Alcohol Intoxication

Alcohol intoxication, also referred to as drunkenness, ethanol intoxication, or alcohol poisoning in severe cases, is a temporary condition caused by drinking too much alcohol. The amount of alcohol needed for intoxication varies from person to person.

Due to the wide availability of alcoholic beverages, acute intoxication is quite common – affecting almost 10 percent of adults in the United States alone, leading to an estimated annual economic cost of over $250 billion. 1

The signs and symptoms of alcohol intoxication result in alterations in a person's consciousness, cognition, perception, judgment, affect, or behavior. These can vary between people and depend on the severity of intoxication. Not only the effects of alcohol but also the complications caused by it – such as accidents and violence – are a major threat to a person’s health.

Diagnosis of alcohol intoxication always requires ruling out other conditions. In moderate and severe cases, measuring the blood alcohol concentration (BAC) is essential. Treatment focuses on managing symptoms and avoiding complications. Management and prognosis also vary depending on the degree of intoxication. The condition can be successfully prevented by abstaining from alcohol or at least limiting consumption. 1, 2, 3, 4, 5

In people affected, it is important to also check for an underlying alcohol use disorder.

If you think that you might experience alcohol intoxication, get a symptom assessment with the free Ada app. Or find out more about how our symptom checker works before you try it for yourself.

Generally, alcohol intoxication is caused by drinking too much alcohol. However, the amount of alcohol needed for intoxication varies from person to person. Factors that influence the likelihood of intoxication include: 1, 2, 6, 7, 3, 8, 9

• Genes - can make people more resistant or susceptible to alcohol.
• Different types of alcohol can have different effects on a person’s health. Besides ethanol, which is found in alcoholic beverages,other types can be found in products, such as industrial applications, antifreeze products, disinfectants, and antiseptics.
• Amount of alcohol, which is crucial for intoxication
• Binge drinking, having five or more alcoholic beverages, generally leads to alcohol intoxication.
• For some people, the threshold lies far below that.
• Risk increases the higher the percentage of alcohol is in the beverage.
• Rate of alcohol intake affects the body’s ability to cope: The faster alcohol is ingested, the higher the risk of intoxication.
• Children and old people have a reduced ability to eliminate alcohol: Children are particularly at risk of accidentally ingesting alcohol found in colognes, perfumes, mouthwash, aftershave, or cough medication.
• Previous food intake and hydration level influence the effects of alcohol.
• Higher body weight increases the ability to eliminate alcohol.
• This makes women on average more susceptible.
• Underlying conditions, which can reduce the ability to eliminate alcohol.
• Certain medications can reduce the ability to eliminate alcohol.
• Frequency and pattern of alcohol use can influence the resistance or susceptibility to the effects of alcohol
• Symptoms in frequent drinkers can be less predictable and sometimes less showing.
• A person that rarely drinks can show signs of intoxication after small amounts of alcohol.

The signs and symptoms of alcohol intoxication result in alterations in a person's consciousness, cognition, perception, judgment, affect, or behavior.

These can vary between people and depend on the severity of intoxication. Symptoms in frequent drinkers can be less predictable and sometimes less showing. 1, 3

Among people who do not live with a chronic alcohol problem, symptoms often relate to the blood alcohol concentration (BAC). These symptoms include: 1, 3, , 8, 11

BAC between 0.01 and 0.1 percent

• Feelings of wellbeing and confidence
• Disinhibition
• Urge to speak
• Feelings of tranquility and relaxation
• Mild deficits in coordination (unsteady gait, difficulties standing upright)
• Slightly decreased attention, memory, and judgement
• Reddening of the skin or flushing of the face
• Slightly fastened heartbeat

BAC between 0.15 and 0.3 percent:

• Mood variability
• Pronounced disinhibition
• Slurred speech
• Greater deficits in coordination and psychomotor skills (Increasing unsteadiness of gait, clumsiness)
• Increasingly impaired attention, memory, and judgement
• Reduction in responsiveness, alertness, and reaction time
• Confusion
• Uncontrolled eye movements
• Sleepiness
• Dizziness
• Nausea and vomiting
• Impaired vision and sound localization
• Memory gap

BAC greater than 0.3 percent:

• Delusions and hallucinations
• Severe difficulty speaking
• Severe dizziness
• Severe deficits in coordination and psychomotor skills
• Potential hypothermia
• Potential coma (usually BAC greater than 0.4 percent, loss of consciousness, lack of defensive reflexes, respiratory failure).

In many cases, other substances, such as drugs or medication, were taken in addition to alcohol. This is important to know because these substances can hide, alter, or even boost some of the signs of alcohol intoxication. 1

Some symptoms of alcohol poisoning need immediate emergency medical attention. These include: 1, 3

• Problems breathing
• Reduced consciousness
• Uncontrollable vomiting
• Chest pain
• Seizures
• Being hypothermic.

If the person lives with an underlying alcohol use disorder, more symptoms may occur.

If you think that you might experience alcohol intoxication, you can try using the Ada app to find out more about your symptoms.

Alcohol intoxication is usually suspected in a few ways: its signs and symptoms, other people witnessing the increased alcohol consumption, or complications that require medical attention such as accidents and violence.

Diagnosis of alcohol intoxication always requires ruling out other conditions. In moderate and severe cases, measuring the blood alcohol concentration (BAC) is essential. 1, 3

The approach to diagnosis includes: 1, 6, 7, 3

Medical history:

• Checking for alterations in a person's consciousness, cognition, perception, judgment, affect, or behavior
• Interviewing other people have witnessed the increased alcohol consumption if present
• Asking specific questions (If the person regularly consumes alcohol or even lives with an alcohol problem. If the person has taken other substances, such as drugs or medication
• About suicidal tendencies
• What type of alcohol has been consumed.

Physical examination: Doing a complete physical examination on the affected person in order to:

• Recognize any signs of alcohol intoxication
• Pick up on other conditions causing similar symptoms
• Notice potential complications (see below)

Measuring the alcohol concentration blood alcohol concentration (BAC) is the most accurate measurement of the alcohol level. Particularly in regular drinkers, symptoms and the BAC do not necessarily relate to each other, making an accurate measurement beneficial. Usually, this is only required in moderate and severe cases.

Breath analysis

• Is an available alternative
• Provides more rapid results
• Requires cooperation
• Is less accurate.

Additional studies are usually unnecessary in cases of mild alcohol intoxication. They should include:

• Other laboratory studies, such as glucose and electrolyte levels, in addition to the BAC
• Imaging tests, such as X-rays or CT scans, if there are signs of an accident.

It is essential to rule out other conditions in order to diagnose alcohol intoxication. These include: 1, 3

Head trauma

• This can also occur as a result of alcohol intoxication due to falling.

Hypoxia

• An insufficient oxygen supply
• This can have numerous causes, such as heart or lung problems.

Hypoglycemia

• Low glucose levels
• This can also occur as a result of alcohol intoxication and generally requires monitoring.

Hypothermia

• This can also occur as a result of alcohol intoxication and the behavioral changes it causes.

Hepatic encephalopathyOther metabolic derangements

In people affected, it is important to also check for underlying alcohol abuse.

The treatment for alcohol intoxication focuses on managing symptoms and avoiding complications. 1, 3

Type of alcohol

• Besides ethanol, which is found in alcoholic beverages, other types can be found in products – such as industrial applications, antifreeze products, disinfectants, and antiseptics.

Other substances involved

• In many cases, drugs or medication were taken in addition to the alcohol.

The severity of intoxication

Presence of complications

• These can range from glucose or electrolyte derangements to injuries and many more (see below)

Pre-existing conditions

Mild alcohol intoxication

• Usually only requires observation
• Might require glucose administration if glucose levels are decreased
• Might require sedative medications if they are agitated, violent, or uncooperative.

Moderate alcohol intoxication

• Requires close monitoring
• Requires glucose administration if glucose levels are decreased
• Often requires fluid hydration via IV access
• Might require sedative medications if they are agitated, violent, or uncooperative.

Severe alcohol intoxication

• Requires constant monitoring
• In some cases, this can only be provided in an emergency department or intensive care unit.
• Requires frequent reassessment of the breathing (If breathing is insufficient, intubation and mechanical ventilation are required).
• Requires glucose administration if glucose levels are decreased
• Requires fluid hydration via IV access
• Might require sedative medications if they are agitated, violent, or uncooperative
• Might require administration of thiamine via IV access. This is also known as vitamin B1. It should be administered if the intoxicated person is in a coma to prevent a complication called Wernicke's encephalopathy.

Once the affected person is sober again, it should be evaluated if alcohol or substance abuse is an ongoing problem due to an alcohol use disorder. This requires further treatment. 1, 4, 5

There are a number of complications that can develop due to alcohol intoxication.These include: 1, 3, 12

Metabolic derangements including

• Low glucose levels
• Low potassium levels

Hypoxia

• An insufficient oxygen supply caused by impaired breathing

Hypothermia

• A low body core temperature

Heart arrhythmia

• Sometimes referred to as “holiday heart”

Injuries

• Caused by accidents or violence due to the influence of alcohol

If you think that you might experience alcohol intoxication, you can try using the Ada app to find out more about your symptoms. 1

Q: When should you go to the hospital for alcohol intoxication?

A: There are a number of reasons to seek immediate medical attention due to alcohol intoxication. These include: 1, 3

Experiencing any of the following symptoms

• Problems breathing
• Reduced consciousness
• Uncontrollable vomiting
• Chest pain
• Seizures
• Being hypothermic

Showing signs of alcohol intoxication and taking other substances, such as drugs or medication, in addition to the alcohol.

Q: What will happen to your body if you drink too much alcohol?

A: Drinking too much alcohol can result in alcohol intoxication. People affected will have symptoms that result in alterations in a person's consciousness, cognition, perception, judgment, affect, or behavior. These can vary between people and depend on the severity of intoxication. People who drink regularly may develop a condition called alcohol use disorder which can lead to serious complications. 1, 3