Here’s What Alcohol Poisoning Can Do to Your Body – Drinking heavily can quickly become dangerous

If you’ve ever been swept up in the moment and said yes to one more shot of tequila when you should have said hell no, you’re probably well aware of what it feels like to have a bit too much to drink. Getting pretty sloshy doesn’t necessarily mean you’ll end up with more than a bad hangover—but alcohol poisoning is still a serious risk of binge drinking, and your chances of reaching this state increase the more you drink at one time, according to the Centers for Disease Control and Prevention (CDC).

A few other factors to consider: Compared to people who do not binge drink, those who drank twice as much as their recommended threshold (more details on that in a sec) were 70 times more likely to have an alcohol-related emergency room visit, per the National Institute on Alcohol Abuse and Alcoholism (NIAAA). In fact, there are six alcohol-poisoning-related deaths every day in the U.S., according to the CDC, and alcohol use disorder is a factor in about 30% of alcohol-poisoning deaths.

All of this is to say that, alcohol poisoning, also known as alcohol toxicity, is not something to mess around with, so we spoke with experts about how to enjoy booze safely—and what to do if you or a loved one has seemingly passed the point of no return.

In general, the CDC considers “moderate” drinking to be no more than one drink a day for women, and no more than two drinks a day for men. Binge drinking, then, is defined as having four or more drinks on one occasion for women and five or more drinks on one occasion for men. Most people who binge drink consume an average of eight drinks per binge, though.

Here’s a refresher on how one drink is defined: 12 oz. of regular beer, 8 to 9 oz. of malt liquor, 5 oz. of wine, or 1.5 oz. of 80-proof hard liquor.

You might hear some people say they have a “high alcohol tolerance.” All that means is some people are better able to tolerate some of alcohol’s effects, Brenna Farmer, MD, an associate professor of clinical emergency medicine in the department of emergency medicine at Weill Cornell Medicine at New York Presbyterian Hospital, tells SELF. So they might imbibe more in a shorter time frame to feel, well, drunk, and that’s when drinking heavily can become dangerous.

Every time you drink alcohol, it’s up to your liver to break it down and filter it until it becomes less toxic for the body to eventually eliminate as waste. For people who drink occasionally, the body can only process a certain amount of alcohol every hour, and that magic number is technically unknown; generally, it’s considered to be one drink per hour. So, glugging much more than that in a short time can result in alcohol poisoning, per the Mayo Clinic.

The legal blood alcohol concentration (BAC) for intoxication is 0.08% or greater, per the NIAAA. With alcohol poisoning, there is no definitive number because intoxication levels can vary greatly from person to person. Generally, a BAC of 0.08% to 0.4% is considered “very impaired,” possibly setting off symptoms like confusion, nausea, drowsiness, and difficulty speaking or walking, according to the U.S. National Library of Medicine.

You also open yourself up to the possibility of a blackout, which might not be obvious to you, for example, until you realize there are gaps in your memory—like if a friend talks about something you did while drinking that you can’t recall. Scientifically, though, what’s going on is a blockage in the brain’s hippocampus, which temporarily prevents the formation of new memories.¹

Here’s where things get dicey: If you can’t even remember your late-night antics, how are you expected to get medical attention if you become injured? Or so sick you can’t move?

If a person’s BAC exceeds 0.31%, it is considered a life-threatening situation in which they immediately need to be brought into the emergency room. At this point, someone’s vital functions can slow so significantly that they could slip into a coma. The main concern here is aspiration, Sarah Andrews, MD, an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, tells SELF. That means you run the risk of choking on your vomit and damaging your lungs or even dying.

Signs of alcohol poisoning can be difficult to distinguish from just being extremely drunk, Dr. Farmer says. According to the CDC, these are the most common symptoms of alcohol poisoning that warrant medical attention:

It’s pretty common to feel a little barfy after downing too much booze, but vomiting is one of the first signs that someone has had too much to drink. It’s actually the body’s way of eliminating a toxic substance from the gut (in this case, ethanol).² While “there is no specific pattern to vomiting in [severe] alcohol poisoning” to differentiate it from extreme intoxication, Dr. Andrews says, it’s a clear sign that you’ll want to watch for the other symptoms on this list.

Alcohol toxicity causes the body’s communication system to slow, which can also slow down other vital functions like breathing. When this happens, your body might go from taking 12 to 20 breaths per minute to less than eight breaths. Irregular breathing, in which a 10-second or more gap between breaths occurs, is also a possibility. Both can lead to respiratory failure, a dangerous buildup of carbon dioxide in the body that can damage the tissues and organs and cause immediate confusion, headache, blurred vision, and rapid, irregular breathing. This may be quickly followed by a drop in blood oxygen levels, where you might notice the skin turning blue, starting with fingers, toes, and lips.

Yes, you might begin to feel heated. That’s because, in the tipsy stages of being drunk, alcohol opens your blood vessels for easier circulation, to keep your core body temperature from rising to a potentially dangerous level.³ You might also notice your cheeks become flushed when this happens. But as you continue to drink and your BAC rises, your blood vessels start to constrict and reduce blood flow and, therefore, heat distribution. This can quickly escalate and raise the risk of hypothermia, a body temperature below 95 degrees, at which point the body begins to lose essential functions.⁴ Signs of hypothermia can include shivering, fumbling hands, confusion, exhaustion, memory loss, and slurred speech, per the CDC.

One of the biggest misconceptions about people who pass out or fall asleep from intoxication is that they are no longer at risk for alcohol poisoning, Dr. Andrews says. “Even if they’re unconscious, the body is still metabolizing the alcohol,” she explains. Not to mention, a person’s BAC can continue to rise long after they’re rendered unconscious, per the NIAAA.

One of the main concerns for people who lose consciousness is the risk of choking on their vomit and dying from a lack of oxygen or the lungs becoming damaged from aspiration, Dr. Farmer says. A telltale sign that a person is unconscious and not just asleep is their inability to be woken, per the Mayo Clinic, in which case, you want to seek immediate medical attention.

Once alcohol is in the body, it acts as a depressant to the central nervous system and alters the brain’s chemical makeup, causing an increase in the number of excitatory neurotransmitters.  Once alcohol’s effects begin to wear off, there is an imbalance between the excitatory and the depressant neurotransmitters, which leads to symptoms of alcohol withdrawal, a syndrome that can lead to seizures and even sudden death.⁵

What makes this possibility especially dangerous is the timeframe in which it can occur: anywhere between six hours to several days after the binge,⁶ and it is more likely to occur following longer binges. Early symptoms of withdrawal include restlessness, rapid heart rate, and tremors, which can progress to hallucinations and uncontrollable shaking of the arms and legs, per the Mayo Clinic.

Treatment can vary slightly but generally consists of the same steps whether a person is able to communicate with doctors or is unconscious. “The first thing that we would do when we have a person come into the emergency department for alcohol poisoning is to check their vital signs,” Dr. Farmer says. Vital measures include heart rate, breathing rate, oxygen level, temperature, blood pressure, and blood sugar, and indicate how far from baseline a person may be. The goal is to give supportive care, which could include things like giving fluids through an IV to prevent dehydration.

Next, the person is checked for bruising, bleeding, or other injuries that could have occurred. If there’s a concern of injury to internal organs, various tests might be performed. An exam of the heart and lungs is also crucial during this time because it can show signs of aspiration. “The lung exam would help us identify that by looking for differences in how the lungs sound and how the air moves when they’re breathing,” Dr. Farmer says.

On occasion, if it’s unclear whether a person has alcohol poisoning, the medical staff might take blood samples to check electrolytes, blood count, and BAC. “That doesn’t happen in every case,” Dr. Farmer says. “Sometimes, a person that’s intoxicated is awake enough to tell us that they actually did drink and they didn’t take [other substances], and we’re not worried about an overdose.”

Once a person wakes up and returns to their baseline vitals, a physician or addiction counselor should be there to educate them on the harmful effects of drinking too much and how to protect themselves in the future. “They would more than likely get a phone number for other resources for alcohol use counseling or substance use counseling,” Dr. Farmer says.

People who don’t get treated may end up with permanent damage to their organs—which depends on how severe the alcohol poisoning is and any other injuries that may have happened while they were intoxicated. “When you don’t get enough oxygen into your blood, you can have brain damage,” Dr. Farmer says. “That would be one of the things we’d worry about if a person had low oxygen levels, because they weren’t breathing enough when they aspirated.”

Unlike lung damage, brain damage is more difficult to detect because it’s not always obvious in symptoms or with imaging after a one-time binge-drinking episode, she adds. “We’d have to follow them over time,” which means that a patient can experience symptoms of brain damage that can go undetected for quite some time.

Of course, not every drink is going to lead to alcohol poisoning, but it’s still important to understand that it can be serious. So if you find that a glass or two turns into a bottle or more, you might want to take a hard look at your drinking habits, Dr. Andrews suggests. Asking for help can be scary, especially if you’re not sure what treatment can entail—but there are people who are experienced in substance use disorders who are ready to support you.

If you feel like you need help with alcohol dependence issues, talk with your doctor or reach out to one of these resources:

• The Substance Abuse and Mental Health Services Administration: Call the national helpline at 1-800-662-4357 for confidential, free, 24-hour information about available treatment options.
• The National Institute on Alcohol Abuse and Alcoholism’s Treatment Navigator: Visit the website to learn more about types of treatment, how to choose a program that meets your needs, and treatment providers available in your area.