Alcoholism Sourcebook, 6th Ed.

By Omnigraphics

Consumer health information about alcohol abuse, addiction, and related health effects, with facts about treatment and recovery. Includes index, glossary of related terms, and other resources.

• Language: English
• Publisher: Omnigraphics
• Release date: Sep 1, 2021
• ISBN: 9780780819184

Book preview

Preface

About This Book

Alcoholism is a specific type of addiction and alcohol is considered to be the most commonly used substance in the United States. Various researches show that American alcohol-use habits can be unhealthy and most people in the United States consider alcohol consumption as a coping mechanism that can turn into disorder over time. According to the 2019 statistics provided by the National Survey on Drug Use and Health (NSDUH), it is reported that about 85.6 percent of people aged 18 and over have consumed alcohol at some point in their lifetime. The statistics also show that about 15 million people aged 12 and older are affected by alcohol-use disorder (AUD).

Alcoholism Sourcebook, Sixth Edition provides detailed information about alcoholism, its consequences, physical effects, treatment, and recovery. It explains the psychosocial factors in alcoholism, binge drinking, underage drinking, and the physical effects of alcohol abuse such as cardiovascular disease (CVD), neuropathy, alcohol-induced liver diseases and organ injury. It also explains blood alcohol concentration (BAC), and other diseases such as cancer, diabetes, and sleep difficulties associated with alcohol. This book also describes the alcohol’s effect on reproductive and fetal health, alcohol-associated mental-health problems such as anxiety, addiction, and suicide along with treatment and recovery methods such as alcohol rehabilitation, strategies for reducing alcohol consumption, and medications. The book concludes with a glossary of terms related to alcoholism and a directory of organizations and support groups for alcohol-related concerns.

How to Use This Book

This book is divided into parts and chapters. Parts focus on broad areas of interest. Chapters are devoted to single topics within a part.

Part 1: Understanding Alcohol Use, Abuse, and Dependence provides statistical information on alcohol usage in the United States, and also explains binge drinking, simultaneous polydrug use, the genetics of alcoholism, and the existing myths and facts of alcohol.

Part 2: Underage Drinking discusses the minimum legal age for drinking, and the factors contributing to underage drinking, the role of advertising in underage drinking, and the efforts taken to prevent and reduce alcohol problems such as parental involvement and school interventions.

Part 3: The Physical Effects and Consequences of Alcohol Abuse explains the various health effects that are caused by alcohol abuse, such as alcohol- induced liver diseases, neuropathy, and cardiovascular diseases (CVDs), and the changes brought by alcohol in the brain. It also contains information about various other organ damage caused by alcohol consumption and other diseases such as diabetes, sleep difficulties, and cancer associated with alcohol consumption.

Part 4: The Effects of Alcohol on Reproductive and Fetal Health describes the problem of infertility due to alcohol consumption, along with information on fetal alcohol spectrum disorders (FASDs), the effects of alcohol consumption during pregnancy, and its impacts on breastfeeding.

Part 5: Mental-Health Problems Associated with Alcohol Abuse consists of the various mental problems that are associated with alcohol consumption such as anxiety, addiction, hangover, psychosocial factors such as stress and posttraumatic stress disorder (PTSD), and suicide.

Part 6: Alcohol’s Impact on Family, Work, and the Community talk about the impacts of alcohol in family and children, alcohol-impaired driving, along with information on alcohol-related fire fatalities, alcohol misuse in the military due to stress, and how to prevent alcohol-related workplace problems.

Part 7: Treatment and Recovery provides information about how to aid a person with alcohol problems such as the strategies for reducing alcohol consumption, medication, and alcohol rehabilitation.

Part 8: Additional Help and Information consists of a glossary of terms related to alcohol abuse along with directories of organizations with information about alcohol use and abuse.

Bibliographic Note

This volume contains documents and excerpts from publications issued by the following U.S. government agencies: Alcohol and Tobacco Tax and Trade Bureau (TTB); Centers for Disease Control and Prevention (CDC); College Drinking; Federal Emergency Management Agency (FEMA); Federal Trade Commission (FTC); Genetic and Rare Diseases Information Center (GARD); HIV.gov; MedlinePlus; National Cancer Institute (NCI); National Center for Posttraumatic Stress Disorder (NCPTSD); National Center on Birth Defects and Developmental Disabilities (NCBDDD); National Highway Traffic Safety Administration (NHTSA); National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); National Institute on Aging (NIA); National Institute on Alcohol Abuse and Alcoholism (NIAAA); NIH News in Health; NIH Osteoporosis and Related Bone Diseases—National Resource Center (NIH ORBD—NRC); Office of Juvenile Justice and Delinquency Prevention (OJJDP); Office on Women’s Health (OWH); Rethinking Drinking; Substance Abuse and Mental Health Services Administration (SAMHSA); U.S. Department of Veterans Affairs (VA); and U.S. Fire Administration (FA).

It also contains original material produced by Omnigraphics and reviewed by medical consultants.

About the Health Reference Series

The Health Reference Series is designed to provide basic medical information for patients, families, caregivers, and the general public. Each volume provides comprehensive coverage on a particular topic. This is especially important for people who may be dealing with a newly diagnosed disease or a chronic disorder in themselves or in a family member. People looking for preventive guidance, information about disease warning signs, medical statistics, and risk factors for health problems will also find answers to their questions in the Health Reference Series. The Series, however, is not intended to serve as a tool for diagnosing illness, in prescribing treatments, or as a substitute for the physician–patient relationship. All people concerned about medical symptoms or the possibility of disease are encouraged to seek professional care from an appropriate health-care provider.

A Note about Spelling and Style

Health Reference Series editors use Stedman’s Medical Dictionary as an authority for questions related to the spelling of medical terms and The Chicago Manual of Style for questions related to grammatical structures, punctuation, and other editorial concerns. Consistent adherence is not always possible, however, because the individual volumes within the Series include many documents from a wide variety of different producers, and the editor’s primary goal is to present material from each source as accurately as is possible. This sometimes means that information in different chapters or sections may follow other guidelines and alternate spelling authorities. For example, occasionally a copyright holder may require that eponymous terms be shown in possessive forms (Crohn’s disease vs. Crohn disease) or that British spelling norms be retained (leukaemia vs. leukemia).

Medical Review

Omnigraphics contracts with a team of qualified, senior medical professionals who serve as medical consultants for the Health Reference Series. As necessary, medical consultants review reprinted and originally written material for currency and accuracy. Citations including the phrase Reviewed (month, year) indicate material reviewed by this team. Medical consultation services are provided to the Health Reference Series editors by:

Dr. Vijayalakshmi, MBBS, DGO, MD

Dr. Senthil Selvan, MBBS, DCH, MD

Dr. K. Sivanandham, MBBS, DCH, MS (Research), PhD

Health Reference Series Update Policy

The inaugural book in the Health Reference Series was the first edition of Cancer Sourcebook published in 1989. Since then, the Series has been enthusiastically received by librarians and in the medical community. In order to maintain the standard of providing high-quality health information for the layperson the editorial staff at Omnigraphics felt it was necessary to implement a policy of updating volumes when warranted.

Medical researchers have been making tremendous strides, and it is the purpose of the Health Reference Series to stay current with the most recent advances. Each decision to update a volume is made on an individual basis. Some of the considerations include how much new information is available and the feedback we receive from people who use the books. If there is a topic you would like to see added to the update list, or an area of medical concern you feel has not been adequately addressed, please write to:

Managing Editor

Health Reference Series

Omnigraphics

615 Griswold St., Ste. 520

Detroit, MI 48226

Part 1 | Understanding Alcohol Use, Abuse, and Dependence

Chapter 1 | Alcohol and Alcohol Use

What Is Alcohol?

Ethyl alcohol, or ethanol, is an intoxicating ingredient found in beer, wine, and liquor. Alcohol is produced by the fermentation of yeast, sugars, and starches.

Why Do Some People React Differently to Alcohol than Others?

Alcohol affects every organ in the body. It is a central nervous system (CNS) depressant that is rapidly absorbed from the stomach and small intestine into the bloodstream. Alcohol is metabolized in the liver by enzymes. However, the liver can only metabolize a small amount of alcohol at a time, leaving the excess alcohol to circulate throughout the body. The intensity of the effect of alcohol on the body is directly related to the amount consumed.

What Is a Standard Drink in the United States?

A standard drink is equal to 14.0 grams (0.6 ounces) of pure alcohol. Generally, this amount of pure alcohol is found in:

12 ounces of beer (5 percent alcohol content)

8 ounces of malt liquor (7 percent alcohol content)

5 ounces of wine (12 percent alcohol content)

1.5 ounces or a shot of 80-proof (40 percent alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey)

Is Beer or Wine Safe to Drink than Liquor?

No. One 12-ounce beer has about the same amount of alcohol as one 5-ounce glass of wine or 1.5-ounce shot of liquor. It is the amount of alcohol consumed that affects a person most, not the type of alcoholic drink.

What Does Moderate Drinking Mean?

According to the Dietary Guidelines for Americans (DGA), adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to two drinks or less in a day for men and one drink or less in a day for women, when alcohol is consumed. Drinking less is better for health than drinking more.

How Do You Know If It Is Okay to Drink?

According to the 2020–2025 Dietary Guidelines for Americans (DGA), some people should not drink alcoholic beverages at all, including:

If they are pregnant or might be pregnant

If they are under the legal age for drinking

If they have certain medical conditions or are taking certain medications that can interact with alcohol

If they are recovering from an alcohol-use disorder (AUD), or if they are unable to control the amount they drink

To reduce the risk of alcohol-related harms, the Guidelines recommend that adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to two drinks or less in a day for men or one drink or less in a day for women, on days when alcohol is consumed. The Guidelines also do not recommend that individuals who do not drink alcohol start drinking for any reason and that if adults of legal drinking age choose to drink alcoholic beverages, drinking less is better for health than drinking more. By following the Dietary Guidelines, you can reduce the risk of harm to yourself or others.

Is It Safe to Drink Alcohol and Drive?

No. Alcohol use slows reaction time and impairs judgment and coordination, which are all skills needed to drive a car safely. The more alcohol consumed, the greater the impairment.

What Does It Mean to Be above the Legal Limit for Drinking?

The legal limit for drinking is the alcohol level above which a person is subject to legal penalties (e.g., arrest or loss of a driver’s license).

Legal limits are measured using either a blood alcohol test or a breathalyzer.

Legal limits are typically defined by state law and may vary according to individual characteristics, such as age and occupation.

All states in the United States have adopted 0.08 percent (80 mg/dL) as the legal limit for operating a motor vehicle for drivers aged 21 years or older (except for Utah, which adopted a 0.05 percent legal limit in 2018). However, drivers younger than 21 are not allowed to operate a motor vehicle with any level of alcohol in their system.

Note: Legal limits do not define a level below which it is safe to operate a vehicle or engage in some other activity. Impairment due to alcohol use begins to occur at levels well below the legal limit.

What Is Excessive Alcohol Use?

Excessive alcohol use includes binge drinking, heavy drinking, any alcohol use by people under the age 21 minimum legal drinking age (MLDA), and any alcohol use by pregnant women.

What Is Binge Drinking?

Binge drinking is defined as a pattern of alcohol consumption that brings the blood alcohol concentration (BAC) level to 0.08 percent or more. This pattern of drinking usually corresponds to five or more drinks on a single occasion for men or four or more drinks on a single occasion for women, generally within about two hours.

What Do You Mean by Heavy Drinking?

For men, heavy drinking is typically defined as consuming 15 drinks or more per week. For women, heavy drinking is typically defined as consuming 8 drinks or more per week.

Do All Excessive Drinkers Have an Alcohol-Use Disorder?

No. About 90 percent of people who drink excessively would not be expected to meet the clinical diagnostic criteria for having a severe AUD. A severe AUD, previously known as alcohol dependence or alcoholism, is a chronic disease. Some of the signs and symptoms of a severe AUD could include:

Inability to limit drinking.

Continuing to drink despite personal or professional problems.

Needing to drink more to get the same effect.

Wanting a drink so badly you cannot think of anything else.

What Does It Mean to Get Drunk?

Getting drunk or intoxicated is the result of consuming excessive amounts of alcohol. Binge drinking typically results in acute intoxication.

Alcohol intoxication can be harmful for a variety of reasons, including:

Impaired brain function resulting in poor judgment, reduced reaction time, loss of balance and motor skills, or slurred speech

Dilation of blood vessels, causing a feeling of warmth, but resulting in rapid loss of body heat

Increased risk of certain cancers, stroke, and liver diseases (e.g., cirrhosis), particularly when excessive amounts of alcohol are consumed over extended periods of time

Damage to a developing fetus if consumed by pregnant women

Increased risk of motor-vehicle traffic crashes, violence, and other injuries

Coma and death can occur if alcohol is consumed rapidly and in large amounts.

How Do You Know If You Have a Drinking Problem?

Drinking is a problem if it causes trouble in your relationships, in school, in social activities, or in how you think and feel. If you are concerned that either you or someone in your family might have a drinking problem, consult your personal health-care provider.

What Can You Do If You or Someone You Know Has a Drinking Problem?

Consult your personal health-care provider if you feel you or someone you know has a drinking problem. Other resources include the National Drug and Alcohol Treatment Referral Routing Service, available at toll-free: 800-662-HELP (800-662-4357). This service can provide you with information about treatment programs in your local community and allow you to speak with someone about alcohol problems.

What Health Problems Are Associated with Excessive Alcohol Use?

Excessive drinking both in the form of heavy drinking or binge drinking, is associated with numerous health problems, including:

Chronic diseases such as liver cirrhosis (damage to liver cells); pancreatitis (inflammation of the pancreas); various cancers, including liver, mouth, throat, larynx (the voice box), and esophagus; high blood pressure (HBP); and psychological disorders

Unintentional injuries, such as motor-vehicle traffic crashes, falls, drowning, burns, and firearm injuries

Violence, such as child maltreatment, homicide, and suicide

Harm to a developing fetus if a woman drinks while pregnant, such as fetal alcohol spectrum disorders (FASDs)

Sudden infant death syndrome (SIDS)

Alcohol-use disorders (AUDs)

You Are Young. Is Drinking Bad for Your Health?

Yes. Studies have shown that alcohol use by adolescents and young adults increases the risk of both fatal and nonfatal injuries. Research has also shown that people who use alcohol before age 15 are six times more likely to become alcohol dependent than adults who begin drinking at age 21. Other consequences of youth alcohol use include increased risky sexual behaviors, poor school performance, and increased risk of suicide and homicide.

Is It Okay to Drink When Pregnant?

No. There is no known safe level of alcohol use during pregnancy. Women who are pregnant or plan on becoming pregnant should refrain from drinking alcohol. Several conditions, including FASDs, have been linked to alcohol use during pregnancy. Women of childbearing age should also avoid binge drinking to reduce the risk of unintended pregnancy and potential exposure of a developing fetus to alcohol.

_____________

This chapter includes text excerpted from Alcohol and Public Health – Frequently Asked Questions, Centers for Disease Control and Prevention (CDC), February 16, 2021.

Chapter 2 | When Can Alcohol Be Used Safely?

Chapter Contents

Section 2.1—Alcohol Drinking Levels

Section 2.2—Alcohol Dietary Guidelines for Americans

Section 2.1 | Alcohol Drinking Levels

This section includes text excerpted from What’s a Standard Drink? Rethinking Drinking, National Institute on Alcohol Abuse and Alcoholism (NIAAA), June 16, 2010. Reviewed August 2021.

What Does Count as a Drink?

What Is a Standard Drink?

In the United States, a standard drink (also known as an alcoholic drink-equivalent) is any drink that contains about 0.6 fluid ounces or 14 grams of pure alcohol. Although the drinks pictured here are different sizes, each contains approximately the same amount of alcohol and counts as one U.S. standard drink or one alcoholic drink-equivalent.

How Many Drinks Are in Common Containers?

A U.S. standard drink (also known as an alcoholic drink-equivalent) is defined as any beverage containing 0.6 fluid ounces or 14 grams of pure alcohol. Below is the approximate number of U.S. standard drinks or alcoholic drink-equivalents in different sized containers of:

The examples above serve as a starting point for comparison. For different types of beer, wine, or malt liquor, the alcohol content can vary greatly. Some differences are smaller than you might expect, however. Many light beers, for example, have almost as much alcohol as regular beer – about 85 percent as much, or 4.2 percent versus 5.0 percent alcohol by volume (alc/vol), on average.

Although the U.S. standard drink (alcoholic drink-equivalent) amounts are helpful for following health guidelines, they may not

Table 2.1. The Percentage of Pure Alcohol Expressed in Alcohol by Volume (alc/vol)

Figure 2.1. Standard Drinks

Each beverage portrayed above represents one U.S. standard drink (also known as an "alcoholic

drink-equivalent"). The percent of pure alcohol, expressed here as alcohol by volume (alc/vol),

varies within and across beverage types.

reflect customary serving sizes. In addition, while the alcohol concentrations listed are typical, there is considerable variability in alcohol content within each type of beverage.

Do you drink cocktails or an alcoholic beverage not listed above? If you are curious and willing to do a little research on your beverage’s alcohol content, you can use Rethinking Drinking's calculator's website: (www.rethinkingdrinking.niaaa.nih.gov/Tools/Calculators/Default.aspx) to estimate the number of U.S. standard drinks (alcoholic drink-equivalents) in a cocktail or container.

What Is Your Pattern?

What Are the Different Drinking Levels?

The Dietary Guidelines for Americans (DGA) defines moderate drinking as up to 1 drink per day for women of legal drinking age and up to 2 drinks per day for men of legal drinking age.

When Is Moderate Drinking Still Too Much?

It is safest to avoid alcohol altogether if you are:

Taking medications that interact with alcohol

Managing a medical condition that can be made worse by drinking

Underage

Planning to drive a vehicle or operate machinery

Participating in activities that require skill, coordination, and alertness

Recovering from alcohol-use disorder (AUD) or unable to control the amount they drink

Pregnant or trying to become pregnant

Why Do Women Face Higher Risks?

A growing body of evidence indicates that women who drink are at increased susceptibility to short- and long-term alcohol-related consequences, including liver disease, cardiovascular disease (CVD), neurotoxicity, and alcohol-related memory blackouts, compared to men. One reason for this is that alcohol resides predominantly in body water, and pound for pound, women have less water in their bodies than men. This means that after a woman and a man of the same weight drink the same amount of alcohol, the woman’s blood alcohol concentration (BAC) will tend to be higher, putting her at greater risk for harm.

Other biological differences may contribute as well. While alcohol misuse by anyone presents a serious public-health concern, women face alcohol-related problems sooner and at lower drinking levels than men. Women who drink are also at greater risk for developing breast cancer than women who do not consume alcohol.

Section 2.2 | Alcohol Dietary Guidelines for Americans

This section includes text excerpted from Dietary Guidelines for Alcohol, Centers for Disease Control and Prevention (CDC), December 29, 2020.

Alcohol consumption is associated with a variety of short- and long-term health risks, including motor vehicle crashes, violence, sexual risk behaviors, high blood pressure (HBP), and various cancers (e.g., breast cancer).

The risk of these harms increases with the amount of alcohol you drink. For some conditions, like some cancers, the risk increases even at very low levels of alcohol consumption (less than 1 drink).

To reduce the risk of alcohol-related harms, the 2020–2025 Dietary Guidelines for Americans (DGA) recommends that adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to 2 drinks or less in a day for men or 1 drink or less in a day for women, on days when alcohol is consumed. The Guidelines also do not recommend that individuals who do not drink alcohol start drinking for any reason and that if adults of legal drinking age choose to drink alcoholic beverages, drinking less is better for health than drinking more.

Two in three adult drinkers report drinking above moderate levels at least once a month.

People Who Should Not Drink at All

The Guidelines note that some people should not drink alcohol at all, such as:

If they are pregnant or might be pregnant.

If they are under the legal age for drinking.

If they have certain medical conditions or are taking certain medications that can interact with alcohol.

If they are recovering from an alcohol-use disorder (AUD) or if they are unable to control the amount they drink.

Figure 2.2. Drink Sizes

The Guidelines also note that not drinking alcohol also is the safest option for women who are lactating. Generally, moderate consumption of alcoholic beverages by a woman who is lactating (up to 1 standard drink in a day) is not known to be harmful to the infant, especially if the woman waits at least 2 hours after a single drink before nursing or expressing breast milk. Women considering consuming alcohol during lactation should talk to their health-care provider.

Science around Moderate Alcohol Consumption

The Guidelines note, Emerging evidence suggests that even drinking within the recommended limits may increase the overall risk of death from various causes, such as from several types of cancer and some forms of cardiovascular disease. Alcohol has been found to increase risk for cancer, and for some types of cancer, the risk increases even at low levels of alcohol consumption (less than 1 drink in a day).

Although past studies have indicated that moderate alcohol consumption has protective health benefits (e.g., reducing risk of heart disease), studies show this may not be true. While some studies have found improved health outcomes among moderate drinkers, it is impossible to conclude whether these improved outcomes are due to moderate alcohol consumption or other differences in behaviors or genetics between people who drink moderately and people who do not.

Most U.S. adults who drink do not drink every day. That is why it is important to focus on the amount people drink on the days that they drink.

Drinking at levels above the moderate drinking guidelines significantly increases the risk of short-term harms, such as injuries, as well as the risk of long-term chronic health problems, such as some types of cancer.

Chapter 3 | Binge Drinking

Binge Drinking Is a Serious but Preventable Public-Health Problem

Binge drinking is the most common, costly, and deadly pattern of excessive alcohol use in the United States. Binge drinking is defined as a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 g/dl or above. This typically happens when men consume five or more drinks or women consume four or more drinks in about two hours. Most people who binge drink do not have a severe alcohol-use disorder (AUD).

Who Binge Drinks

One in six U.S. adults binge drinks about four times a month, consuming about seven drinks per binge. This results in 17 billion total binge drinks consumed by adults annually, or 467 binge drinks per binge drinker.

Binge drinking is most common among younger adults aged 18–34 years, but more than half of the total binge drinks are consumed by those aged 35 and older.

Binge drinking is twice as common among men than among women. Four in five total binge drinks are consumed by men.

Binge drinking is more common among people with household incomes of $75,000 or more and higher educational levels. Binge drinkers with lower incomes and educational levels, however, consume more binge drinks per year.

Over 90 percent of U.S. adults who drink excessively report binge drinking in the past 30 days.

Most people younger than age 21 who drink alcohol report binge drinking, often consuming large amounts.

Binge Drinking Has Serious Risks

Binge drinking is associated with many health problems, including the following:

Unintentional injuries such as car crashes, falls, burns, and alcohol poisoning

Violence including homicide, suicide, intimate partner violence (IPV), and sexual assault

Sexually transmitted diseases (STDs)

Unintended pregnancy and poor pregnancy outcomes, including miscarriage and stillbirth

Fetal alcohol spectrum disorders (FASDs)

Sudden infant death syndrome (SIDS)

Chronic diseases such as high blood pressure, stroke, heart disease, and liver disease

Cancer of the breast, mouth, throat, esophagus, liver, and colon

Memory and learning problems

Alcohol-use disorders (AUDs)

Binge Drinking Costs Everyone

Drinking too much, including binge drinking, cost the United States $249 billion in 2010, or $2.05 a drink. These costs resulted from losses in workplace productivity, health-care expenditures, criminal justice costs, and other expenses. Binge drinking was responsible for 77 percent of these costs, or $191 billion.

Preventing Binge Drinking

The Community Preventive Services Task Force (CPSTF) recommends evidence-based interventions to prevent binge drinking and related harms. Recommended strategies include:

Using pricing strategies, including increasing alcohol taxes.

Limiting the number of retail alcohol outlets that sell alcoholic beverages in a given area.

Holding alcohol retailers responsible for the harms caused by illegal alcohol sales to minors or intoxicated patrons (dram shop liability).

Restricting access to alcohol by maintaining limits on the days and hours of alcohol retail sales.

Consistently enforcing laws against underage drinking and alcohol-impaired driving.

Maintaining government controls on alcohol sales (avoiding privatization).

The U.S. Preventive Services Task Force (USPSTF) also recommends screening and counseling for alcohol misuse in medical settings.

_____________

This chapter includes text excerpted from Binge Drinking, Centers for Disease Control and Prevention (CDC), December 30, 2019.

Chapter 4 | Alcohol Overdose

Celebrating at parties, cheering a favorite sports team, and enjoying get-togethers after work are common ways to relax or be with friends. For some people, these occasions may also include drinking – even binge or high-intensity drinking. And when that happens, the results can be deadly.

Drinking too much and too quickly can lead to significant impairments in motor coordination, decision-making, impulse control, and other functions, increasing the risk of harm. Continuing to drink despite clear signs of significant impairments can result in an alcohol overdose.

What Is an Alcohol Overdose?

An alcohol overdose occurs when there is so much alcohol in the bloodstream that areas of the brain controlling basic life-support functions – such as breathing, heart rate, and temperature control – begin to shut down. Symptoms of alcohol overdose include mental confusion, difficulty remaining conscious, vomiting, seizure, trouble breathing, slow heart rate, clammy skin, dulled responses such as no gag reflex (which prevents choking), and extremely low body temperature. Alcohol overdose can lead to permanent brain damage or death.

What tips the balance from drinking that produces impairment to drinking that puts one’s life in jeopardy varies among individuals. Age, sensitivity to alcohol (tolerance), gender, speed of drinking, medications you are taking, and amount of food eaten can all be factors.

Alcohol use and taking opioids or sedative-hypnotics, such as sleep and antianxiety medications, can increase your risk of an overdose. Examples of these medications include sleep aids such as zolpidem and eszopiclone, and benzodiazepines such as diazepam and alprazolam. Even drinking alcohol, while taking over-the-counter (OTC) antihistamines, can be dangerous. Using alcohol with opioid pain relievers such as oxycodone and morphine or illicit opioids such as heroin is also a very dangerous combination. Like alcohol, these drugs suppress areas in the brain that control vital functions such as breathing. Ingesting alcohol and other drugs together intensifies their individual effects and could produce an overdose with even moderate amounts of alcohol.

Who May Be at Risk?

Anyone who consumes too much alcohol too quickly may be in danger of an alcohol overdose. This is especially true of individuals who engage in binge drinking, defined as a pattern of drinking that brings blood alcohol concentration (BAC) to 0.08 percent or higher,* typically occurring after a woman consumes four drinks or a man consumes five drinks in about two hours; as well as high-intensity drinking, defined as drinking two or more times the binge-drinking thresholds for women and men.

Teenagers and young adults who drink may be at particular risk for alcohol overdose. Research shows that teens and college-age young adults often engage in binge drinking and high-intensity drinking. Drinking such large quantities of alcohol can overwhelm the body’s ability to break down and clear alcohol from the bloodstream. This leads to rapid increases in BAC and significantly impairs brain and other bodily functions.

*A blood alcohol concentration (BAC) of 0.08 percent corresponds to 0.08 grams per deciliter or 0.08 grams per 100 milliliters.

As Blood Alcohol Concentration Increases – So Do the Risks

As BAC increases, so does the effect of alcohol – as well as the risk of harm. Even small increases in BAC can decrease motor coordination, make a person feel sick, and cloud judgment. This can increase an individual’s risk of being injured from falls or car crashes, experiencing acts of violence, and engaging in unprotected or unintended sex. When BAC reaches high levels, blackouts (gaps in memory), loss of consciousness (passing out), and death can occur.

BAC can continue to rise even when a person stops drinking or is unconscious. Alcohol in the stomach and intestine continues to enter the bloodstream and circulate throughout the body.

It is dangerous to assume that an unconscious person will be fine by sleeping it off. One potential danger of alcohol overdose is choking on one’s own vomit. Alcohol at very high levels can hinder signals in the brain that control automatic responses such as the gag reflex. With no gag reflex, a person who drinks to the point of passing out is in danger of choking on her or his vomit and dying from a lack of oxygen (i.e., asphyxiation). Even if the person survives, an alcohol overdose such as this can lead to long-lasting brain damage.

Critical Signs and Symptoms of an Alcohol Overdose

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

Know the Danger Signs and Act