man on the floor with alcohol bottles

Blackouts and Alcohol Poisoning

Although many people enjoy moderate drinking, defined as one drink per day for women or two for men, drinking excessively can lead to many consequences including overdose. Binge drinking is a common practice in the U.S., with one in six adults consuming about eight drinks per binge episode. Approximately 92% of U.S. adults who drink excessively reported binge drinking in the past 30 days.1 In 2013, the National Survey on Drug Use and Health reported that 14% of youth ages 12 to 20 binge drank in the past 30 days.2 Older people also reported binge drinking, and more frequently than younger individuals, with five to six episodes per month.1

The Repercussions of Binge Drinking in Youth

In general, youth who binge drink are at far greater risk of serious problems than peers who do not engage in this dangerous behavior. A study published in 2007 found that 45% of high school students reported drinking alcohol during the past 30 days, and of those, 29% binge drank. Binge-drinking rates were similar among boys and girls and increased with age and school grade. Students who binge drank were more likely than both nondrinkers and moderate drinkers to experience poor school performance and engage in risky health behaviors such as riding with a drunk driver, being sexually active, smoking tobacco, being a victim of date-related violence, attempting suicide and using illicit drugs. Researchers discovered a solid relationship between the frequency of binge drinking and the prevalence of all other risky health behaviors.3

The Health Risks of Binge Drinking

There are many health-related risks associated with excessive alcohol intake, some of which are immediate and others that are long term. Binge drinking can cause unintentional injuries (e.g. vehicular accidents, falls, burns and drowning); intentional injuries (e.g. firearm injuries, sexual assault and domestic violence), alcohol poisoning and blackouts.1

What Is Alcohol Poisoning?

Some people continue to drink despite clear signs that they are significantly impaired. The liver can only process a limited amount of alcohol, which equates to about one unit of alcohol every hour.4 One unit of alcohol is measured as 10 ml of pure alcohol. This equals a single 25 ml measure of whisky, a third pint of beer or a 175 ml glass of red wine. An overdose or alcohol poisoning occurs when a person has a high-enough blood-alcohol content (BAC) to produce deficiencies that increase the risk of harm. When this happens, a person’s breathing, heart rate, and ability to control body temperature start to shut down.

“How long does alcohol poisoning last?” is a fairly common question. The answer is complex because age, gender, drinking experience, the amount of food eaten and ethnicity are factors that influence at what point a person incurs alcohol poisoning and how long it lasts.4 Most professionals state that the overdose period can last several hours, although death can be near immediate and damage can last a lifetime. Patients with self-inflicted alcohol poisoning often need hours of observation in emergency departments and are frequently hospitalized.5

Alcohol acts as a depressant, hindering signals in the brain that control automatic responses such as the gag reflex. A person with alcohol poisoning can pass out, choke on his or her vomit and die from asphyxiation. When drinkers survive, an alcohol overdose can lead to permanent brain damage.6 In the U.S., there are an estimated 50,000 cases of alcohol poisoning every year and about 52 alcohol overdose-related deaths annually.4 Research conducted in Norway uncovered 2,343 cases of acute poisoning from substance abuse, of which 55% or 1,291 were caused by alcohol.5

Signs of Alcohol Poisoning

  • Mental confusion
  • Stupor
  • Coma
  • Difficulty remaining conscious
  • Vomiting
  • Seizures
  • Slow breathing (fewer than eight breaths per minute)
  • Irregular breathing (10 seconds or more between breaths)
  • Slow heart rate
  • Clammy skin
  • Dulled responses (e.g. no gag reflex)
  • Hypothermia (low body temperature)
  • Bluish skin color or paleness5

If you suspect an individual has alcohol poisoning, there are important steps to follow that could make the difference between life and death.4

  • Never assume that the person is sleeping it off. Try to keep them awake.
  • Do not leave the individual alone.
  • Try to keep them in a sitting position, not lying down.
  • If they are able to drink liquids, give them water, but avoid coffee because it will worsen dehydration.
  • If the person is unconscious, put them in the recovery position and check to see if they are breathing. If breathing is slow or irregular, call 911 immediately.
  • Turn the person over so that they are on their side. This allows them to keep breathing and prevents the airway from being clogged with vomit.
  • Check the person’s skin temperature and body color. If they appear blue, pale, clammy and cold, call 911 immediately.

Any or all of these signs may indicate alcohol poisoning. If you cannot wake the individual, or have any concerns over what to do, call 911 without delay.

Alcohol Blackout Facts

There are key differences between blackouts and passing out from alcohol. For many years, the effects of alcohol were thought to inflict generalized depression of neural activity, resulting in global impairment of cognitive, psychological and behavioral brain functions. An alcoholic blackout was perceived as a severe manifestation of this effect. Blackouts are characterized by amnesia during episodes of intoxication in which the subject is conscious and able to carry on conversations or even drive a vehicle. This indicates that alcohol induces selective effects on specific brain systems.7 More recent research underscores the key role of the hippocampus in blackouts, the part of the brain responsible for forming new memories. When a person has a high BAC, this impairs the ability of the hippocampus to form new memories. Therefore blackouts do not result in forgetting what happened; moreso that the memories never existed in the first place.8

Passing out is a loss of consciousness and not being able to be awakened. Individuals with alcohol poisoning can pass out or experience a blackout. Both of these can result in negative consequences such as unintentional injuries, although blackouts are associated with long-term damage.8

Alcohol-induced blackouts are reported by approximately 50% of drinkers. A 2015 study on 1,402 teens in the U.K. (ages 15 to 19) found that 30% of 15-year-olds reported blacking out from excessive alcohol consumption, while 74% of 19-year-olds reported suffering a blackout.8 Blackouts were once associated with alcohol dependence or alcoholism, however, anyone who drinks too much, too fast may experience a blackout, which explains the high rate in teenagers. However, not all subjects who drink rapidly and excessively experience blackouts, suggesting that some people are more genetically predisposed to alcohol-induced memory impairment.7 The consequences of blackouts extend beyond those related to the drinking episode and include psychiatric symptoms and neurobiological abnormalities.8,9

Although it is evident blackouts are not limited to full-blown cases of alcoholism, a large majority of alcoholics experience blackouts during the early phases of addiction. Alcohol poisoning and blackouts have many dangerous implications. If you or someone you know has experienced an alcohol overdose and or a blackout, seek help before the problem turns into an addiction.

  1. Fact Sheets – Binge Drinking. Centers for Disease Control and Prevention website. http://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm Updated October 16, 2015. Accessed July 30, 2016.
  2. Fact Sheets – Underage Drinking. Centers for Disease Control and Prevention website. Updated http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm Updated November 12, 2015. Accessed July 30, 2016.
  3. Miller JW, Naimi TS, Brewer RD, Jones SE. Binge drinking and associated health risk behaviors among high school students. Pediatrics. 2007 Jan;119(1):76-85.
  4. What is alcohol poisoning? MedicalNewsToday website. http://www.medicalnewstoday.com/articles/215627.php Updated November 25, 2015. Accessed July 30, 2016.
  5. Vallersnes OM, Jacobsen D, Ekeberg Ø, Brekke M. Outpatient treatment of acute poisoning by substances of abuse: a prospective observational cohort study. Scand J Trauma Resusc Emerg Med. 2016;24:76. doi:10.1186/s13049-016-0268-6.
  6. Alcohol Overdose: The Dangers of Drinking Too Much. National Institute on Alcohol Abuse and Alcoholism website. http://pubs.niaaa.nih.gov/publications/AlcoholOverdoseFactsheet/Overdosefact.htm Published October 2015. Accessed July 30, 2016.
  7. Lee H, Roh S, Kim DJ. Alcohol-Induced Blackout. Int J Environ Res Public Health. 2009;6(11):2783-2792. doi:10.3390/ijerph6112783.
  8. Drinking Too Much Alcohol? Here’s What Happens When Heavy Drinkers Blackout. Medical News Today website. http://www.medicaldaily.com/black-out-heavy-drinkers-drinking-too-much-alcohol-383524 Published April 26, 2016. Accessed July 30, 2016.
  9. Wetherill RR, Fromme K. Alcohol-Induced Blackouts: A Review of Recent Clinical Research with Practical Implications and Recommendations for Future Studies. Alcohol Clin Exp Res. 2016 May;40(5):922-35. doi: 10.1111/acer.13051. Epub 2016 Apr 8.

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