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Key Signs of an Alcohol Overdose

By Megan MacKay, Neha Kashyap
Anyone can overdose on alcohol. Knowing the signs can help save a life.

An alcohol overdose can impact anyone drinking heavily in one sitting, regardless of their history with alcohol. During an alcohol overdose, basic bodily functions like breathing and heart rate begin to slow down, putting the drinker at risk for permanent brain damage or death, according to the National Institutes of Health (NIH).

If you consume alcohol or are around others who drink, it’s important to know the key signs of overdose and what to do when an overdose occurs.

Alcohol Overdose Symptoms

The key signs of an alcohol overdose include:

  • Slurred speech
  • Confusion
  • Nausea and vomiting
  • Irregular breathing
  • Anxiety
  • Delirium
  • Being unresponsive
  • Seizures

Slurred speech and confusion after drinking might seem amusing. However, these can be signs that a person is experiencing alcohol poisoning. If drinking continues, the chances of overdosing could increase.

“In general, early warning signs of alcohol toxicity consist of confusion, slurred speech, poor coordination and pale skin,” Patrick Gallus, D.O., Founder and Chief Medical Officer of Gallus Medical Detox Center in Scottsdale, Arizona, tells WebMD Connect to Care. “This can quickly develop into more concerning signs to include irregular breathing, hypothermia, unresponsiveness and coma.”

Alcohol overdoses are more likely to happen to binge drinkers. Binge drinking is defined as four drinks in two hours for women and five drinks in two hours for men. It's important to note that inexperienced drinkers, like teens and young people, are more likely to binge drink, according to the NIH.

An alcohol overdose can impact anyone drinking heavily at one time, regardless of their history with alcohol. During an alcohol overdose, basic bodily functions like breathing and heart rate begin to slow down, putting the drinker at risk for permanent brain damage or death, according to the National Institutes of Health (NIH).

If you consume alcohol or are around others who drink, it’s important to know the key signs of overdose and what to do when an overdose occurs.

What are the Stages of Alcohol Intoxication?

Doctors can use blood alcohol content (BAC) to calculate the amount of blood in your alcohol as a percentage. According to the University of Toledo, BAC is calculated in grams per 100 mL of blood--so a BAC of 0.09 means that your blood is 0.09% alcohol by volume. In a person who has not developed tolerance as a result of chronic alcohol use, certain signs and symptoms will predictably appear in correlation with a rising BAC. 

  • 0.2-0.4% BAC corresponds to the "lightheaded" stage of intoxication. Feelings of relaxation, warmth, or a high" will typically be present. You may also have minor impairments in your judgments. 
  • .05-.07% BAC corresponds to the "buzzed" stage of intoxication. Feelings of relaxation, euphoria, lower inhibitions, exaggerated positive and negative emotions, and minor impairment of reason and memory will typically be present. 
  • .08-.10% BAC corresponds to the "legally impaired" stage of intoxication. Feelings of euphoria and fatigue, as well as impairments in balance, speech, vision, reaction time, hearing, judgment, and self-control will typically be present. 
  • .11-.15% BAC corresponds to the "drunk" stage of intoxication. During this stage, the "high" feeling recedes, while depressive symptoms such as anxiety, depression, or unease will typically appear. Severe impairments in motor skills, judgment, and perception will also typically be present. 
  • .16-.19% BAC corresponds to the "very drunk" stage of intoxication. This stage typically manifests with a strongly depressive state, nausea, disorientation, dizziness, blurry vision, and increased impairment of motor skills and judgment. 
  • .20-24% BAC corresponds to the "dazed and confused" stage of intoxication. During this stage, you'll become highly disoriented toward time and place. Increased nausea and vomiting may also appear, along with needing assistance to stand or walk. You may become insensitive to pain, and a blackout becomes likely. 
  • .25-.30% BAC corresponds to the "stupor" stage of intoxication. All mental, physical, and sensory abilities become severely impaired at this stage. You'll show little general comprehension and become very prone to an accident or sudden loss of consciousness. 
  • .31% and above BAC corresponds to the "coma" stage of intoxication. The possibility of acute alcohol poisoning and death due to a stoppage in breathing becomes likely in 50% of people who reach this stage. 

"For people who do not use alcohol regularly, blood alcohol concentration can help predict the severity of intoxication and is associated with typical clinical signs of intoxication," Amer Raheemullah, MD, Clinical Assistant Professor of Addiction Medicine at Stanford University and Senior Vice President of Addiction Medicine and Behavioral Sciences at Lucid Lane, tells WebMD Connect to Care. "In regards to the ranges of BAC that correlate with certain clinical signs of intoxication, this can be divided in several different ways. However, for people who use alcohol heavily and regularly, blood alcohol concentration does not correlate well with the severity of intoxication,” Raheemullah says. 

Therefore, the above delineations willl typically not uniformly apply to those who have developed alcohol tolerance. The University of Toledo reports that those who have developed tolerance will require a higher BAC than nontolerant people in order to experience the same effects of drinking. This is because, with tolerance, your body has begun to suppress its normal reactions to toxins. However, this is by no means an incentive to develop tolerance. 

With tolerance, your body is incurring damage without your knowledge. Since you don't feel as drunk, you're less able to accurately assess your level of intoxication. Also, because you're less likely to vomit or pass out with tolerance, your body may reach higher and more toxic levels of BAC. And perhaps most importantly, tolerance is a sign of alcohol use disorder, which can have serious and even life-ending effects. 

What About Alcohol Poisoning Symptoms the Next Day?

American Addiction Centers notes that the amount of alcohol it takes for a person to overdose varies because of things like the amount ingested over time, age, and weight--as well as the potential development of tolerance. The presence or absence of alcohol poisoning symptoms on a day following drinking will therefore vary. 

It's also important to note that binge-drinking is a major cause of alcohol poisioning. Sparrow Health Systems describes binge drinking as four or more drinks in a two hour period for a woman, or five or more drinks in this same time frame for men. Importantly, this kind of drinking may occur over a number of hours or a number of days--which is another factor to consider while evaluating next-day symptoms.

Aperson with alcohol poisoning may exhibit life-threatening symptoms that could include:

  • Confusion
  • Unconsciousness
  • Seizures
  • Vomiting
  • Slowed breathing
  • Sweaty skin
  • Lowered bodily temperature
  • Poor coordination
  • Incontinence

These symptoms can occur on the day of, or days during, a binge-drinking episode. Alcohol poisoning is a life-threatening condition and should be treated as an emergency. Letting the person “sleep it off” can lead to that individual falling into a coma, or dying, as Sparrow Health systems details under the myths of treating symptoms of alcohol toxicity.

Hangover symptoms, on the other hand, are different from alcohol poisoning. Mayo Clinic has compared each symptoms of alcohol poisoning versus a hangover, emphasizing that alcohol poisoning is more severe. Hangovers occur as your BAC drops to zero, and they disappear over time, with most hangovers receding after a maximum of 24 hours. The difference is in the BAC. With a hangover, your body is near or at a zero BAC and continues to drop. With alcohol poisoning, your BAC continues to rise as your body gets overwhelmed with alcohol. Alcohol is still being released into the blood from your stomach and gut.

Getting Help

If you notice someone is stumbling or confused while drinking, it’s best to watch over them while keeping them away from alcohol. “The first thing to do is to make sure no further alcohol is consumed. The person should never be left alone,” Dr. Gallus says.

The person should also be kept away from hazards like cars, bicycles, bodies of water and machinery. It’s also important to watch their breathing and to make sure they don’t lie down. “Protect their airway at all costs either by having them sit up, or if unable to do so by laying them on their side to protect them from aspiration,” Dr. Gallus says.

Home remedies like coffee or cold showers do not work when a person is already exhibiting signs of alcohol poisoning, according to University of Virginia Health. It’s also dangerous to assume the person can sleep it off, as blood alcohol levels continue rising during sleep. Also, sleeping increases the chance of choking on vomit.

“Even seasoned emergency medicine physicians can find this clinical situation challenging,” Dr. Gallus says. “Call early before the person becomes unconscious, because it may already be a life-threatening situation at this point.”

It’s best to stay with the person and keep them sitting up until help arrives. By heeding the signs and calling for help as soon as possible, you could be saving a life.

Don’t Wait. Get Help Now.

If you or a loved one are struggling with addiction, WebMD Connect to Care Advisors are standing by to help.




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