Dear Dr. Jeff: What's the difference between alcohol poisoning and just being real drunk? R.S.
Dear R.S.: Quite simply, alcohol poisoning occurs when you've drunk more alcohol than your body can handle.
Alcohol is a Central Nervous System depressant, which, in sufficient quantity, dulls your reflexes and slows down your breathing and heart rate. Higher blood alcohol levels cause unconsciousness and coma.
One important reflex to consider is your gag reflex. As it gets dulled, you become less likely to vomit. This may not seem like too bad a thing, but vomiting when drunk does help you get rid of the excess alcohol you've not yet absorbed and processed. If your gag reflex gets very dulled and you vomit, your airway may not be adequately protected, and you might aspirate (inhale) 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 fewer than 12 times a minute (less than once every five seconds) or if their breathing stops for longer than 10 seconds, and 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 expelled from Bowdoin for just being intoxicated. If you are in doubt about someone's condition, always err on the side of caution and get this person some help before it is too late. Call Security, a proctor or RA, or an ambulance.
How do you avoid alcohol poisoning? By drinking safely and responsibly. If you don't 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 five drinks in a sitting) are all not safe drinking practices.
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 state of "Euphoria," 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 significant and growing number of students, that seems to be the right approach.
If you're going to drink, drink safely and responsibly. Know your "BAC limits," and pace yourself appropriately. A good rule of thumb: no more than one drink per hour, and no more than 3 drinks per night. Don't drink alone, watch out for each other, and whatever else you do, don't drink and drive.
To your health!
Jeff Benson, MD
Dudley Coe Health Center