Dear Dr. Jeff: How would I know if a friend is alcohol poisoned or just really drunk? C.B.
Dear C.B.: Alcohol poisoning occurs when you've drunk more alcohol than your body can handle.
Alcohol is a Central Nervous System depressant, which at moderate levels can dull your reflexes and slow down your breathing and heart rate. Higher blood alcohol levels can cause unconsciousness and coma.
One of your more important reflexes is your gag reflex. As it gets dulled, you'll be less likely to vomit. This may seem like not too bad a thing! But vomiting when drunk can help you get rid of excess alcohol you've not yet absorbed. That can mean the difference between alcohol poisoning and just getting really drunk. And if your gag reflex gets very dulled, and you vomit, your airway may not be adequately protected, and you can aspirate vomit into your lungs.
How can you tell if someone's alcohol poisoned? If they're asleep, but can't be woken up. If they're breathing less than 12 times per minute (less than once every five seconds) or if their breathing stops for longer than 10 seconds. If their skin is cold, pale, and clammy, or their lips bluish in color. These are all signs of acute alcohol poisoning, and this person needs to be evaluated and treated in a hospital emergency room?urgently.
Remember: No one has ever been kicked out of Bowdoin just for drinking too much. If you are in doubt about someone's condition, please, always err on the side of caution, and get this person some help before it is too late. Call Security, a proctor or R.A., or an ambulance.
How do you avoid alcohol poisoning? Pretty straightforward: by drinking safely and responsibly. If you don't yet know how to drink safely and responsibly, then there are a few things you need to learn. Drinking shots, playing drinking games, and "binge drinking" (more than fives drinks in a sitting) are all not drinking safely. One key to understanding what constitutes safe drinking is to understand something about alcohol metabolism and blood alcohol content (BAC).
The alcohol content of one shot of 80-proof liquor is the same as that of a 12-ounce bottle of beer, and the same as that of a five-ounce glass of wine. On average, our bodies need about one hour to metabolize each drink.
Take a look at the BAC tables. Let's say you're a 140-pound woman. If you drink two beers over two hours, you'll raise your BAC to 0.045, and you'll likely experience relatively mild effects on your higher functions. If you drink four beers over two hours, you'll end up with a BAC of 0.115. That might leave you in a stage of "Euphoria," (see chart at orient.bowdoin.edu) or, more likely, depending on your own particular metabolism and neurophysiology, in the more compromised state of "excitement." "Excitement," here, by the way, is only meant neurologically. When you're "neurologically excited," you become uncoordinated, disoriented, and lose your ability to think critically, to react quickly, and to remember what's happening to you.
Now if you do shots, say eight shots, over those same two hours, you'll end up with a BAC of 0.245, which would definitely launch you into a state of "confusion," and probably bring you close to "stupor." Only two additional shots, however, over that same period of time, might put you into a coma.
Responsible drinking involves more, though, than just avoiding alcohol poisoning. The national statistics are impressive.
Drinking contributes to 500,000 injuries, and 1,400 deaths, on college campuses each year (mainly in motor vehicle accidents.)
Each year 400,000 college students have unprotected sex because of drinking. Drinking contributes to 70,000 reported cases of sexual assault or date rape. Up to 90 percent of sexual assaults on college campuses involve the use or abuse of alcohol.
The bottom line? For some of us, it means that it's just not worth it to drink at all. For a considerable number of students, that seems to be the right approach.
And for the rest of you, if you're going to drink, drink safely and drink responsibly. Know your BAC limits, and pace yourself appropriately. A good rule of thumb is: Do not have more than one drink per hour, and do not have more than three drinks per night. Don't drink alone, watch out for each other, and whatever else you do, don't ever drink and drive.
Salud!
Jeff Benson, MD
Dudley Coe Health Center