Alcohol Poisoning: Causes, Symptoms, Diagnosis, and Treatment

Alcohol poisoning is a medical emergency that occurs mainly because of the intake of excess alcohol within a short period of time. The symptoms vary depending on the amount of intake and the time of intake. Alcohol belongs to the inebriant group of the neurotic class of poisons which intoxicate the individual and produce the symptoms of excitement and narcosis.

Alcohol poisoning can be produced by various types of alcohol such as ethanol, methanol, isopropanol, and ethylene glycol. These alcohols inhibit mitochondrial respiration and cause acid accumulation in the body that leads to circulatory failure and decreased oxygen supply to the tissues presenting with symptoms of toxicity

Alcohol can be consumed by various routes such as topical, inhalational, intravenous, and oral routes. It is an emergency condition and should be treated as early as possible to prevent life-threatening complications. Measures should be taken at home as well as at the hospital.

Alcohol Poisoning: Causes

Alcohol poisoning is caused because of the excess consumption of alcohol in a shorter duration of time

  • The amount of alcohol intake required to cause poisoning is not given exactly it varies from person to person. It is shown that a blood alcohol concentration of more than 350mg% is the fatal dose. The fatal dose is less in the case of thinner individuals, females, mentally unstable individuals, persons suffering from liver diseases, epilepsy, and cerebral trauma, and patients using some the drugs such as histamines, tranquilizers, and hypnotics. The fatal dose is more in individuals having high alcohol intolerance

  • The effects of alcohol poisoning depend on the blood concentration of alcohol, the presence or absence of food, the status of the stomach and its rate of emptying, tolerance to the alcohol, and the rate and quantity of the alcohol consumed.

Alcohol Poisoning: Symptoms

Alcohol poisoning affects the heart, CNS, respiratory system, gastrointestinal system, urinary tract, and reproductive system. The symptoms of alcohol poisoning present in various stages of intoxication depending on the individual status and amount of alcohol consumed.

The 3 stages of alcohol poisoning are discussed below.

Stage of Excitement

In this stage, the patient presents with the;

  • Increases talking

  • Increased self-confidence

  • Decreased sensations

  • Loss of balancing and motor activities

  • Decreased thought processing

  • Increased sexual desires

Stage of Coordination

In this stage, the patient presents with;

  • In coordination of thoughts, and speech, an individual is not able to make proper decisions, slurring of speech and altered walking

  • Nausea and vomiting

  • Pupils are dilated

Stage of Narcosis

In this stage, the patient presents with;

  • Deep sleep

  • Increased heart rate and decreased body temperature

  • Breathing is shallow

  • Patients can go into a coma and death can occur

Alcohol Poisoning: Risk Factors

Any individual habituated with alcohol intake and consuming excess alcohol in a short duration of time can develop alcohol poisoning, but some individuals can get affected early compared to others because of the various risk factors which include −

  • Body weight - Thinner and lean persons are at increased risk

  • Health status of the individual   a person suffering from any liver disease as in them metabolism of alcohol is delayed because of the abnormal functioning of the liver

  • Empty stomach  Eating food before drinking alcohol is always better as the food delays the absorption of alcohol

  • Alcohol taken with patients taking medications like tranquilizers, histamines, and hypnotics

  • Percentage of alcohol in the drinks: alcohol drinks with a higher percentage of alcohol increase the blood alcohol concentration

  • Rate and quantity of alcohol consumption

  • Alcohol tolerance

  • Sex − Females more than males

  • Individuals suffering from mental disorders, epilepsy, and cerebral trauma

  • Drinking at an early age

Alcohol Poisoning: Diagnosis

The diagnosis of alcohol poisoning is done based on the history of alcohol intake just before the presentation and the clinical presentation. Some of the tests done are;

  • Blood test − To measure the amount of blood alcohol concentration

  • Breath analyzer − This measures the amount of alcohol concentration in the pulmonary artery

  • Infrared breath test − it uses infrared rays to measure the amount of alcohol

  • Fuel cell breath test

Some of the clinical tests are done, that include −

  • Horizontal gaze nystagmus − Repetitive toandpro movements of the eyes when the person is asked to see on the side

  • Walk and turn − In this, the individual is asked to walk in a straight line placing one foot in front of the other with the heel of one foot touching the toes of the other. After the 9 steps, the person is asked to turn around and return back in the same manner. This is abnormal in patients who have consumed alcohol

  • One leg stand test − In this, the individual is asked to raise either leg about 6 inches above the ground

Alcohol Poisoning: Treatment

Immediate measures to be taken at home, include the folliwng −

  • Stop the patient to drink more alcohol

  • Do not allow the person to sleep, should be awake

  • Should keep the person in a slightly bent forward position do not allow to be in a sleeping position

  • keep the patient warm no cold-water shower should be given

Hospital management includes −

  • Gastric lavage is done to prevent the further absorption of the already-consumed alcohol

  • Maintain airway

  • Electrolyte correction

  • A urinary catheter should be put

  • Intravenous hypertonic glucose solution and vitamins to prevent further complications

  • Dialysis should be done when required

Alcohol Poisoning: Prevention

Prevention of alcohol poisoning can be done by following some of the measures which include −

  • Drinking alcohol in a limited amount: drinking a large amount in a short time should be avoided, and alcohol should be taken in sips

  • Alcohol should be avoided taking on an empty stomach

  • Should not be taken with any other drugs

  • Plenty of water should be taken along with alcohol

  • Person suffering from other health issues should avoid taking alcohol


Alcohol poisoning is an emergency condition that occurs after the excess consumption of alcohol in a shorter duration of time. The type of alcohol the individual health status and several factors contribute to the amount of toxicity. The patient presents with nausea vomiting, altered speech, loss of balance, and in severe conditions the patient can go into a coma and which can lead to death.

Alcohol poisoning is a fatal situation and hence should be treated immediately. The patient should be taken to the hospital once there is any suspicion of alcohol poisoning. Do not allow the patient to sleep, if a person is unconscious then should be turned on the side to prevent choking, keep them warm, and in the hospital should be treated with gastric lavage, IV fluids, vitamins, hypertonic glucose, and electrolyte correction should be done.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha