Alcohol intoxication

Alcohol intoxication
Other names	Inebriation, drunkenness, ethanol intoxication, internal damage by alcohol[1][2]
The Drunkenness of Noah by Michelangelo, 1509
Specialty	Toxicology, psychiatry
Symptoms	Mild: Mild sedation, decreased coordination[3] Moderate: Slurred speech, trouble walking, vomiting[3] Severe: Decreased effort to breathe, coma[3]
Complications	Seizures, aspiration pneumonia, injuries, low blood sugar[3][4]
Usual onset	Over minutes to hours[5]
Duration	Several hours[5]
Causes	Alcohol (ethanol)[6]
Risk factors	Social environment, impulsivity, alcoholism[5][7]
Diagnostic method	Typically based on history of events and physical examination[6]
Differential diagnosis	Hepatic encephalopathy, Wernicke encephalopathy, methanol toxicity, meningitis, traumatic brain injury[6]
Treatment	Supportive care[6]
Frequency	Very common
Deaths	c. 2,200 per year (U.S.)[8]

Alcohol intoxication, commonly described in higher doses as drunkenness or inebriation,^[9] and known in overdose as alcohol poisoning,^[1] is the behavior and physical effects caused by recent consumption of alcohol.^[6][10] The technical term intoxication in common speech may suggest that a large amount of alcohol has been consumed, leading to accompanying physical symptoms and deleterious health effects. Mild intoxication is mostly referred to by slang terms such as tipsy or buzzed. In addition to the toxicity of ethanol, the main psychoactive component of alcoholic beverages, other physiological symptoms may arise from the activity of acetaldehyde, a metabolite of alcohol.^[11] These effects may not arise until hours after ingestion and may contribute to a condition colloquially known as a hangover.

Symptoms of intoxication at lower doses may include mild sedation and poor coordination.^[3] At higher doses, there may be slurred speech, trouble walking, and vomiting.^[3] Extreme doses may result in a respiratory depression, coma, or death.^[3] Complications may include seizures, aspiration pneumonia, low blood sugar, and injuries or self-harm such as suicide.^[3][4] Alcohol intoxication can lead to alcohol-related crime with perpetrators more likely to be intoxicated than victims.^[12]

Alcohol intoxication typically begins after two or more alcoholic drinks.^[5] Alcohol has the potential for abuse. Risk factors include a social situation where heavy drinking is common and a person having an impulsive personality.^[5] Diagnosis is usually based on the history of events and physical examination.^[6] Verification of events by witnesses may be useful.^[6] Legally, alcohol intoxication is often defined as a blood alcohol concentration (BAC) of greater than 5.4–17.4 mmol/L (25–80 mg/dL or 0.025–0.080%).^[13][14] This can be measured by blood or breath testing.^[5] Alcohol is broken down in the human body at a rate of about 3.3 mmol/L (15 mg/dL) per hour,^[6] depending on an individual's metabolic rate (metabolism).^[15] The DSM-5 defines alcohol intoxication as at least one of the following symptoms that developed during or close after alcohol ingestion: slurred speech, incoordination, unsteady walking/movement, nystagmus (uncontrolled eye movement), attention or memory impairment, or near unconsciousness or coma.^[16]

Management of alcohol intoxication involves supportive care.^[6] Typically this includes putting the person in the recovery position, keeping the person warm, and making sure breathing is sufficient.^[4] Gastric lavage and activated charcoal have not been found to be useful.^[6] Repeated assessments may be required to rule out other potential causes of a person's symptoms.^[6]

Acute intoxication has been documented throughout history, and alcohol remains one of the world's most widespread recreational drugs.^[17][18] Some religions, such as Islam, consider alcohol intoxication to be a sin.^[5][19]