OVERVIEW

What does acute alcohol poisoning mean?

Alcohol poisoning, also known as "ethanol poisoning," refers to symptoms caused by excessive alcohol intake, characterized by initial excitement followed by depression. It may manifest as slurred speech, unsteady standing, irritability, drowsiness, coma, and in severe cases, can lead to death. When severe symptoms occur due to excessive drinking, immediate medical attention is required.

Mild alcohol poisoning does not require special treatment, while severe cases may necessitate life-support measures.

The consequences of this condition are often overlooked and require serious attention.

Why do people seem to develop tolerance when drinking too much?

Tolerance refers to the body's ability to withstand alcohol, which varies among individuals.

For example: A person may experience relaxation and euphoria after drinking alcohol. However, as the frequency and amount of drinking gradually increase, the same amount of alcohol will produce a diminished effect, requiring higher consumption to achieve the original euphoria. This is how the body develops tolerance and addiction to alcohol.

SYMPTOMS

Can drinking alcohol really be fatal?

Yes.

When blood alcohol concentration rises to 400–700 mg/dL (equivalent to an adult consuming 250–500 mL of pure alcohol at once), it can lead to death.

What harm does alcohol cause to the human body?

• Damages brain cells, leading to impaired memory, decision-making, and physical reflexes, and even intoxication, drowsiness, or coma;
• Damages liver cells, causing fatty liver and cirrhosis;
• Damages gastrointestinal mucosa, leading to peptic ulcers and, in severe cases, gastrointestinal bleeding;
• Increases the risk of cardiovascular and cerebrovascular diseases;
• Damages reproductive cells, hindering normal fetal development.

What are the symptoms of acute alcohol poisoning?

Acute alcohol poisoning progresses from mild to severe through stages of excitement, ataxia, and coma. After sobering up, a range of discomforts may occur, such as headaches, dizziness, fatigue, and nausea. Symptoms vary in severity depending on the amount consumed and individual tolerance, and not all the above manifestations may occur.

What are the symptoms during the excitement phase of acute alcohol poisoning?

As blood alcohol concentration increases, symptoms in the excitement phase gradually change: at around 50 mg/dL, euphoria, excitement, and headaches may occur; at around 75 mg/dL, the person may become talkative, emotionally unstable, irritable, and exhibit rude behavior.

What behaviors occur during acute alcohol poisoning?

At a blood alcohol concentration of around 150 mg/dL, symptoms include blurred vision, slurred speech, and signs of ataxia, such as unsteady gait, poor muscle coordination, and clumsy movements.

What are the symptoms of a patient in the coma phase of acute alcohol poisoning?

At a blood alcohol concentration of around 250 mg/dL, the patient enters the coma phase, characterized by unconsciousness, dilated pupils, and lowered body temperature. At around 400 mg/dL, the coma deepens, potentially leading to respiratory or circulatory failure, which can be life-threatening.

Does discomfort persist after sobering up from acute alcohol poisoning?

Post-sobriety discomfort depends on the amount consumed and individual tolerance. Most people experience dizziness, headaches, fatigue, or nausea. Mild discomfort may be alleviated by drinking sugar water to aid alcohol metabolism, while severe symptoms require medical attention.

What serious consequences can acute alcohol poisoning cause?

Mild cases may involve slight acid-base imbalance, electrolyte disturbances, or hypoglycemia. Severe cases can lead to acute kidney failure, shock, coagulation disorders, and other life-threatening complications.

Does acute alcohol poisoning mean "acting drunk," "passing out," or "getting wasted"?

These colloquial terms describe manifestations of alcohol poisoning. For example, "acting drunk" refers to irritability caused by excessive drinking, while "passing out" refers to unconsciousness due to alcohol poisoning.

CAUSES

What causes acute alcohol poisoning?

When people consume large amounts of alcohol, it is fully absorbed within about 30 minutes to 3 hours and rapidly distributed to all water-containing tissues and body fluids.

When blood alcohol concentration rises to an individual's maximum tolerance level, affecting normal brain cell metabolism and function, poisoning symptoms occur. This tolerance varies from person to person. However, the lethal concentration of alcohol shows little individual variation—when blood alcohol concentration reaches 400–700 mg/dL (equivalent to an adult consuming 250–500 mL of pure alcohol in one sitting), it can be fatal.

Why do different people show different reactions after drinking the same amount of alcohol?

Consuming a large amount of alcohol in a short period overwhelms the body's metabolic capacity, leading to symptoms of central nervous system depression. The severity depends on the amount consumed, blood alcohol concentration, and individual tolerance.

Is acute alcohol poisoning less likely to occur in people with high alcohol tolerance?

Since alcohol poisoning is diagnosed based on external symptoms, and individual tolerance varies, the amount of alcohol required to trigger poisoning symptoms differs—commonly referred to as "alcohol tolerance."

Those with higher tolerance ("better drinkers") are less likely to show poisoning symptoms after consuming the same amount of alcohol, and vice versa.

Is acute alcohol poisoning caused by fake alcohol (industrial alcohol)?

Both industrial and edible alcohol primarily contain ethanol, which can cause poisoning (ethanol toxicity) in sufficient quantities. However, edible alcohol is produced from grains and yeast, while industrial alcohol is made from coal or petroleum and contains toxic substances like methanol. Industrial alcohol poisoning may also involve methanol toxicity, which can be fatal or cause permanent blindness.

Though fake alcohol may resemble grain alcohol in appearance and taste, and its poisoning symptoms overlap with genuine alcohol poisoning, its harm and consequences are more severe.

Is acute alcohol poisoning more common in people who drink hard liquor?

Whether drinking hard liquor or beer, poisoning occurs as long as the total alcohol intake exceeds the body's tolerance level.

DIAGNOSIS

How is acute alcohol poisoning diagnosed?

In addition to relying on the patient's drinking history and the aforementioned clinical manifestations, doctors diagnose acute alcohol poisoning by measuring the patient's serum alcohol concentration or exhaled alcohol concentration.

What diseases are easily confused with acute alcohol poisoning?

Diseases such as sedative-hypnotic drug poisoning, carbon monoxide poisoning, cerebrovascular disease, and traumatic brain injury can also present clinical symptoms similar to alcohol poisoning. Sometimes, patients with alcohol poisoning may also have these conditions simultaneously, requiring professional doctors to assist in differentiation.

For example, in cases of sleeping pill poisoning, carbon monoxide poisoning, or alcohol poisoning, the corresponding components can be detected in the patient's blood sample. Cerebrovascular disease and traumatic brain injury can be quickly diagnosed through CT scans. However, a special situation arises when a patient has alcohol poisoning combined with sleeping pill poisoning, carbon monoxide poisoning, cerebrovascular disease, or traumatic brain injury. Therefore, doctors must carefully inquire and comprehensively evaluate to avoid misdiagnosis.

Are acute alcohol poisoning and alcohol allergy the same thing?

Alcohol allergy refers to an immune reaction triggered by alcohol in the body.

In other words, the immune system identifies alcohol in the bloodstream as an invading enemy and initiates a series of immune responses to eliminate it. This can lead to symptoms such as skin itching, erythema, difficulty breathing, or even anaphylactic shock. Thus, alcohol allergy and alcohol poisoning are not the same.

What emergency tests are needed for patients with acute alcohol poisoning?

Serum alcohol concentration measurement and breath alcohol testing are necessary for diagnosing alcohol poisoning.

Additionally, depending on the patient's condition, doctors may perform arterial blood gas analysis, serum electrolyte concentration tests, serum glucose concentration tests, liver and kidney function tests, electrocardiograms (ECG), and head CT scans.

What is the significance of arterial blood gas analysis in acute alcohol poisoning?

Alcohol poisoning can disrupt the body's acid-base balance, leading to conditions such as metabolic acidosis or respiratory alkalosis. Blood gas analysis helps detect these imbalances promptly, allowing timely treatment to correct them.

What is the significance of measuring serum electrolyte concentration in acute alcohol poisoning?

Alcohol poisoning can cause a significant drop in blood potassium levels, known as hypokalemia. Besides causing muscle weakness, hypokalemia poses a serious risk by triggering malignant arrhythmias, which can be fatal. Doctors must promptly identify and treat hypokalemia to maximize patient survival.

Therefore, measuring electrolyte concentrations, including potassium, is essential.

What is the significance of blood glucose testing in acute alcohol poisoning?

When large amounts of alcohol are metabolized in the body, they consume substantial glucose, leading to hypoglycemia. This can cause symptoms ranging from fatigue and hunger to coma and shock. Thus, measuring serum glucose levels is crucial for doctors to detect and treat hypoglycemia promptly.

Why is an ECG necessary for acute alcohol poisoning?

Long-term alcohol consumption can lead to alcoholic cardiomyopathy, and acute alcohol poisoning can disrupt acid-base balance and electrolyte levels, potentially causing life-threatening arrhythmias. An ECG helps doctors diagnose and treat these conditions in time.

What should be noted when performing an ECG on a patient with acute alcohol poisoning?

• Patients with acute alcohol poisoning may exhibit agitation, chills, or tremors, which can destabilize the ECG baseline and affect accuracy. Family members should assist medical staff in restraining the patient to ensure better cooperation.

• If the patient is at risk of vomiting, they should be placed in a lateral position to prevent aspiration, which could lead to choking or aspiration pneumonia.

• Since the chest must be exposed for an ECG, keeping the patient warm is important.

What should be noted when performing a head CT scan on a patient with acute alcohol poisoning?

• Alcohol poisoning may trigger complications like cerebral hemorrhage or infarction, and intoxicated patients are also prone to head injuries from falls or impacts. Doctors will assess the need for a head CT based on the patient's medical history, head trauma, and clinical symptoms.

• Agitation, chills, or tremors in acute alcohol poisoning can cause artifacts in CT images, obscuring actual lesions. Family members should help restrain the patient for better imaging results.

• If vomiting is a risk, the patient should be positioned laterally to prevent aspiration.

• If the patient shows unstable breathing, heartbeat, or blood pressure, indicating a life-threatening condition, the CT scan may be postponed unless urgently needed. In such cases, emergency equipment and medications must be on hand.

TREATMENT

Can acute alcohol poisoning heal without treatment?

Mild poisoning caused by small amounts of alcohol can resolve quickly without treatment. However, if excessive alcohol is consumed and severe symptoms such as unconsciousness occur, it can be life-threatening, and immediate medical attention is necessary.

Which department should acute alcohol poisoning patients visit?

Emergency department.

How should acute alcohol poisoning be managed?

If the patient is conscious, vomiting can be induced to expel unabsorbed alcohol from the stomach. Drinking sugar water in moderation can help accelerate alcohol metabolism and prevent hypoglycemia.

For mild alcohol poisoning (e.g., excitement, ability to walk, non-aggressive behavior, drowsiness but responsive), no treatment is required, and home observation is sufficient. Keep the patient warm and place them in a lateral position to prevent aspiration from vomiting.

If the patient shows severe alcohol poisoning symptoms, they should be taken to the hospital as soon as possible to avoid delaying treatment.

What are the treatment measures for acute alcohol poisoning?

• First, induce nausea and vomiting (do not do this for unconscious patients) to help the patient expel alcohol from the stomach (alcohol is absorbed quickly, so early vomiting is meaningful) and prevent worsening of poisoning.

• Patients with mild poisoning may not require medical treatment. Drinking sugar water in moderation can promote alcohol metabolism. For agitated or restless patients, mild restraint may be applied.

• If the patient shows signs of ataxia, they should avoid activity to prevent accidents. Glucose and potassium chloride injections can be administered to accelerate alcohol metabolism and prevent hypokalemia.

• If the patient experiences drowsiness, coma, or other consciousness impairments, intravenous naloxone should be given to shorten the duration of unconsciousness while maintaining vital functions such as breathing and circulation.

• For comatose patients who have not vomited within 2 hours of drinking and whose condition may worsen upon medical evaluation, gastric lavage is recommended.

• Severe alcohol poisoning patients, especially those with obvious gastrointestinal symptoms, may be given gastric mucosal protectants.

Can acute alcohol poisoning fully recover after treatment?

The prognosis depends on the severity of poisoning and whether complications occur. Most severe acute poisoning cases can recover if treated promptly without complications.

DIET & LIFESTYLE

How can acute alcohol poisoning be detected early in daily life?

If a patient has consumed excessive alcohol and exhibits symptoms such as euphoria, slurred speech, talkativeness, emotional instability, or unconsciousness, alcohol poisoning must be suspected. Immediate medical attention is crucial to avoid tragic consequences caused by negligence or delay.

What are drunk driving and intoxicated driving?

The former refers to driving after drinking alcohol, while the latter means driving while heavily intoxicated. Both situations significantly increase the risk of traffic accidents and tragedies. The most reliable way to distinguish between them is by measuring the driver's breath alcohol content or conducting a blood alcohol concentration test. If the blood alcohol level is ≥20 mg but <80 mg per 100 mL, it is considered drunk driving; a level ≥80 mg per 100 mL qualifies as intoxicated driving.

PREVENTION

How to prevent acute alcohol poisoning?

Understanding the dangers of alcohol poisoning, we should avoid drinking whenever possible during daily gatherings; do not force others to drink; and remind friends who overindulge to control their alcohol intake.

Can acute alcohol poisoning be treated or prevented with "hangover health products" or "sobering soups" available on the market?

These are health supplements that may alleviate alcohol absorption or promote its metabolism, but they cannot replace medical treatment or completely prevent alcohol poisoning. Therefore, never drink uncontrollably just because you've taken these supplements in advance.