One night, after having several drinks, you notice that your loved or friend has begun to slur their words and stumble when they walk. Should you let them sleep it off? Are you overreacting if you call for help? Knowing the difference between alcohol intoxication (being drunk) and alcohol poisoning symptoms could save a life. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), these two conditions have different signs and levels of danger.¹ 

What Is Alcohol Intoxication?

Alcohol intoxication happens when alcohol enters the bloodstream and starts affecting the body and brain. Even a small amount of alcohol can make someone drunk. How much it affects a person depends on things like body weight, how fast they drink, and their tolerance to alcohol.

Signs of Alcohol Intoxication: 

• Feeling happy and less shy 
• Bad judgment and poor coordination 
• Slurred speech 
• Trouble thinking clearly or focusing 
• Slower reaction times 
• Feeling sleepy or confused 

Most people recover from mild intoxication by resting, drinking water, and giving it time. However, if someone keeps drinking, their intoxication can become more serious and affect how they think and move.

What Is Alcohol Poisoning?

Alcohol poisoning is much more dangerous than being drunk. It happens when someone drinks too much alcohol too quickly. This causes the alcohol in the blood to rise so much that it starts to affect important body functions, like breathing and heart rate.

Binge drinking (drinking a lot in a short time) is a common cause of alcohol poisoning, and it needs urgent medical attention.

Alcohol Poisoning Symptoms: 

• Vomiting
• Seizures
• Slow or uneven breathing (fewer than 8 breaths per minute)
• Low body temperature (feeling cold)
• Confusion or passing out and not waking up
• Pale or blue skin or lips
• Being unconscious and hard to wake up 

Alcohol poisoning can lead to serious health problems, such as brain damage or even death, if not treated right away. Unlike being drunk, alcohol poisoning doesn’t get better with sleep or water. It requires immediate medical help.

When to Get Help

If you see someone showing signs of alcohol poisoning, call 911 or get them to the nearest emergency room immediately. While waiting for help, you should: 

• Try to keep the person awake. 
• Stay with them and watch their breathing. 
• Turn them on their side so they don’t choke if they vomit. 
• Do not give them coffee, put them in a cold shower, or let them “sleep it off”—this can make things worse. 
• Be ready to let emergency responders know what they drank and how much, other substances they might have taken (e.g., cannabis, pain or anxiety pills, cocaine, etc.) and any other health information you have.

If someone is very drunk but not showing signs of poisoning, it’s still important to watch them carefully. If they keep drinking or their symptoms get worse, they may be at risk of alcohol poisoning. Get help if they: 

• Are extremely confused 
• Can’t stand up or walk without falling
• Are acting aggressive or violent 

Don’t let the fear of arrest or legal action prevent you from calling for medical help, even if you’re underage or using additional illicit substances. Every state in the country has some sort of Good Samaritan law, which protects both the person with alcohol poisoning and the person assisting them.²

How Alcohol Poisoning Is Treated

If someone with alcohol poisoning goes to the hospital, doctors will treat them to keep their body working while the alcohol leaves their system. Treatments may include:

1. IV fluids – Alcohol can make a person dehydrated. IV fluids help hydrate the body and keep important things like salt and minerals balanced.
2. Oxygen therapy – If the person is having trouble breathing, doctors might give them oxygen to make sure their brain and body get enough air. 
3. Watching vital signs – Doctors will watch the person’s heart rate, breathing, and blood pressure. If breathing slows or stops, they may use a machine to help them breathe. 
4. Stomach pumping – If there is still alcohol in the stomach, doctors may pump it out to stop more alcohol from entering the bloodstream. 
5. Medications – Some people need medicine to prevent seizures or raise low blood sugar levels, which can drop during alcohol poisoning. 
6. Treating problems – Alcohol poisoning can cause problems like low body temperature or uneven heartbeats, which doctors will treat as they happen.

Alcohol poisoning is very serious, and treatment depends on how bad it is and how quickly the person gets help. Even if they recover, alcohol poisoning can cause lasting damage to the brain and organs. 

Knowing the difference between being drunk and alcohol poisoning is very important. While being drunk may pass without medical help, alcohol poisoning is a medical emergency that needs quick action. If you’re unsure if someone needs help, it’s always better to be safe and call for assistance.  

Check out our free and confidential alcohol screening tool and learn more about ways to reduce the risks of alcohol use.