When to Call 911: Do You Know the Signs of Alcohol Overdose?

Drinking too much alcohol and too quickly is dangerous. Consuming large amounts of alcohol can lead to significant impairments in motor coordination, decision-making, impulse control, and other functions, increasing the risk of harm and alcohol poisoning. Ignoring these symptoms and signs can lead to alcohol overdose.1 Abusing alcohol, in general, has certain short-term and long-term effects.

You may notice warning signs to determine if someone has crossed the line and is at risk for alcohol overdose. You can prevent this from happening by staying informed, looking out for the warning signs, and by calling 911 if needed. Additionally, alcohol overdose may indicate signs of Alcohol Use Disorder (AUD), and if so, treatment options are available.

In this article:

Alcohol Overdose (Alcohol Poisoning)

“Drinking by college students age 18-24 contributes to an estimated 1,400 student deaths, 500,000 injuries, and 70,000 cases of sexual assault or date rape each year.”2

People often wonder how alcohol poisoning occurs, but this may depend on several factors, such as how fast the liver can metabolize the alcohol.3 Once ingested, alcohol enters the stomach and small intestine, where it is then carried to the bloodstream via the blood vessels.3 The initial euphoria one experiences from the alcoholic “high” is a result of the alcohol crossing the blood-brain barrier and the corresponding surge of dopamine released in the brain reward/reinforcement pathways.

If you or someone you know has an alcohol addiction, call 800-839-1686Who Answers? to speak to a treatment specialist and get help before it’s too late.

Blood Alcohol Content

The rate at which alcohol leaves the system depends on the concentration of alcohol in the body. The blood alcohol concentration is determined by the amount of alcohol consumed, by the presence or absence of food in the stomach, and the rate of alcohol oxidation.4 Also, the higher the concentration of alcohol, the more rapid the absorption rate.4

In other words, the more alcohol in your system, the harder the body works to get rid of it to prevent alcohol poisoning. Alcohol is metabolized by the liver, whose main job is to detoxify chemicals and metabolize drugs. If you have consumed food before drinking, this will reduce the absorption of the alcohol and prevent overdosing on alcohol and other harmful effects.

According to Brown University, “Peak Blood Alcohol Content (BAC) could be as much as 3 times higher in someone with an empty stomach than in someone who has eaten a meal before drinking.”5 This is why you sometimes hear about people trying to “sober up quickly” by eating food.

Who Is At Risk of Alcohol Poisoning?

Alcohol metabolizes mostly in the liver. Multiple organ systems, such as the stomach and immune system, interact with the liver cells so alcohol metabolism varies according to the resiliency or lack of resiliency in each person’s physiology.3,4 Additionally, certain personal attributes may also affect alcohol metabolism and the likelihood of alcohol poisoning or alcohol overdose.6

Factors that contribute to the likelihood of alcohol poisoning/overdose may include:3,4,6

Signs and Symptoms of Alcohol Overdose

The following warning signs can indicate alcohol overdose:1

  • Mental confusion, stupor
  • Difficulty remaining conscious, or inability to wake up
  • Vomiting
  • Seizures
  • Slow breathing (fewer than 8 breaths per minute)
  • Irregular breathing (10 seconds or more between breaths)
  • Slow heart rate
  • Clammy skin
  • Dulled responses, such as no gag reflex (which prevents choking)
  • Extremely low body temperature, bluish skin color, or paleness

Alcohol overdose occurs if you have so much alcohol in the bloodstream that basic life functions—such as breathing, heart rate, and body temperature regulation—begin to shut down.1

Serious long-term conditions such as “wet brain,” where your brain cannot function normally due to the high amounts of alcohol, can occur. Chronic alcohol misuse can negatively affect your:

  • Coordination
  • Movement
  • Memory
  • Ability

If left untreated, the brain damage can be irreversible. If you see someone exhibiting overdose symptoms, get help immediately. You can decrease the risk of an alcohol overdose by getting help for an addiction. Call 800-839-1686Who Answers? to speak to a rehab specialist about your options.

How Binge Drinking Leads to Alcohol Overdose

Alcohol overdose happens frequently with binge drinking. In fact, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 13% of the U.S. population has participated in binge drinking on at least one occasion.7

Social and problem drinking is not uncommon, especially among young adults, and can often lead to dangerous outcomes. Often, innocent partying and fun on social occasions can get out of hand, leading to deadly outcomes and alcohol overdose. Parents need to be especially mindful of drinking behavior in teenagers, who are often susceptible to peer pressure.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), “19% of college students between the ages of 18 and 24 met the criteria for alcohol misuse or dependence.”8

In addition to possibly leading to alcohol poisoning, while binge drinking you can choke on your own vomit after passing out due to high alcohol intoxication. College binge drinking can also cause a host of interpersonal problems, affecting relationships as well.9,10

If you are a chronic binge drinker and feel like alcohol is taking over your life, call 800-839-1686Who Answers? to discuss your rehab options.

Mixing Alcohol and Drugs

Combining alcohol with other illicit drugs can increase the chances of overdose as well. Often, a person will mix depressants, like alcohol, with stimulants, such as cocaine, meth, etc., as a pick-me-up. Misusing prescription stimulants, such as Adderall, also increases the risk of overdose.

Ingesting alcohol and other drugs together intensifies their individual effects and could produce an overdose with even moderate amounts of alcohol.1 What results is a lethal cocktail.

Alcohol Overdose Treatment

Alcohol overdose is a serious issue and may lead to death if not treated. If you suspect that someone has an alcohol overdose, call 911 for help immediately. Do not wait for the person to have all the symptoms, and be aware that a person who has passed out can die. Don’t try to remedy the situation yourself; cold showers and coffee may not be enough to revive someone in extreme cases.

How to Help Someone Who Has Overdosed on Alcohol

Alcohol overdose is a serious, life-threatening issue. Here’s what you can do if you believe someone has overdosed on alcohol.1

  • Call 911.
  • Do not play doctor and attempt to sober up the individual yourself.
  • While waiting for help to arrive, be prepared to provide information to the responders, including the type and amount of alcohol the person drank; other drugs they took, if known; and any health information that you know about the person, such as medications they’re currently taking, allergies to medications, and any existing health conditions.
  • Do not leave an intoxicated person alone, as they are at risk of getting injured from falling or choking. Keep the person on the ground in a sitting or partially upright position rather than in a chair.
  • Help a person who is vomiting by having him or her lean forward to prevent choking. If a person is unconscious or lying down, roll them onto one side with an ear toward the ground to prevent choking.

Alcohol Use Disorder

Problem or binge drinking that worsens is known as alcohol use disorder (AUD). According to NIAAA, AUD is characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using.11 Binge drinking caught early enough can prevent full-blown AUD and the risk of death from alcohol overdose.

Here are some warning signs to assess if you may have AUD:

  • Drinking more, or longer, than you had planned
  • Trying to cut back or stop more than once and couldn’t
  • Spending a lot of time drinking, being sick, or hung-over
  • Obsessively thinking about drinking or wanting alcohol so badly you can’t focus
  • Having problems with work, school, or family because of your habit (or because you’re sick from drinking)
  • Drinking even though it has caused problems for you or in your relationships
  • Quitting other activities that were important to you in order to drink
  • Finding yourself in situations while drinking or afterward that put you in danger
  • Drinking alcohol even though it made you depressed or anxious, hurt your health, or led to a blackout
  • Having to drink more than you used to for the same effect
  • Experiencing withdrawal symptoms when the buzz wore off, like trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, a seizure, or hallucinations11

Two or three of the above symptoms in the past year indicate a mild AUD. It’s a moderate disorder if you’ve had four to five. Six or more of these symptoms categorizes severe AUD.11

Several evidence-based treatment approaches are available for AUD. One size does not fit all—a treatment approach that may work for one person may not work for another. Treatment can be outpatient and/or inpatient and may include special programs, CBT, support groups, therapy, family groups, and alternative approaches (yoga, meditation, Tai Chi, etc.).

If you or a loved one is experiencing symptoms of alcohol overdose, call 911 immediately. If you are concerned about your drinking habits and want information on treatment for AUD, you can call our support line at 800-839-1686Who Answers?. Our trained specialists are here to support you 24/7.


  1. National Institute on Alcohol Abuse and Alcoholism. Understanding the dangers of alcohol overdose.
  2. National Institute on Alcohol Abuse and Alcoholism. (2002). College drinking hazardous to campus communities task force calls for research-based prevention programs.
  3. (2015). Alcohol and your body.
  4. Cedarbaum, A. (2012). Alcohol metabolism. Clinical Liver Disorders, 16(4): 667-685.
  5. Nagy, L. (2004). Molecular aspects of alcohol metabolism: Transcription factors involved in early ethanol-induced liver injury. Annual Review of Nutrition, 24: 55-78.
  6. Edenberg, H. (2007). The genetics of alcohol metabolism: Role of alcohol dehydrogenase and aldehyde dehydrogenase variants. Alcohol Research & Health, 30(1): 5-13.
  7. National Institute on Alcohol Abuse and Alcoholism. (2017). Study finds tens of millions of Americans drink alcohol at dangerously high levels
  8. National Institute on Alcohol Abuse and Alcoholism. (2015). College Drinking.
  9. Turrisi, R., Mallett, K., Mastroleo, N. (2006). Heavy drinking in college students: Who is at risk and what is done about it? Journal of General Psychology, 133(4): 401-420.
  10. Weitzman, E., Nelson, T., & Wechsler, H. (2003). Taking up binge drinking in college: The influences of person, social group, and environment. Journal of Adolescent Health, 32: 26-35.
  11. National Institute on Alcohol Abuse and Alcoholism. Alcohol Use Disorder.

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