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?

Sincerely,
Traumatized drinker

Dear Traumatized drinker,

Having alcohol poisoning can be very scary, but it's great that you're reaching out for information to ensure that you avoid similar experiences in the future. Since you didn't describe exactly what happened, it's hard to determine if you had alcohol poisoning or not. Regardless, understanding the risks involved with over-consumption and the steps you can take to minimize risk are skills everyone can use (even if it's to help a friend). And, to answer your question about how consuming “beer before liquor” factors in to the issue at hand — the type of alcohol doesn’t matter so much as the amount over time (more on that in a bit). Keep reading for more on the specifics of alcohol poisoning, how to help a friend who may have had too much to drink, and ways to drink in moderation (to avoid negative consequences in the future).

Alcohol poisoning occurs when a large amount of alcohol is consumed, usually over a short period of time. A healthy human body can process about one standard drink an hour. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) a standard drink could include:

  • A twelve ounce (oz.) bottle or can of beer containing five percent alcohol by volume (ABV)
  • A five oz. glass of wine containing twelve percent ABV
  • A drink containing 1.5 oz. of distilled spirits with 40 percent ABV. It might be helpful to keep in mind that many mixed drinks contain more than one standard drink of liquor depending on the type of drink and the person doing the mixing.

If you drink many standard drinks too quickly, your body doesn't have enough time to process the alcohol and you could overdose. So essentially alcohol poisoning is an alcohol overdose. How do you know if someone is experiencing alcohol poisoning? Keep an eye out for the following possible symptoms:

  • Vomiting
  • Confusion
  • The person is asleep and cannot be woken up — they’re unconscious
  • Seizures
  • Breathing less than eight 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 (hypothermia)

Adapted from Mayo Clinic.

If you're with someone who's experiencing any of these symptoms, it's crucial that you contact emergency medical services immediately because alcohol poisoning can be fatal. It's also recommended that you stay with the person until help arrives and share with the health care providers as much information as you can about what and how much the person consumed. Additionally, if the person needs to lie down, gently prop them up on their side while you wait; this can help prevent them from choking if they begin to vomit. For more information on how you can help someone who's had too much to drink, you could review How should I help my drunk friend? in the Go Ask Alice! archives.

You also asked about the very common idea that mixing certain alcoholic beverages makes you more drunk. Your example is beer before liquor, but many have anecdotes about mixing drinks or eating "the wrong" foods right before drinking. The truth is that mixing alcoholic beverages doesn't make you more or less drunk. But consider this — if someone starts out drinking beer, they could be gulping large amounts of liquid with a low ABV and then they switch to liquor with a high ABV — if they drink the liquor at the same quantity and speed as they were drinking their beer, it could lead to them getting drunk because they are consuming a drink with more alcohol by volume. This might account for the saying. Regardless, paying attention to how alcohol affects you and your own limits and reactions is wise to keep in mind when drinking.

As for avoiding both unpleasant drunkenness and more serious alcohol poisoning, it might be handy consider the following protective factors if you choose to drink:

  • Eat before you start drinking.
  • Alternate alcoholic with non-alcoholic beverages (especially water!).
  • Pace yourself by drinking no more than one standard drink per hour.
  • Avoid drinking games and taking shots.
  • Determine in advance not to exceed a set number of drinks.
  • Pay attention to how intoxicated you are before having another drink.

If you're interested in learning more about how to drink in a low-risk manner, it might help to take a quick peek at Hangover helper and tips for healthy drinking in the Go Ask Alice! archives. If you’re interested in exploring your relationship with alcohol further, you may want to right out to a professional such as a health care provider, a health promotion professional, or a substance abuse prevention specialist.  By engaging in protective behaviors, you can hopefully avoid negative experiences in the future.

Be safe,

Alice!

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