Here's something you probably already know but bears repeating: Alcohol is a drug—and while it's available pretty much everywhere and can be totally fine in moderation, too much of it can cause some serious damage to your body.
Case in point: alcohol poisoning. According to the most recent data, about six people die of alcohol poisoning each day in the United States, per the Centers for Disease Control and Prevention, most of whom are men (30 percent of all alcohol poisoning deaths are also related to alcoholism). So knowing the signs and symptoms of what alcohol poisoning looks like is important—not just for your own wellbeing, but also for that of anyone else around you who also happens to be drinking.
To understand exactly what alcohol poisoning looks like, Health spoke with a medical expert to learn how to tell if someone is suffering from alcohol poisoning—and what to do about it.
First things first: What exactly is alcohol poisoning?
Essentially, alcohol poisoning is an overdose on alcohol, says Peter Shearer, MD, an emergency room physician at Mount Sinai Brooklyn. It can typically happen when someone drinks too much, too quickly, which may also be referred to as binge drinking or extreme binge drinking, per the National Institute on Alcohol Abuse and Alcoholism (NIAAA). (FYI: Binge drinking is classified as having four or more drinks for women and five or more drinks for men in a short period of time.)
Something to keep in mind, though: Alcohol poisoning is not the same thing as being intoxicated. Dr. Shearer recommends thinking about the condition as a point on a spectrum. Mild intoxication is on one end, and alcohol poisoning is on the opposite end. While, over time, intoxication itself can cause a variety of health problems such as liver and heart trouble, it’s not the same as alcohol poisoning, which is technically “when you’ve surpassed your body’s ability to metabolize the alcohol,” Dr. Shearer explains.
“When you get alcohol in your blood, it passes through the liver, and the liver breaks it down,” George Koob, PhD, director of the NIAAA, previously told Health. "An alcohol overdose occurs when there is so much alcohol in the bloodstream that areas of the brain controlling basic life-support functions—such as breathing, heart rate, and temperature control—begin to shut down," per the NIAAA.
What are the symptoms of alcohol poisoning?
Here's the thing: While alcohol intoxication and alcohol poisoning are not the same thing, their symptoms can mimic each other, says Dr. Shearer. For that reason, it can be hard to determine how serious one's condition is.
Still, telltale symptoms of alcohol poisoning include lack of coordination, dizziness, nausea, and an unsteady gait, says Dr. Shearer, along with more serious symptoms like seizures, slow heart rate, and no gag reflex, per the NIAAA—and overall, alcohol poisoning can lead to brain damage or death.
A few symptoms to pay close attention to are vomiting and unconsciousness—that's what makes alcohol poisoning particularly dangerous. “If they’re unconscious and vomiting, that puts them at risk for aspirating, inhaling the vomiting substance,” says Dr. Shearer, which can lead to choking or even pneumonia or a lung infection.
For this reason, it’s important for people with alcohol poisoning to be positioned correctly: positioned on their side, not faceup or facedown. (FYI: If you or a friend are able to get yourself up and to the bathroom to vomit, you might not need to rush to the hospital for medical assistance, says Dr. Shearer.)
So how is alcohol poisoning treated?
Unfortunately, “doctors can’t magically get the alcohol out of your system," says Dr. Shearer. "They can observe you [and] help keep you well positioned,” but there’s no magical drug that can make the alcohol poisoning your body simply disappear.
That means the misconception that hydration can make alcohol poisoning run its course a little faster is just that. “A common myth [is that] getting rehydrated is going to help you—but [it] doesn’t really push the alcohol any faster.” Dr. Shearer says that if you suspect a friend is experiencing alcohol poisoning you shouldn’t necessarily push water on them. “[I] wouldn’t try and force someone to hydrate if they’re not awake and alert. That will increase their risk of aspirating.”
And as far as stomach pumping goes (in which the contents of a person's stomach are medically cleaned out), that's not necessarily done anymore either, says Dr. Shearer. “Alcohol passes out of your stomach fairly quickly [so] usually we don’t do that.” But it's still crucial to seek medical help for yourself or your friend if you suspect either are at risk of suffering from alcohol poisoning. The importance of staying in a safe position cannot be understated for someone who might be drifting in and out of consciousness for a long time.
What should you keep in mind if you are with someone who has alcohol poisoning?
Aside from calling emergency personnel for help when you think something’s off and making sure the person is positioned on their side, you should consider the possibility that sexual assault was involved, Dr. Shearer says. “If you come back and your roommate was unconscious in bed or on the sofa, you might be concerned of other trauma. Probably the main thing used to facilitate a rape is alcohol. Maintain some suspicion about that,” he adds.
Additionally, you should keep in mind that if someone has passed out after a night of drinking, it could be due to a medical condition that isn't alcohol poisoning. You probably can't be 100% sure they're ill because of alcohol poisoning, so if you see someone unconscious you shouldn’t automatically assume it’s because of the amount of alcohol they’ve consumed. That's just another reason to seek assistance immediately so the person can get the help they need.