What is Alcohol Poisoning?

According to the Alcohol Education Trust, 35% of all ambulance Accident & Emergency attendance costs are likely to be related to alcohol in some way. In 2018, in England alone, there were 11,233 alcohol-related hospital admissions for under 18s. Even more worrying is the number of deaths, with 530 people dying from alcohol poisoning in the UK. More recently, the Office for National Statistics (ONS) states that in 2020, there were 552 deaths due to acute alcohol poisoning.

The statistics don’t stop with alcohol poisoning. In the same year, there were 240 fatal drink-driving accidents and 13% of pedestrian road deaths are thought to be due to alcohol impairment. Of all deaths, those in young people aged between 16 and 24 have a huge percentage that are related to alcohol in some way, with 21% of male deaths and 9% of female deaths, respectively.

What is alcohol poisoning?

Alcohol poisoning is when a person drinks too much alcohol over a relatively short period of time. The amount of alcohol drunk is toxic and is often caused by binge drinking. Drinking lots of alcohol quickly overwhelms the body and can stop it from working properly.

What are the signs and symptoms of alcohol poisoning?

Alcohol poisoning is not the same as simply being drunk. It means that the body is starting to shut down and it is very dangerous. The amount of alcohol consumed does not necessarily indicate how dangerous a person’s condition is. If they’ve only had a couple of drinks or a lot, alcohol poisoning is very serious.

Spotting the signs that it’s serious is essential. These are some important signs and symptoms to look out for:

• Very slurred speech.
• Confusion.
• Vomiting.
• Loss of co-ordination.
• Slow or irregular breathing.
• Low body temperature – blue-tinged/pale skin.
• Being unresponsive even though they appear conscious.
• Passing out/becoming unconscious.
• Loss of bladder/bowel control.

What should you do if you suspect someone is suffering from alcohol poisoning?

If you suspect that someone is suffering from alcohol poisoning it is always sensible to call an emergency ambulance.

In the meantime, it’s important to try to keep them sitting up and awake, or in the recovery position if this is not possible. If they can drink, give them water only. Given that alcohol lowers the body temperature, keep them warm and stay with them until help arrives.

There are also things that you should not do:

• Do not make them sick. They could choke on their vomit if their gag reflex has stopped working properly.
• Do not leave them alone to ‘sleep it off’. Even when someone has stopped drinking, their body still may be absorbing the alcohol that they have drunk in recent hours and their blood alcohol level continues to rise.
• Do not give them coffee. This does not cause someone to ‘sober up’ as is often portrayed on TV. If the person is dehydrated, coffee can increase dehydration.
• Do not make them walk about. They may have an accident due to their lack of balance and/or confusion.
• Do not make them have a cold shower. This could increase their risk of injury. Cold showers also lower the body’s temperature which could already be too low due to the alcohol poisoning.
• Do not allow them to drink any more alcohol, even if they are insisting.

What complications can be caused by alcohol poisoning?

There are many complications that can happen as a result of alcohol poisoning.

These include:

• Choking – Alcohol poisoning often causes choking because it causes people to vomit. It also depresses the body’s gag reflex which means that a person is more likely to choke on vomit if they have passed out.
• Severe dehydration – Alcohol causes dehydration itself but vomiting also increases the body’s dehydration. Severe dehydration causes the blood pressure to drop extremely low and the heart tries to compensate by beating faster. This can have catastrophic results.
• Hypothermia – Alcohol causes the body temperature to drop. This can eventually lead to cardiac arrest.
• Irregular heartbeat – The heartbeat is maintained by systems in the body that are affected by alcohol poisoning. As a result, the heart’s rhythm can be affected by too much alcohol and can even stop altogether.
• Stopping breathing – Stopping breathing can occur due to inhaling vomit into the lungs. This can cause someone to stop breathing altogether, especially if they are alone.
• Seizures – Seizures are often a result of alcohol poisoning as it causes the blood sugar levels to drop dangerously low which causes seizures.
• Brain damage – Brain damage as a result of alcohol poisoning is two-fold. The alcohol poisoning itself causes brain cells to die off or become damaged but excessive alcohol consumption also leads to serious accidents, the effects of which could also be brain damage.
• Foetal Alcohol Syndrome (FAS) – This can occur if a pregnant woman drinks heavily during pregnancy.
• Death – All the issues above can lead to death on their own. However, a combination of these due to alcohol poisoning increases that risk immeasurably.

Aside from these health complications, there are other risks of excess alcohol consumption too including:

• Increase in risk-taking behaviour.
• Reduced sense of danger.
• Reduced decision-making skills/judgement.
• Increased risk of injuries/accidents.
• Becoming involved in antisocial or violent behaviour.
• Having unsafe sex, resulting in STIs or unwanted pregnancy.
• Losing possessions.
• Increased vulnerability to assault/sexual violence.

What causes alcohol poisoning?

Firstly, it must be made clear that alcohol is a toxic substance. Every time a person drinks alcohol it can cause some harm. Because it’s a toxin, the liver must filter it out of the blood to keep the body working properly. Alcohol poisoning is the result of the alcohol level in the blood reaching a dangerous level that cannot be filtered out of the blood easily by the liver.

Alcohol poisoning is usually caused by binge drinking. Drinkaware defines binge drinking as having a lot of alcohol in a short space of time. Drinking with the purpose of getting drunk (and then not knowing when to stop) is what often results in alcohol poisoning.

Drinking alcohol is considered a ‘binge’ when a person drinks more than eight units of alcohol in a single session if they are male and more than six units if they are female. If you’re unsure of your units, eight units is the equivalent of around four pints of regular larger or beer for men and around three pints for women.

Having said this, it’s important to note that there is not a set amount that will cause alcohol poisoning in a person. It very much depends on the person, including factors such as their sex, age, the food they’ve eaten that day, how fast they have been drinking, their overall health and whether they’ve also taken any drugs or medications.

Drinking a lot of alcohol in a short space of time can:

• Irritate the stomach and cause vomiting.
• Slow down the brain functioning and reduce the sense of balance.
• Dehydrate the body, increasing the risk of brain damage in some extreme cases.
• Lower the body temperature, leading to hypothermia.
• Lower blood sugar levels, risking brain damage or seizures.
• Affect the body’s cardiovascular system that controls the heart and breathing.

What are the risk factors of alcohol poisoning?

There are a number of factors that increase a person’s risk of alcohol poisoning.

Sex, Size and Weight

Men and women tend to have different tolerance levels for alcohol, and this is largely due to body composition as well as size and weight. Generally, the less a person weighs, the more alcohol affects them. Alcohol enters the bloodstream and if a person is smaller, they generally have less blood in their body. This means that the alcohol doesn’t get as diluted as it would in a larger person with a larger blood volume. Additionally, if a person has a higher body fat percentage, they are more susceptible to alcohol poisoning.

General Health

If a person is generally very healthy, they will usually cope much better with alcohol and alcohol poisoning if it occurs. However, someone who has other conditions or takes medication is generally more likely to be more at risk of alcohol poisoning and the complications resulting from it.

Food Consumption

Drinking alcohol on an empty stomach puts a person at increased risk of alcohol poisoning. This is because food serves to slow down the absorption rate of alcohol into the bloodstream.

Other Drugs

Combining alcohol with other drugs and medications is always a bad idea, regardless of how little a person drinks. Drugs can affect the metabolism of alcohol.

The Strength of Drinks

If a person is drinking a few pints of low strength lager, they are at reduced risk of alcohol poisoning compared with a person drinking shots of spirits. Drinking fake and illegal alcoholic drinks is also a risk factor.

Rate of Consumption

Generally, the quicker a person drinks, the more at risk they are, regardless of the type of drink. Of course, drinking stronger drinks quickly does increase the risk further. The rate of consumption is a significant factor in causing alcohol poisoning as the body can quickly become overwhelmed.

Tolerance Levels

You may have noticed that if you’ve not drunk alcohol in a while, your tolerance level is low whereas those who drink regularly are able to drink more with reduced effect. For this reason, a person with a low tolerance for alcohol is at an increased risk of suffering from alcohol poisoning.

Can alcohol poisoning be prevented?

Alcohol poisoning is prevented by drinking alcohol sensibly or abstaining altogether. However, if a person is going to drink alcohol, there are certain things that they can do to reduce their risk of suffering from alcohol poisoning.

1. Set Limits

By planning to avoid drinking too much alcohol, you are much more likely to not overdo it.

2. Eating Well

Plenty of us have heard the adage of “lining the stomach” before a drinking session, but there is good reason for it. Making sure you have eaten well that day will greatly reduce your risk of alcohol poisoning. This is because it slows down how quickly the body absorbs alcohol. It does not make it safe to binge drink, however, which is a mistake a lot of people make.

3. Alternate Alcoholic and Non-Alcoholic Drinks

A person who is drinking alcohol should aim to alternate their alcoholic drinks with water or soft drinks. This paces the drinker, ensuring the body is not overloaded with too much alcohol too quickly. Again, it’s important to reiterate that it still does not make drinking excessively safe.

4. Plan Ahead

Forearmed is forewarned as they say. Planning where you will go, who with and what time you’ll stay out until is a good way of preventing alcohol overindulgence which can lead to alcohol poisoning. Preparations such as booking table reservations rather than pub crawls, making sure your phone is fully charged and pre-booking a taxi for a certain time will all help you stay safer whilst drinking alcohol and will reduce the risk that you overdo it.

5. Stay with Friends

This is a tricky one. Sticking with friends is an important aspect of staying safe if you have been drinking alcohol. It can reduce the risk of alcohol poisoning if your friends are looking out for you and spot the signs that you are overdoing it.

However, it does depend greatly on the company a person keeps and the personalities of their friends. If your friends are huge binge drinkers, they may encourage you to do the same even though you’d rather not. There can be a bit of peer pressure that comes into play around alcohol, and drinking games are common. This can lead to alcohol poisoning even if you’re in the company of friends who should be looking out for you.

6. Look After Others

This one goes with the one above. If you’re being sensible and doing everything you can to avoid overdoing it, look after those that you’re with. You can try to reduce their risk of becoming intoxicated and can also help them if they do overdo it and need caring for.

How is alcohol poisoning diagnosed?

Alcohol poisoning is usually diagnosed by treating doctors due to the circumstances leading up to a person’s admission to hospital as a result of their intoxication. Usually, doctors are informed if alcohol has been involved by the person bringing the ill person to the hospital. However, doctors also order blood and urine tests to check for low blood sugar and other signs of toxicity too.

How is alcohol poisoning treated?

Alcohol poisoning is treated depending on the severity of the person’s condition. For many people, treatment simply includes supervision and supportive care whilst the body metabolises the alcohol.

In more severe cases, patients may need oxygen therapy and intravenous fluids to prevent or reduce dehydration. Medications containing glucose and vitamins are also treatment pathways for those who are more severely affected.

If you or someone you know has problematic drinking, there is help out there. For advice and support, you can contact one of the following organisations:

Help and support

• Drinkaware.
• Alcoholics Anonymous.
• Alcohol Change UK.
• Alcohol-Help.