Alcohol is a legal, inexpensive and social drug often ingested in excess. A typical drink is defined by the Dietary Guidelines for Americans as one 12-ounce beer (at five percent alcohol), one five-ounce glass of wine (at 12 percent alcohol), or one shot (1.5 ounces) of 80 proof distilled spirits (at 40 percent alcohol).
The Centers for Disease Control and Prevention (CDC) reports that the most common form of excessive drinking in the United States is binge drinking. One in six American adults drinks an average of eight drinks in binge drinking episodes four times a month, while those over age 65 do so more often, closer to five to six times per month. Men are twice as likely to binge drink as women, and binge drinking is more prevalent in those with household incomes of at least $75,000, according to the CDC.
Levels of alcohol in the blood are measured by blood alcohol concentration, or BAC. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) describes binge drinking as raising BAC levels to 0.08 g/dl. Alcohol’s effects and risk factors increase with BAC levels. The effects of alcohol range from a loss of motor control, impaired cognition, slurred speech and decrease of inhibitions to coma and even death.
Binge drinking increases the risks for an alcohol overdose. An overdose on alcohol is defined by the NIAAA as the increase of BAC to a level that increases the risk of harm due to alcohol-related impairments. Alcohol overdoses range in severity depending on age, gender, experience with drinking, food ingested, speed of consumption, and genetic factors. Alcohol poisoning is a particularly dangerous form of alcohol overdose.
Underage Drinking
The legal drinking age in the United States is 21. Drinking before this age increases health risks, the likelihood of developing an alcohol use disorder and even the potential for brain damage. Research published in the Richmond Times-Dispatch found a 10 percent reduction of the brain’s hippocampus in underage drinkers. This region of the brain is responsible for memory and learning. Adolescents have an underdeveloped prefrontal cortex, which is the part of the brain involved in responsible decision-making and impulse control. This may lead young people to take more risks and engage in hazardous activities such as underage drinking.
The Monitoring the Future survey of 2013 found that 48.4 percent of 8th-12th graders had consumed alcohol at some point in their lifetime, and 31.7 percent reported being drunk at least once. The CDC reports that youths aged 12-20 drink 11 percent of the alcohol consumed in America, and more than 90 percent of it is consumed through binge drinking. The NIAAA further estimates that drinkers under age 20 generally drink at least five drinks in a sitting, rapidly raising BAC levels and making adolescents particularly at risk for an alcohol overdose and/or alcohol poisoning.
Alcohol is a central nervous system depressant. The central nervous system is responsible for respiration, heart rate, blood pressure, and temperature regulation. When consumed in excess, alcohol may cause these vital life functions to begin to shut down.
Alcohol is processed through the stomach and intestines. BAC levels may continue to rise as alcohol is circulated into the bloodstream even when the drinker is unconscious. Warning signs of alcohol poisoning include:
- Vomiting
- Seizures
- Loss of the gag reflex
- Irregular, shallow, or slowed breathing
- Hypothermia (low body temperature)
- Bluish skin
- Paleness
- Mental confusion
- Inability to wake up
- Stupor
- Coma
Excessive drinking accounted for 88,000 deaths in America between 2006 and 2010 and was responsible for one in 10 deaths of adults between the ages of 20 and 64, as published by the CDC. Every increase in BAC due to alcohol consumption causes different side effects. BAC and general levels of impairment are as follows:
- 00-0.05: decreased balance; minor speech, attention and memory impediments
- 05-0.15: increased lack of coordination; impaired driving functions; heightened risk of injury to self as well as others; potential aggression; memory, speech, attention, and memory issues
- 16-0.30: severe impairment of balance, coordination, memory, speech attention, focus, and reaction time; significantly impaired decision-making, judgment, and driving abilities; potential blackouts; vomiting; possible loss of consciousness
- 31-0.45: loss of consciousness; life-threatening suppression of vital functions or fatal alcohol poisoning
Levels of BAC are affected depending on how much food you have eaten that day as well weight, alcohol tolerance levels, and genetic factors. There are approximately 50,000 cases of alcohol poisoning each year in the United States, with one a week being fatal, as published by Medical News Today. Alcohol poisoning can cause death either by suppressing necessary life functions such as breathing, heart rate, blood pressure, and temperature or due to choking on vomit when automatic responses sent through the central nervous system, such as the gag reflex, are inhibited.
The potential for injuries and accidents goes up with BAC levels. With higher levels, judgment and coordination are further impaired, increasing the odds for engaging in risky or hazardous behavior. Risks for domestic violence, sexual assault, car accidents due to impaired driving, and unintentional injuries all increase with alcohol consumption amounts. Alcohol poisoning may also lead to severe dehydration or dangerous drops in blood sugar levels that can cause seizures, permanent brain damage, or even death.
Alcohol is a central nervous system depressant. The central nervous system is responsible for respiration, heart rate, blood pressure, and temperature regulation. When consumed in excess, alcohol may cause these vital life functions to begin to shut down.
Alcohol is processed through the stomach and intestines. BAC levels may continue to rise as alcohol is circulated into the bloodstream even when the drinker is unconscious. Warning signs of alcohol poisoning include:
- Vomiting
- Seizures
- Loss of the gag reflex
- Irregular, shallow, or slowed breathing
- Hypothermia (low body temperature)
- Bluish skin
- Paleness
- Mental confusion
- Inability to wake up
- Stupor
- Coma
Prevention and Treatment
The key to preventing alcohol poisoning is to drink responsibly if you decide to drink at all. The NIAAA considers low-risk drinking to be no more than three drinks per day or seven drinks per week for women, and no more than four drinks per day for men or 14 drinks in a week. Making sure to eat something before drinking and staying hydrated are important as well as regulating how much and how fast you drink in order to avoid alcohol poisoning. Drinking too much too fast can lead to rapid and dangerous rises in BAC levels. The liver helps filter alcohol and can only process about one unit of alcohol per hour, so drinking less over a longer amount of time can decrease the chances of an alcohol overdose.
Those under the age of 21 should not drink at all as risk factors for both overdose and the development of an alcohol use disorder increase. The National Survey on Drug Use and Health (NSDUH) in 2013 estimated that 15.4 percent of those consuming alcohol before age 14 were diagnosed with an alcohol dependency or abuse problem as opposed to the 2.3 percent of the population that waited until after the legal age of 21 to take their first drink.
Chronic episodes of binge drinking also can lead to drinkers developing a tolerance to alcohol, meaning it will take more each time in order to feel intoxicated. Along with the negative side effects, alcohol also makes drinkers feel good by increasing the production of the neurotransmitter dopamine. Alcohol also has a sedative effect on the central nervous system, producing calm and relaxing feelings. This alteration of the brain’s natural reward circuitry may lead to the development of a dependence on alcohol, creating cravings and withdrawal symptoms when it is removed.
Learn More
Alcohol addiction is defined as a chronic and relapsing brain disease characterized by a compulsive desire to continue drinking regardless of any interpersonal, emotional, or physical consequences. Binge drinking and non-fatal episodes of alcohol overdose may increase the risks for developing an alcohol use disorder.
Alcohol poisoning requires immediate medical attention in order to reverse the harmful toxins within the body. The stomach may be flushed, and breathing and heart rate closely monitored by medical professionals. Fluids are generally administered in an attempt to balance blood sugar and hydration levels.
If alcohol poisoning is the result of a pattern of excessive drinking or an alcohol use disorder then specialized treatment or a detox protocol may be necessary. Medications are sometimes used to manage the symptoms of withdrawal and to help manage alcohol cravings during medical detox, which is supervised by consulting physicians. Alcohol addiction treatment also includes behavioral therapies and group and individual counseling sessions.
Relapse is a common part of alcohol addiction. The risks for alcohol poisoning may go up for those who have an alcohol use disorder, remained sober for a period of time, and then returned to drinking. Drinkers may return to levels of consumption they were used to in the past; however, sobriety will have decreased their tolerance. A return to previous amounts of alcohol ingestion may rapidly lead to unintentional alcohol poisoning or overdose.
Peer support and self-help groups play an important role in maintaining a long-term recovery, lessening the duration and severity of relapse and helping to prevent future episodes of alcohol poisoning.
If you, or a loved one, are battling an alcohol use disorder, the comprehensive care and treatment provided by compassionate and professional staff at FRN treatment centers can help give you the tools necessary to prevent a potentially life-threatening overdose. Call today to discuss your options with one of our admissions coordinators.
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton