Alcohol Poisoning: Signs, What to Do and When to Call 911

What is alcohol poisoning?

Alcohol poisoning (alcohol overdose) happens when there is so much alcohol in the bloodstream that areas of the brain controlling basic life functions — breathing, heart rate and body temperature — begin to shut down. It is most often caused by binge drinking: drinking a large amount in a short time, such as shots, drinking games or chugging. Blood alcohol can keep rising for 30–40 minutes after the last drink, so someone can get worse even while "sleeping it off".

Warning signs

According to the U.S. National Institute on Alcohol Abuse and Alcoholism, signs include:

• Mental confusion or stupor
• Difficulty staying conscious, or cannot be woken up
• Vomiting (especially while semi-conscious)
• Seizures
• Slow breathing — fewer than 8 breaths a minute
• Irregular breathing — 10 seconds or more between breaths
• Slow heart rate
• Clammy skin
• Dulled responses, such as no gag reflex (which prevents choking)
• Extremely low body temperature; bluish or pale skin

What to do

1. Call 911 (or your local emergency number) immediately. Explain that you suspect alcohol poisoning and whether any other drugs or medications may have been taken.
2. Stay with the person. Never leave them alone.
3. Try to keep them awake and sitting up if they are conscious.
4. If they are unconscious or lying down, put them in the recovery position (on their side) to prevent choking on vomit.
5. Keep them warm with a blanket or jacket.
6. If they are vomiting, help them lean forward or keep them on their side.
7. Give information to responders: how much and what they drank, when, any medications or drugs, and any health conditions.

The recovery position

1. Kneel beside the person, who is lying on their back.
2. Place the arm nearest you at a right angle to their body, palm up.
3. Bring the far arm across the chest and hold the back of their hand against the cheek nearest you.
4. Bend their far knee, then pull on the knee to roll them toward you onto their side.
5. Tilt their head back slightly and keep the airway open. Check their breathing regularly until help arrives.

What NOT to do

• Don't let them "sleep it off." Blood alcohol can keep rising after drinking stops.
• Don't give coffee. Caffeine doesn't reduce blood alcohol and can worsen dehydration.
• Don't put them in a cold shower. They are already at risk of dangerously low body temperature, and could fall.
• Don't try to make them vomit. Their gag reflex may not work, and they could choke.
• Don't give more alcohol ("hair of the dog") or any food or medication.
• Don't walk them around — this does not sober anyone up and increases the risk of falls.

Worried about getting someone in trouble?

Many US states and colleges have medical amnesty or Good Samaritan policies that protect people who call for help in an alcohol emergency, including underage drinkers, from certain penalties. Regardless of the rules, a person's life is always more important. Call for help.

How to prevent alcohol poisoning

• Know what a standard drink is and count yours.
• Avoid shots, drinking games, chugging and "bottomless" drinks.
• Eat before and while drinking, and drink water in between.
• Watch out for friends — agree to look after each other when going out.
• Be especially careful with strong cocktails, punches and homemade spirits whose strength is unknown.
• Never mix alcohol with opioids, sedatives, sleeping pills or other drugs.

Frequently asked questions