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Health Answers

How do you know if someone might have alcohol poisoning or just be really drunk?

By Courtney Humphries
February 28, 2011

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Q. How do you know if someone might have alcohol poisoning or just be really drunk?

A. Christopher Rosenbaum, an emergency medicine physician and toxicologist at UMass Memorial Medical Center, says that the best way to understand alcohol toxicity and poisoning is to realize that alcohol acts as a sedative. At smaller exposures, it begins to lower your inhibitions. At more moderate levels, you start to lose coordination, your speech slurs, and you’re not able to perform tasks or process thoughts as quickly. With very high exposures, alcohol can affect you in the same way heavy anesthesia does, suppressing even basic functions like breathing, heart rate, and gag reflex.

Alcohol poisoning represents the extreme end of this spectrum. “You can get so sedated that you’ve basically taken away your vital ability to keep yourself breathing,’’ Rosenbaum says. When you go under general anesthesia, a ventilator can keep you breathing. Without this type of support, people with severe alcohol poisoning can die — most commonly by vomiting into their own mouths and suffocating.

How do you know if someone is in danger? One critical sign is if someone has already passed out and can’t be roused. “If you can’t wake them up, if they’re not responding to you, then they need to be brought to medical care,’’ Rosenbaum says. For someone who seems severely drunk, Rosenbaum says there’s no way to know for sure whether they’re in danger — seeking help is a judgment call. “If you’re concerned enough to ask the question, it’s a good use of a 911 call,’’ he says. Use the person’s condition as a guide, not how much they drank; the same amount of alcohol can be dangerous for different people, depending on sex, weight, genetic factors, and interactions with other medications.

Correction: Because of a reporting error, the UMass Memorial Medical Center was incorrectly identified in this “Health Answers” column.