Dear Alice,

There seems to be no advice or information on the subject of alcohol poisoning that I can find on your web site. Recently I had a very bad experience that I think must have involved alcohol poisoning, and would like to have some information on the causes and signs of alcohol poisoning. Does beer before liquor have anything to do with it?

Traumatized drinker

Dear Traumatized drinker,

Since you didn't describe what happened to you exactly, it's hard to determine if you did experience alcohol poisoning or not; but you're right, it needs to be discussed. Understanding the risks involved with over-drinking and the guidelines for avoiding them is a skill everyone can use (even if it's just to help a friend).

Alcohol poisoning occurs when a large amount of alcohol is consumed, usually over a short period of time. The human body can process one to one and a half ounces (oz.) of alcohol an hour, the amount contained in a single standard drink — a twelve oz. bottle or can of beer, a five oz. glass of wine, or one mixed drink. Keep in mind that many mixed drinks and alcoholic punches contain far more liquor depending on the type of drink and the person doing the mixing.

Alcohol is a depressant, and, in large amounts, dulls the nerves that regulate one's breathing, heartbeat, and gag reflex. The gag reflex is what is responsible for allowing our bodies to vomit — to get rid of extra alcohol that it cannot process. Sometimes, however, because this reflex is unable to work properly, our systems continue to absorb the excess alcohol. In severe cases, this can cause alcohol poisoning — a condition that usually involves the following symptoms:

  • The person is asleep and cannot be woken up — meaning, they are unconscious.
  • Breathing is less than twelve times per minute, or breathing stops altogether for periods of longer than ten seconds.
  • Skin or lips are cold, clammy, and pale or bluish in color.

Call 911 immediately if the any of the above signs are present. If you are with someone who is experiencing alcohol poisoning, gently prop them up on their side while waiting for an ambulance; this will prevent them from choking if they begin to vomit while unconscious.

Anytime a person has been drinking excessively, they need to be watched very carefully for danger signs that they could be at risk for alcohol poisoning or other medical emergencies. These might include:

  • Slurred speech
  • Difficulty walking or standing up
  • Erratic behavior
  • Inability to make eye contact or sustain a conversation
  • Feeling very ill, including prolonged vomiting

A person with alcohol poisoning, or experiencing any kind of alcohol or other drug emergency, requires attention from medical professionals. Alcohol poisoning is serious, and can be fatal.

In your question, you bring up the very common idea that mixing certain alcoholic beverages will make you more drunk or sick. Your example is beer before liquor, but just about everyone has a favorite anecdote about mixing drinks or eating "the wrong" foods right before drinking. The truth is that mixing alcoholic beverages won't make one more or less drunk; the only thing that matters is the amount of alcohol consumed in a specific time frame. It is possible, however, that certain mixtures of alcohol, and the various ingredients those beverages contain, may upset some individuals' stomachs. The best things to do are to pay attention to your own reactions and limits and keep these in mind when drinking.

As for avoiding both unpleasant drunkenness and more serious alcohol poisoning, it might be handy to recap some advice given in another Go Ask Alice! answer, Hangover helper and tips for healthy drinking:

  • Drink slowly.
  • Sip rather than gulp drinks.
  • Dilute drinks.
  • Avoid shots.
  • Alternate alcoholic with non-alcoholic beverages.
  • Eat a substantial meal before drinking.

One last note: in case your "very bad experience" involved blackouts — periods of time after you started drinking that you don't remember at all — you might want to take a look at some of the related Q&As for more information. Blackouts are often a sign that your drinking deserves some attention, even if the quantity you consume doesn't seem excessive. In fact, they appear to be an early sign of alcoholism, especially in those with a family history.

Be safe,


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