The Diagnosis and Management of Toxic Alcohol Poisoning in the Emergency Department: A Review Article PMC

Using alcohol with opioid pain relievers, such as oxycodone and morphine, or illicit opioids, such as heroin, is also a very dangerous combination. Like alcohol, these drugs suppress areas in the brain that control vital functions such as breathing. Ingesting alcohol and other drugs together intensifies their individual effects and could produce an overdose with even moderate amounts of alcohol. If you think someone is experiencing alcohol poisoning, seek emergency medical attention immediately.

Acetone is primarily eliminated through the renal system with some escaping via the lungs. Acetone produces a “fruity” odor on the breath as seen in DKA.1 Most commonly, the patient with isopropanol intoxication will present with an elevated osmolar gap without an acidosis (2). This is not always the case because high levels of isopropanol can cause hypotension leading to hypoperfusion and a lactic acidosis.

Statistics on Alcohol Poisoning

Chronic alcohol abuse produces marked alterations in pulmonary function resulting from decreased GSH, increased ROS production, and marked alterations in lung host defense mechanisms. GM-CSF, granulocyte-macrophage colony-stimulating factor; RAAS, renin-angiotensin-aldosterone system; ARDS, acute respiratory distress syndrome. The most relevant clinical manifestations of alcohol-induced alterations in cardiopulmonary function are shown in the box. Because toxic alcohol poisoning may cause potentially irreversible damage in a time-dependent fashion, prompt diagnosis and treatment are crucial (2). Though we lack immediate testing for the toxic alcohols, there are useful laboratory clues that can help clinicians quickly zero in on the most likely toxic agent. Those clues include the osmol gap, the anion gap, and the patient’s acid-base status.

Rapid fluid ingestion can be harmful in and of itself, as it can alters the fluid concentration in the body, potentially disrupting fluid and electrolyte balance. Call 911 or go to the nearest hospital if you notice signs of alcohol poisoning. Never leave someone who is drunk alone, whether they are asleep or awake. If you are concerned that they could hurt you, maintain a safe distance while waiting for professional help.


If your pattern of drinking results in repeated significant distress and problems functioning in your daily life, you likely have alcohol use disorder. However, even a mild disorder can escalate and lead to serious problems, so early treatment is important. Of course, not every drink is going to lead to alcohol poisoning, but it’s still important to understand that it can be serious. So if you find that a glass or two turns into a bottle or more, you might want to take a hard look at your drinking habits, Dr. Andrews suggests.

stages of alcohol poisoning

These factors combined with the increased likelihood of becoming injured while drunk means alcohol poisoning increases the risk of hemorrhage (bleeding) in the brain and elsewhere in the body, which can be profuse. The best way to avoid alcohol poisoning is to not drink or to limit your alcohol consumption. If you choose to drink, it’s a good idea to drink responsibly and stick to the guidelines for moderating drinking that are mentioned above. Treatment for alcohol intoxication, poisoning, and overdose typically takes place in the emergency care setting and is supportive, which means it is designed to help manage symptoms and avoid complications.

Impact of Alcohol on Body Composition

Not only does this cause a lack of physical coordination, which can cause falls or other accidents, but it also contributes to alcohol-induced nausea and vomiting. These are often overlooked, perhaps because people just consider them indications of being “drunk” (i.e., they perceive the condition as impaired, stages of alcohol poisoning but not serious). But it’s important to know that, at this stage, the situation can progress rapidly. Unlike food, which can take hours to digest, the body absorbs alcohol quickly — long before most other nutrients. If you think that someone has alcohol poisoning, seek medical care right away.

In any case, it’s unlikely that the paramedics or hospital team will call the police. Most states have Good Samaritan laws, which allow people to call 911 without fear of arrest if they’re having a drug or alcohol overdose or see someone else who is overdosing. Every one in three cases brought to the emergency rooms in critical conditions is a victim of excess consumption of alcohol.Responsible for one out of ten deaths in working-age adults, alcoholism is no less than a fatal disease. This is because it is an abnormal addiction for over-consumption, evident through extremely dangerous stages of alcohol poisoning. Alcohol abuse; the most common and costly form of drug abuse, is a major contributing factor to many disease categories.

What to Do if Someone Has Alcohol Poisoning

Alcohol in the form of ethanol, also called ethyl alcohol, is in alcoholic beverages. It’s also in mouthwash, some cooking extracts, some medicines and certain household products. Ethyl alcohol poisoning generally results from drinking too many alcoholic beverages in a short period of time. The early stages of alcohol-related liver disease can potentially be reversed by abstaining from alcohol. If damage persists, alcoholic cirrhosis can develop, which can’t be reversed. If excessive alcohol consumption continues, inflammation levels can begin to increase in the liver.

This typically occurs when people consume excessive amounts of alcohol in a short space of time. As discussed above, the measurements of anion gap and osmol gap are not sensitive nor specific enough to definitively diagnose or rule out toxic alcohol poisoning. Treatment with ethanol, fomepizole, and/or dialysis may need to be started before a definitive diagnosis has been made. A clear understanding of the toxic alcohol pathophysiology, patient presentation, the usefulness and limitations of the laboratory workup, and treatment options will expedite the diagnosis and improve patient outcomes.

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