once the effects of alcohol subside.

Ultimately, the only surefire remedy for a hangover is to avoid getting one by not drinking excessively.

Drinking to the point of a blackout has gained pop culture notoriety in recent years. Blackouts are typically associated with consuming excessive amounts of alcohol that can lead to impaired memory of events that transpired while intoxicated, and a drastically increased risk of injuries and other harms. They can occur in anyone who drinks alcohol, no matter their age or level of experience with drinking. In this factsheet, we will take a sober look at this common but deeply concerning consequence of alcohol misuse.

What Are Blackouts?

Alcohol-related blackouts are gaps in a person’s memory for events that occurred while they were intoxicated. These gaps happen when a person drinks enough alcohol to temporarily block the transfer of memories from short-term to long-term storage—known as memory consolidation—in a brain area called the hippocampus.

Types of Blackouts

There are two types of blackouts; they are defined by the severity of the memory impairment. The most common type is called a “fragmentary blackout” and is characterized by spotty memories for events, with “islands” of memories separated by missing periods of time in between. This type is sometimes referred to as a grayout or a brownout.

Complete amnesia, often spanning hours, is known as an “en bloc” blackout. With this severe form of blackout, memories of events do not form and typically cannot be recovered. It is as if the events simply never occurred.

When Do Blackouts Occur?

Blackouts tend to begin at blood alcohol concentrations (BACs) of about 0.16 percent (nearly twice the legal driving limit) and higher. At these BACs, most cognitive abilities (e.g., impulse control, attention, judgment, and decision-making) are significantly impaired. The level of impairment that occurs at such high BACs makes the intoxication level associated with blackouts especially dangerous.

Blackouts can occur at much lower BACs in people who drink and take sleep and anti-anxiety medications.

Research indicates that blackouts are more likely to occur when alcohol enters the bloodstream quickly, causing the BAC to rise rapidly. This could happen if someone drinks on an empty stomach or consumes excessive amounts of alcohol in a short amount of time. Because females, on average, weigh less than males and, pound for pound, have less water in their bodies, they tend to reach higher peak BAC levels than males with each drink and do so more quickly. This helps explain why being female appears to be a risk factor for having blackouts.

Because blackouts tend to occur at high BACs, they commonly stem from binge drinking, defined as a pattern of drinking that increases a person’s BAC to 0.08 percent or higher. This typically occurs after 4 drinks for women and 5 drinks for men—in about 2 hours. In fact, many people who have blackouts do so after engaging in a behavior known as high-intensity drinking, which is defined as drinking at levels that are at least twice as high as the binge-drinking thresholds for women and men.

Blackouts vs. Passing Out

A blackout is not the same as “passing out,” which means either falling asleep or losing consciousness from excessive alcohol consumption.

During a blackout, a person is still awake but their brain is not creating new memories. Depending on how much the person drank, it is possible to transition from having a blackout to passing out.

Are Blackouts a Sign of an Alcohol-Related Problem?

Research among college students and other young adults has shown that the frequency of blackouts predicts other alcohol-related consequences (such as missing work or school, having a lower grade point average [GPA], being injured, ending up in the emergency room, getting arrested, or experiencing other negative outcomes). Questions about blackouts during routine medical visits could serve as an important simple screen for the risk of alcohol-related harms.

Blackouts are not necessarily a sign of alcohol use disorder, but experiencing even one is a reason for concern and should prompt people to consider their relationship with alcohol and talk to their healthcare provider about their drinking.

6 a day: An average of 6 people die of alcohol poisoning each day in the US.

3 in 4: 76% of alcohol poisoning deaths are among adults ages 35 to 64.

76%: About 76% of those who die from alcohol poisoning are men.

On average, 6 people died every day from alcohol poisoning in the US from 2010 to 2012. Alcohol poisoning is caused by drinking large quantities of alcohol in a short period of time. Very high levels of alcohol in the body can shutdown critical areas of the brain that control breathing, heart rate, and body temperature, resulting in death. Alcohol poisoning deaths affect people of all ages but are most common among middle-aged adults and men.

States and communities can take steps to reduce alcohol poisoning deaths by preventing binge drinking, including:

• Partnering with police, community groups, health departments, and doctors, nurses, and other health care providers to reduce binge drinking and related harms.
• Tracking the role of alcohol in injuries and deaths.
• Supporting proven programs and policies that decrease binge drinking. States with stronger alcohol policies have less binge drinking.

Problem

There are 2,200 alcohol poisoning deaths in the US each year.

Alcohol poisoning deaths:

• Most people who die are 35-64 years old.
• Most people who die are men.
• Most alcohol poisoning deaths are among non- Hispanic whites. Although a smaller share of the US population, American Indians/Alaska Natives have the most alcohol poisoning deaths per million people of any of the races.
• Alaska has the most alcohol poisoning deaths per million people, while Alabama has the least.
• Alcohol dependence (alcoholism) was identified as a factor in 30% of alcohol poisoning deaths.

Binge drinking can lead to death from alcohol poisoning.

• Binge drinking (4 or more drinks for women or 5 or more drinks for men in a short period of time) typically leads to a blood alcohol concentration (BAC) that exceeds 0.08 g/dL, the legal limit for driving in all states.
• US adults who binge drink consume an average of about 8 drinks per binge, which can result in even higher levels of alcohol in the body.
• The more you drink the greater your risk of death.

What Can Be Done

The US government is

• Supporting proven programs and policies to reduce binge drinking.
• Helping states and communities measure binge drinking and related harms, including alcohol poisoning.
• Expanding access through the Affordable Care Act to new health insurance plans to cover alcohol screening and brief counseling.

States and communities can

• Support proven programs and policies that decrease binge drinking. States with stronger alcohol policies have less binge drinking.
• Partner with police, community groups, health departments, and doctors, nurses, and other health care providers to reduce binge drinking and related harms.
• Track the role of alcohol in injuries and deaths.

Doctors, nurses, and other providers can

• Screen all adult patients for binge drinking and counsel those who binge drink to drink less.
• Recognize that most people who drink too much are not alcohol dependent (alcoholics) but may still need counseling.
• Support proven programs and policies to prevent binge drinking.

Everyone can

• Avoid binge drinking. If you choose to drink alcohol, follow the dietary guidelines.
• Avoid drinks with unknown alcohol content or mixing alcohol with energy drinks. Caffeine can mask alcohol's effects and cause people to drink more than they intend.
• Get help for anyone experiencing lifethreatening signs of alcohol poisoning.
• Talk to your doctor, nurse, or other health care provider if you think you may have a drinking problem, or call the national Treatment Referral Routing Service (1-800-662-HELP).

2010 Dietary Guidelines for Americans:

• Don't start drinking or increase the amount you drink on the basis of potential health benefits. If you choose to drink, do so in moderation – up to 1 drink a day for women or up to 2 drinks a day for men.
• Don't drink at all if you are under age 21, pregnant or may be pregnant, have health problems that could be made worse by drinking, or are engaging in activities for which alcohol is dangerous (e.g., driving).

If you choose to drink alcohol, drink in moderation (for women, no more than 1 drink a day; for men, no more than 2 drinks a day). Avoid "binge drinking."

What's Important to Know?

If you choose to drink alcohol, drink in moderation. Women and everyone over age 64 should drink no more than 1 drink per day (and not more than 7 drinks per week). Men aged 64 and under should drink no more than 2 drinks per day (and not more than 14 drinks per week). One drink is equivalent to:

• 12 oz. regular beer, usually about 5% alcohol or
• 8-9 oz. malt liquor, or
• 5 oz. table wine (12%), or
• 1.5 oz. 80-proof hard liquor

Drinking too much alcohol, or “binge drinking,” can lead to a higher risk of health problems such as liver damage, pancreatitis, or other issues. Binge drinking is defined as:

• More than 3 drinks on one occasion for women and adults over age 64
• More than 4 drinks on one occasion for men

For many adults, drinking small amounts of alcohol does not cause serious health problems. Women who drink no more than 1 drink a day (and not more than 7 drinks per week) and men who drink no more than 2 drinks a day (and not more than 14 drinks per week) are at low risk for developing problems with alcohol use.

However, as we age, our bodies do not process alcohol as easily, and the limits for all people over age 64 are no more than 1 drink a day and 7 drinks per week. In addition, there are people such as children, pregnant women, and those with certain medical conditions who should not drink any alcohol.