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Alcohol Poisoning

Overview

Alcohol poisoning, also known as alcohol toxicity, can occur due to drinking too much alcohol in a short period. On a regular basis, your body can tolerate mild to moderate amounts of alcohol without serious side effects. But intake of a large amount of alcohol in a short period raises the level of alcohol in blood to a point where the body cannot metabolize it properly. Since alcohol is a depressant, an increased amount of this substance in the blood causes brain activity to decrease. This results in lower efficiency of other organs, leading to a severe life-threatening condition that requires emergency medical care.

Causes

The cause of alcohol poisoning is a large intake of alcohol within a very short period. This includes a high intake of beer, wine, vodka, whiskey, and other types. It can also occur if a child or adult accidentally ingests a product with a large amount of ethanol. Your liver normally metabolizes alcohol, and your body can manage well if taken in mild or moderate amounts. A high alcohol intake at once gives significantly less time to the liver to metabolize the excessive alcohol level in the bloodstream. As this intoxicated blood reaches your brain, it depresses the activity of potent neurotransmitters. The delayed activity by the brain lowers down the function of the rest of the organs as well, such as the heart, lungs, GIT, etc. This results in major symptoms of alcohol poisoning, which need to be addressed immediately.

Risk Factors And Epidemiology

Alcohol toxicity can occur in individuals if they consume more than a tolerable amount of alcohol. But certain risk factors can increase the tendency of developing this condition. One of the important factors is your mental health. People facing grief, sorrow, or traumas tend to drink larger amounts of alcohol as a way to cope with their depressed state. On the contrary, few people may consume too much alcohol during a celebratory event. The social environment and peer pressure also significantly affect your alcohol intake. Age, weight, gender, and liquor tolerance may also determine the level of alcohol you can withstand before it causes toxicity. If you have any existing liver disease such as hepatitis, cirrhosis, etc., it may also increase your risk of alcohol poisoning.
Alcohol poisoning is more frequently observed in people from 20 to 40 years old, although it may occur at any age. It is more common among males than females. Research indicates that alcohol poisoning has been observed higher among developed states such as the United States, United Kingdom, etc., than developing countries.

Signs And Symptoms

Signs and symptoms of alcohol poisoning depend on alcohol levels in your bloodstream. Blood-Alcohol Content (BAC) below 0.30% can cause symptoms like dizziness, instability, clumsiness, drowsiness, nausea, vomiting, and impaired decision making. Your system still tolerates these levels, and excess alcohol can be metabolized. If these levels rise above 0.30%, it depresses the central nervous system and reduces the activity of all other systems as well, which may lead to irregular breathing, low heart rate, low respiratory rate, hypothermia, bluish discoloration of the skin, extreme confusion, irregular bowel movement, urinary incontinence, and seizures. You may also experience difficulty in remaining conscious or completely unconscious. There is also a risk of choking on your vomit. Immediate medical attention is required if such symptoms are observed.

Diagnosis

The initial step towards a diagnosis of alcohol poisoning is obtaining a history of recent alcohol consumption and checking for all vital signs (blood pressure, pulse rate, temperature, and breathing rate). Low or irregular vital signs followed by excessive alcohol consumption are diagnostic of alcohol poisoning. Your doctor will require a blood-alcohol content (BAC) test and urinalysis to check the level of alcohol in your system. A high percentage of BAC over 0.30% can be identified as alcohol poisoning, although this may vary depending on age, weight, and other factors.

Differential Diagnosis

Alcohol poisoning needs to be differentiated from toxicity caused by overdosage of other drugs or other systemic conditions that may present with similar symptoms. These include barbiturate toxicity, severe hypoglycemia, diabetic ketoacidosis, benzodiazepine toxicity, hepatic encephalopathy, meningitis, encephalitis, etc.

Treatment

Acute alcohol poisoning requires emergency medical care in which the first step is to secure an open airway and prevent choking on vomit. This is done by lying the patient down on aside. If the airway is already blocked, it is necessary to remove any obstruction, and intubation may be done if the patient cannot breathe on their own. Oxygen therapy is given to stabilize the breathing rate. Intravenous fluids are given to restore sugar levels and prevent dehydration. Stomach pumping may be required in some cases via a tube to reduce the alcohol content in the stomach. In the case of children or adults with severe toxicity, hemodialysis is suggested to filter out excessive alcohol. After primary emergency care, it is essential to wait till the body metabolizes the rest of the alcohol until stable vital signs are achieved.

Medication

No particular medications are prescribed to treat alcohol poisoning. However, medicines may be given for symptomatic care, such as anti-emetic drugs for nausea and vomiting.

Prognosis

The prognosis of alcohol poisoning depends upon the severity of the condition and quick access to a medical emergency. Most cases recover well if they are given immediate medical attention once the symptoms appear. Severe alcohol poisoning can lead to coma or even death if the level of alcohol consumption is too high or the affected person didn’t receive emergency treatment.

Prevention

Alcohol poisoning can be prevented by drinking alcohol in moderate amounts. It is also important to avoid drinking on an empty stomach or if you have severe dehydration. Water intake should be assured after drinking to stabilize blood-alcohol levels. If you face a psychological issue, it is better to seek help from loved ones or professionals to avoid overdosing on alcohol as a coping mechanism. Social gatherings where a high amount of alcohol is consumed should be avoided in such a state or if you have an alcohol dependency.

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