What is alcohol poisoning? |

Causes

Most alcohol poisoning cases are caused by ethanol
(C2H5OH), which is a component of alcoholic beverages, namely beer, wine, and hard liquor. Ethanol has been produced by the fermentation of sugar since antiquity. Other alcohol poisoning cases are caused by methanol (CH3OH) or isopropyl alcohol (C3H8O). Methanol is primarily used in the production of other chemicals; it is sometimes used as an automotive fuel. Isopropyl alcohol is a component of rubbing alcohol and is widely used as a solvent and a cleaning fluid.

All forms of alcohol are flammable and colorless, and all are readily available in the marketplace. Although the purchase of alcoholic beverages in the United States is generally restricted to adults age twenty-one years and older, minors often obtain the product through a third party, sometimes even their parents, without difficulty.

Risk Factors

A number of factors increase the risk of becoming ill through alcohol poisoning. They include the following:

• Rate of drinking. The more rapidly a person consumes a given amount of alcohol, the more likely the risk of alcohol poisoning. One to two hours are required to metabolize one drink.

• Gender. Young men age eighteen through twenty-five years are the most likely to experience alcohol poisoning; however, women are more susceptible to alcohol poisoning than men because they produce less of an enzyme that slows the release of alcohol from the stomach.

• Age. Teenagers and college-age youth are more likely to engage in binge drinking; however, the majority of these drinking-related deaths occur in persons age thirty-five to fifty-four years. This older age group often does not metabolize alcohol as readily as younger persons and is more likely to have an underlying health problem that increases the risk.

• Body mass. A heavier person can drink more alcohol than a lighter person and still register the same BAC. For example, a 240-pound man who drinks two cocktails will have the same BAC as a 120-pound woman who consumes one cocktail.

• Overall health. Persons with kidney disease, liver disease, heart disease, or other health problems may metabolize alcohol more slowly. A person with diabetes, for example, who binge drinks might experience a dangerous drop in blood sugar level.

• Food consumption. A full stomach slows the absorption of alcohol, so drinking on an empty stomach increases the risk.

• Drug use. Prescription and over-the-counter drugs might increase the risk of alcohol poisoning. Ingestion of illegal substances, such as cocaine, methamphetamine, heroin, and marijuana, also increases the risk.

Symptoms

Alcohol poisoning symptoms include confusion, stupor, or unconsciousness; respiratory depression (slow breathing rate); irregular breathing (a gap of more than ten seconds between breaths); slow heart rate; low blood pressure; low body temperature (hypothermia); vomiting; seizures; and pale or blue skin.

Screening and Diagnosis

The BAC is a definitive test for alcohol poisoning. Persons with alcohol poisoning often have a BAC of 0.35 to 0.5 percent. By way of comparison, a person is considered to be driving under the influence in all US states if his or her BAC is 0.08 percent or higher. Other blood tests include those that check a person’s complete blood count (CBC) and those that check levels of glucose, urea, arterial pH (acid), and electrolytes.

Treatment and Therapy

Treatment consists of supportive measures until the body metabolizes the alcohol. This includes insertion of an airway (endotracheal tube) to prevent vomiting and aspiration of stomach contents into the lungs; close monitoring of vital signs (temperature, heart rate, and blood pressure); provisions of oxygen; medication to increase blood pressure and heart rate, if necessary; respiratory support, if necessary; maintenance of body temperature (blankets or warming devices); and administration of intravenous fluids to prevent dehydration. In such cases, glucose should be added if the person is hypoglycemic, that is, if the person has low blood sugar (also, thiamine is often added to reduce the risk of a seizure). Another form of treatment is hemodialysis (blood cleansing), which might be needed for a dangerously high BAC (of more than 0.4 percent). Hemodialysis also is necessary if methanol or isopropyl alcohol has been ingested.

Prevention

The best prevention against binge drinking is education, especially of persons who participate in at-risk activities. Young men make up the group with the highest risk of alcohol poisoning. Often, young men have a sense of invincibility and they may disregard helpful advice from any source. Peer pressure is probably the best deterrent; however, it also is a factor that can encourage binge drinking. Furthermore, children with a good parental relationship are less likely to drink to excess.

Bibliography

Fisher, Gary, and Thomas Harrison. Substance Abuse: Information for School Counselors, Social Workers, Therapists, and Counselors. 5th ed. Upper Saddle River: Merrill, 2012. Print.

Ketcham, Katherine, and William F. Asbury. Beyond the Influence: Understanding and Defeating Alcoholism. New York: Bantam, 2000. Print.

Miller, William R., and Kathleen M. Carroll, eds. Rethinking Substance Abuse: What the Science Shows, and What We Should Do about It. New York: Guilford, 2010. Print.

Olson, Kent R., et al., eds. Poisoning and Drug Overdose. 6th ed. New York: McGraw, 2012. Print.