Alcohol poisoning

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

In alcohol poisoning (alcohol intoxication), brain functions are disturbed by an overdose of alcohol. This leads to the typical signs of alcohol intoxication such as balance disorders, nausea and vomiting as well as disorders of consciousness. Severe alcohol poisoning can also have long-term health consequences. Read more about the topic here: From how much per mille is there a risk of alcohol poisoning? What are the possible symptoms? What does the doctor?

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. F10T51

Brief overview

What to do in case of alcohol poisoning Affected people who are conscious: make them drink plenty of water, lie down soft and stable, warm, check breathing regularly. Unconscious patients: place them on their side, warm them, call an emergency doctor.
Alcohol poisoning - risks: hypothermia, organ damage / failure, respiratory and / or cardiovascular arrest
What does the doctor? Depending on the severity of the alcohol intoxication, give fluids by infusion, monitor vital functions (heartbeat, breathing, etc.), dialysis or ventilation if necessary

Caution!

In small amounts, alcohol only has a selective effect on the regions of the brain that control our emotions. In higher doses, however, it paralyzes the entire central nervous system.
In addition to drinkable alcohol (ethanol), many alcoholic beverages also contain “fusel alcohols” such as isopropanol and methanol. In higher doses they can be harmful to health and increase the intoxicating effect.

Alcohol poisoning: symptoms

There are smooth transitions between a slight swipe and a solid alcohol intoxication. The symptoms that occur change with increasing alcohol consumption - more quickly in some people, more slowly in others (see below: Causes and risk factors):

A slight intoxication with alcohol ("Schwips") often feels pleasant, at least initially. The head is light, you feel relaxed, a warm feeling spreads in the body.

If you continue to drink, changes in personality and behavior occur: some people become euphoric, others sad, others again aggressive or very clingy. There is also an increasingly slurred pronunciation (slurping). In addition, the drunk is increasingly insecure on his feet: Standing and walking (staggering!) No longer work so well because the sense of balance is impaired.

Problems with orientation and a reduced ability to react also accompany the increasing alcohol intoxication. Nausea and vomiting soon set in.

If alcohol intoxication progresses, symptoms such as disorders of the thinking functions, perception and consciousness occur. For example, the cold is no longer perceived and the drunk can hardly be addressed. He may eventually pass out and even fall into a coma (alcoholic coma). Then breathing may stop! But there is also a danger to life because protective reflexes such as the cough reflex fail in severe alcohol intoxication. Then vomit can get into the airways - there is a risk of suffocation!

In the event of severe alcohol intoxication, the entire cardiovascular system can ultimately collapse. Without quick help, alcohol poisoning then leads to death.

It is not only bad when you are full of intoxication, but usually afterwards as well. For example, after alcohol poisoning, symptoms may include headache, nausea, and a general feeling of weakness.

Stages of alcohol intoxication

Doctors differentiate between the following stages of alcohol intoxication:

Excitation stage (1 - 2 per thousand in the blood): low levels of drunkenness, slight gait disorder, feeling of relaxation, carelessness and disinhibition, talkativeness, overestimation of oneself, imprecise reactions etc.
Hypnosis stage (2 - 2.5 per thousand): The drunk tends to sleep, but can still be woken up. In addition, severe balance disorders when walking, slowed perception, slowed thinking, clear and often aggressive mood, etc.
Stage of anesthesia (2.5 - 4 per thousand): deep unconsciousness, reflexes fail, reduced sensitivity to pain, muscle relaxation, shock, etc.
Asphyxia stage (> 4 per thousand in the blood): circulatory and / or respiratory disorders, rapid cooling in the cold (risk of frostbite), possible death.

Alcohol poisoning: what to do?

There are no home remedies or an antidote to alcohol or an alcohol intoxication. Fresh air, a cold shower or a painful stimulus (e.g. a juicy slap in the face) can make the person concerned appear more alert again for a short time. However, such measures have no influence on the effect of the alcohol.

If you suspect or see signs of alcohol poisoning in someone, the first thing you should do is check their consciousness: speak to them or shake them gently. Also check to see if the person concerned has a head injury that may have caused the symptoms.

The next steps in first aid for alcohol poisoning depend on whether the person is conscious or not:

Conscious Drunk:

Stop drinking alcohol: Make sure the drunk does not drink any more alcohol.
Vomiting: Vomiting (also deliberately induced) removes residual amounts of alcohol from the stomach.
Plenty of water: If the person can hold any fluids, give them plenty of water to drink.
Rest and sleep: Sleeping off the intoxication usually brings drunks back (slowly) on their feet. Cover it with a cover to prevent it from cooling down.

In the case of mild alcohol poisoning, "treatment" at home is possible. In most cases, the intoxication can be "slept off" without medical assistance. Nevertheless, you should not leave the person affected alone for the duration of the symptoms of poisoning.

Unconscious drunk:

Stable lateral position: If someone with severe alcohol intoxication is unconscious, you should immediately place them in the stable lateral position with their head overstretched. This prevents vomit from getting into the windpipe.
Warming: Alcohol practically overrides the control mechanism for maintaining core body temperature. Therefore, keep the unconscious person warm (e.g. with a blanket).
Call an ambulance: alert the ambulance and stay with the drunk until he arrives.
If necessary, resuscitation: Until the rescue service arrives, check regularly whether the unconscious person is still breathing. If breathing stops, you must start resuscitation immediately!

If drunk people behave aggressively or self-harming, you should call the police without hesitation!

Alcohol poisoning: causes and risk factors

The extent of alcohol intoxication does not always correlate with the amount of alcohol consumed. Because the severity of the symptoms of alcohol poisoning and their duration depend on the one hand on the physical condition of the person concerned at the time of alcohol consumption (fluid and food intake in the hours before, rest, underlying illnesses, etc.). On the other hand, it plays a role what physique the person concerned has (e.g. very tall, athletic, thin), how old he is and how accustomed he is to alcohol consumption.

For example, people who consume alcohol often show fewer symptoms than those who hardly or rarely drink alcohol. Lightweight people (such as children and teenagers) are more prone to alcohol poisoning. People with brain damage (due to illness, for example) also have an increased risk of alcohol poisoning after even very small amounts of alcohol.

What happens in the body

The liver breaks down the alcohol in the blood. However, their mining capacities are limited. If they are exceeded, ethanol, lint, but also toxic breakdown products accumulate in the blood. Ethanol changes the structure of nerve cells so that they no longer function properly or destroy themselves. The typical symptoms of drunkenness - up to alcohol poisoning - occur.

Danger from alcohol and heavy drinking

Alcohol poisoning can occur particularly easily if someone drinks hard liquor (such as vodka). Even with a relatively small number of glasses, high amounts of alcohol come together. For comparison: a bottle of vodka (750 ml) contains as much pure alcohol as six liters of beer.

Binge drinking is also dangerous, ie consuming large amounts of alcohol within a short period of time. Alcohol poisoning can quickly occur, especially when binge drinking with hard liquor. The liver then has to deal with a large dose of alcohol all at once. The first slight signs of alcohol poisoning are usually absent. Instead, severe poisoning occurs suddenly and directly.

Alcohol poisoning: examinations and diagnosis

First, the doctor tries to obtain important background information (anamnesis) in a short conversation. If you can no longer talk properly to the drunk, the doctor will turn to other people present (relatives, friends, etc.).

This is followed by a physical exam. This allows the doctor to assess the severity of alcohol poisoning.

He then measures the person's blood sugar level. Symptoms similar to those of alcohol poisoning can occur, especially in diabetics whose blood sugar level is too low.

Blood work and drug screening

In the hospital, the doctors also measure the alcohol concentration in the blood of the drunkard. In chronic alcoholics in particular, you must also determine additional blood values, as concomitant diseases can lead to complications.

Since the affected person could knowingly or unknowingly also have taken other drugs, the doctor also carries out a so-called “drug screening”. For therapy, it is important to know whether other substances caused the poisoning or worsened the symptoms.

What the doctor should also consider: In some cases, the symptoms of alcohol withdrawal syndrome are similar to those of alcohol intoxication.

Alcohol poisoning: treatment by the doctor

In the case of alcohol intoxication, the doctor tries to alleviate the symptoms and prevent complications. In addition, the patient must not have any possibility of endangering himself. In individual cases, the treatment is based on the type and extent of the symptoms of alcohol intoxication.

First of all, the person concerned receives fluid through a venous access. Most of the time, the drunkard is allowed to “sleep in” under observation - with continuous monitoring of cardiac function, oxygen saturation, blood pressure and blood sugar. Severe alcohol poisoning requires monitoring in an intensive care unit. If kidney failure is imminent, dialysis is usually necessary; if breathing has stopped, ventilation is necessary.

If the drunk is very excited or aggressive, the doctor will usually give you a calming drug. In exceptional cases, those affected are restrained for their own protection.

Alcohol poisoning with poisonous alcohols such as methanol or isopropanol must usually be treated with medication.

Alcohol poisoning: consequences

As a rule, mild alcohol poisoning heals without any consequences. However, repeated or severe alcohol intoxication can damage the brain, liver and kidneys. In particularly severe cases, alcohol poisoning is fatal.

Pregnant women should definitely refrain from any alcohol (even in small amounts), as it can profoundly disrupt the development of the child.

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