Alcohol Overdose: Causes, Risk Factors, and Symptoms

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The symptoms of alcohol intoxication range from mild to severe, depending on how much alcohol a person consumes and how quickly their body metabolizes it. As blood alcohol concentration (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. As with all emergency patients, initial treatment should focus on the airway, breathing, and circulation.

These alcohols are relatively non-toxic by themselves; however, once they are initially metabolized by alcohol dehydrogenase, they can present with increased anion gap metabolic acidosis and elevated serum osmolality [2, 3]. Ethylene glycol intoxication, in particular, can lead to life-threatening complications, including metabolic acidosis and diverse secondary damage to the cardiopulmonary and renal systems if not properly treated [4]. Besides hemodialysis, effective therapy for ethylene glycol intoxication consists of administration of fomepizole and ethanol, both of which inhibit alcohol dehydrogenase in the initial step of the metabolism [5, 6].

A Practical Review

The use of fomepizole simplifies management of many patients, and potentially reduces the use of intensive care beds 14, 15, 19. Two large studies have tried to compare the effects of ethanol and fomepizole 94, 95. Although Paasma and coworkers did not find a significantly better overall outcome with fomepizole, methanol‐poisoned patients that could hyperventilate had a significantly better survival with fomepizole compared to ethanol 95.

One of the most common medications used to reverse alcohol overdose is metadoxine. This drug is used for acute alcohol intoxication, alcohol overdose, and for chronic intoxication, which may be seen in alcohol addiction. The alcohol overdose antidote consists of supportive measures such as keeping an eye on vital signs, giving fluids and thiamine supplements, and occasionally using activated charcoal or gastric lavage to restrict absorption. While there isn’t a single remedy for this, getting medical help quickly is essential to avoiding serious consequences.

How does alcohol cause intoxication?

Folic acid should be administered for several days to enhance folate-dependent metabolism of formic acid to carbon dioxide and water. Titration to serum levels between 0.10 g/dL (100 mg/dL) and 0.15 g/dL (150 mg/dL) typically used. To guarantee that all of our information is accurate, we ensure that all our sources are reputable. That means every source is authenticated and verified to be backed only by medical science. There are also additional resources such as therapy, recovery education, and support groups at Bedrock.

Do not disregard or avoid professional medical advice due to content published within Cureus. There are a couple of different breathing assessments that may be used on you during an alcohol overdose. An antidote is a drug, chelating substance, or a chemical that counteracts (neutralizes) the effects of another drug or a poison. If you drink more than this and your body isn’t able to break it down fast enough, it accumulates in your body. CW and EC generated the systematic review protocol and wrote the manuscript.

Alcohol and Melatonin: What You Need to Know About Combining These Substances

Ethylene glycol is eventually converted to oxalic acid, which causes renal and cranial nerve damage secondary to calcium oxalate deposition [1, 2, 5]. Metabolic acidosis and inebriation are common features of methanol and ethylene glycol metabolite toxicity [4]. The American Academy of Clinical Toxicology has outlined recommendations for antidote therapy with either ethanol or fomepizole as well as indications for hemodialysis [5,6,7]. Hemodialysis effectively removes both the parent compound and its toxic metabolites in addition to correcting metabolic disturbances [5, 6, 8]. provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include alcohol overdose Micromedex (updated 2 Jan 2024), Cerner Multum™ (updated 16 Nov 2023), ASHP (updated 10 Jan 2024) and others. If you suspect an alcohol overdose and the person is unconscious, do not leave them alone. You don’t need to have all of the symptoms listed above to have an alcohol overdose.

As such, all content on our blog has been thoroughly reviewed by a doctorate level clinician such as a Medical Doctor, or Psy.D, so that you can trust all of the data we publish. The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional.

  • However, there is likely variation in treatment practice due to the lack of robust consensus regarding thresholds for initiating medical therapies such as antidotes and renal replacement therapy [1, 2, 4].
  • In a pregnant woman with severe metabolically‐toxic alcohol poisoning, an antidote is obligatory, and if fomepizole is not available, ethanol should be used.
  • An exception to this may be a patient who presents immediately after ingestion of a toxic alcohol in whom one might reasonably expect to be able to recover a significant amount of the toxin via aspiration through a nasogastric tube.
  • To our knowledge, no prior systematic review of clinical outcomes of toxic alcohols exists.
  • However, there are antidotes and procedures that can help reverse its effects.

As a consequence, variations exist in the interventions utilized for management of all toxic alcohol poisonings. To our knowledge, no prior systematic review of clinical outcomes of toxic alcohols exists. The objective of this study is to summarize existing evidence on short- and long-term outcomes of patients following toxic alcohol poisonings, including methanol, ethylene glycol, isopropanol, propylene glycol, and diethylene glycol. These compounds are readily available worldwide in commercial products as well as in homemade alcoholic beverages, both of which lead to most of the poisoning cases, from either unintentional or intentional ingestion.

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