Alcohol Poisoning: When to Call 115

Key takeaways

Two very different illnesses share the one name “alcohol poisoning”: drinking far too much ordinary alcohol, and drinking industrial methanol that has been cut into the drink. The second can cause permanent blindness, and its signs arrive much later.
Someone drunk who cannot be roused is not asleep. According to NIAAA at the United States National Institutes of Health, do not assume an unconscious person will be fine once they have slept: alcohol removes the gag reflex, so they can choke on their own vomit and die from lack of oxygen.
What is right at home: lay them on their side, keep them warm, stay beside them and watch, and call 115 if any dangerous sign appears. No coffee, no cold water poured over them, no fingers down the throat to make them vomit, no more alcohol.
According to CDC, the harm of methanol poisoning may show nothing at all during a symptom-free interval lasting up to three days after drinking. If drink of unknown origin has been swallowed, be seen the same day; do not wait for symptoms.
Blurred vision, a mist or dancing spots in front of the eyes, loss of sight after drinking: go to emergency care at once and say exactly what was drunk and where it came from.

Two very different things share the one name. The first is drinking far too much ordinary alcohol, drunk to the point of coma, which can kill through stopped breathing or through choking on vomit. The second is drinking industrial alcohol that has been cut into the drink, which can cause permanent blindness, and whose signs usually arrive late — by which time the person thinks the drunkenness has passed. The most dangerous thing families habitually do with both is put a blanket over them and wait to see how they are in the morning.

Recognising it: where heavy drunkenness and poisoning part ways

Someone drunk can usually still be roused, can still speak, can still turn themselves over and can still vomit by themselves. Alcohol poisoning is when those reflexes start to go. According to CDC, these are the life-threatening signs:

Cannot be roused: calling loudly and shaking the shoulder firmly brings only a mumble, or no response at all.
Vomiting, and most worrying of all vomiting while barely conscious or lying on the back.
Breathing much slower than normal, or breathing in fits and starts with long gaps where no breath is taken.
Fits.
The body ice cold, the skin pale or blue, most obvious at the lips and fingertips.

NIAAA at the United States National Institutes of Health adds: a slow pulse, clammy skin, confusion or slipping into a stupor, and loss of the gag reflex. Losing that reflex is precisely what kills — according to NIAAA, someone who has drunk to the point of unconsciousness is at risk of choking on their own vomit and dying from lack of oxygen.

The easiest mistake is to assume everything is down to the drink. Someone who has been drinking can still fall and hit their head, or have a stroke at the same time: a drooping face on one side or marked weakness down one side is handled as a stroke — there is a separate article on this site. And according to NIAAA, alcohol taken together with sleeping tablets, allergy medicines or opioid painkillers carries a much higher risk, because they all press down on the part of the brain that controls breathing.

Drink cut with industrial alcohol: a second illness, arriving late

According to MedlinePlus at the United States National Library of Medicine, methanol is an alcohol used in industry and in vehicles, not something to be drunk. It has no place at all in a bottle of spirits — so what to be wary of is drink of unknown origin, home-distilled or home-blended drink, drink poured from an unlabelled container.

What makes it a killer is the quiet interval. According to CDC, the harm of methanol poisoning may show nothing at all during a symptom-free interval lasting up to three days after drinking. Which means the person can have sobered up, eaten and walked about normally, and only then deteriorate.

THE EYES: blurred vision, seeing as though through mist or a veil, dancing spots or flashes, loss of sight.
Fast, deep breathing — the sign of acid building up in the blood.
Severe abdominal pain, vomiting, nausea, no appetite.
Headache, dizziness, unsteady walking, confusion, slipping into a stupor.
More severely: fits, coma.

According to MedlinePlus, blindness from methanol is common and is usually permanent, even once treatment has been given.

What to do straight away

STAY BESIDE THEM; do not leave them to sleep alone.
If they have slipped into a stupor or are unconscious: lay them on one side, so that if they vomit it runs out rather than down into the lungs. If they are still awake, sit them up.
Keep them warm with a coat or a light blanket.
If they are fully awake, can swallow and are not vomiting, give small sips of water. If they are barely conscious, put nothing in the mouth.
Write it down on paper: from when until when they drank, what the drink was and where it came from, whether any medicines were taken with it, and when they began to go under. Keep the bottle or the container.
Call 115 if any sign in the box below is present, and say clearly that alcohol has been drunk and that drink of unknown origin is suspected.

What must not be done

DO NOT let them sleep it off and see how they are in the morning. According to NIAAA, do not assume an unconscious person will be fine once they have slept.
DO NOT give them more alcohol.
DO NOT give coffee or energy drinks, and DO NOT pour cold water over them or make them take a shower. According to NIAAA, coffee, a cold shower and walking someone about do nothing to undo the effects of alcohol and can make things worse.
DO NOT put fingers down the throat to make them vomit. According to MedlinePlus, do not induce vomiting unless instructed to by a health professional.
DO NOT give food while they are still barely conscious — choking is very easy.
DO NOT trust hangover cures, sobering-up drinks or folk remedies; ask a doctor or pharmacist before any medicine.
If a sign in the box below is present, do not call for a drip at home instead of going in.

When you must go to hospital

CALL 115 (the emergency number in Vietnam) NOW — do not wait for morning, do not wait for them to sober up — if: calling does not wake them, shaking brings no response, they are unconscious; they vomit while barely conscious; breathing is much slower than normal or comes in fits and starts with long gaps where no breath is taken; the skin is pale, the lips and fingertips blue; the body is ice cold; there are fits; the confusion is deepening; the vomiting is continuous and not a sip of water stays down. Or, after drinking alcohol of unknown origin, if there is: blurred vision, mist or dancing spots in front of the eyes, loss of sight; fast, deep breathing; severe abdominal pain. — BE SEEN THE SAME DAY, do not wait until tomorrow, if: alcohol of unknown origin has been drunk, home-blended drink, or drink poured from an unlabelled container, even while everything seems normal; there was a fall with a blow to the head while drinking.

Plainly: severe alcohol poisoning and methanol poisoning are illnesses that have to be treated in hospital — at home there is no blood test, no way to correct acidosis, and no antidote. Our role is a remote consultation when you are not sure whether to go in, a doctor coming to the house to take the history and examine when it is unclear, and a nurse providing recovery care at home after discharge. With a sign from the box above, go in first and call afterwards.

This article passes on the recommendations of public health authorities — sources: CDC in the United States, NHS in the United Kingdom and NIH — in our own words, and does not replace being examined in person. Citing CDC here does not imply that CDC endorses Y Te Xanh or our services.

Need personalised advice for your loved one? Call our hotline 094 368 81 15 (24/7) — calling to ask a question or to book costs nothing. GreenCare has doctors who come to examine, nurses who carry out doctor's orders (injections, infusions, dressing changes), remote consultation by video call, and a review of the medicines you are taking; an in-depth remote consultation, or any one after the first, is a paid service. For children we take examination and acute care only — not long-term care at home, and not newborns or expectant mothers. We confirm we have staff in your area and provide transparent pricing before we begin.

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Frequently asked questions

Someone is out cold drunk. Should we let them sleep until morning?

Not if they cannot be roused. According to NIAAA, do not assume an unconscious person will be fine once they have slept: alcohol removes the gag reflex, so they can choke on their own vomit and die from lack of oxygen. Try calling loudly and shaking the shoulder. If they can still respond, lay them on their side, keep them warm and sit beside them watching, trying to rouse them again every so often. If they do not wake, if they vomit while barely conscious, or if breathing is much slower than normal or comes in fits and starts, call for an ambulance.

Should we put fingers down the throat to make them vomit so they sober up faster?

No. According to MedlinePlus, do not induce vomiting unless instructed to by a health professional. Once the alcohol is in the bloodstream, vomiting cannot take it back, and someone who is barely conscious has lost the reflexes that protect the airway, so vomit very easily goes down into the lungs. What needs doing is laying them on their side, staying beside them, and calling for an ambulance if any dangerous sign appears.

Do strong coffee, a cold shower or a hangover remedy sober someone up faster?

No. According to NIAAA, coffee, a cold shower and walking someone about do nothing to undo the effects of alcohol and can make things worse. Cold water poured over someone who is already cold drops their temperature further, and someone unsteady on their feet can fall or faint in the bathroom. The remedies and sobering-up drinks sold over the counter are no substitute for watching the person and taking them in when that is needed.

How can I tell whether a bottle has industrial alcohol in it?

You cannot tell by looking, smelling or tasting — that is exactly what makes it dangerous. The only thing you can judge is where it came from: unlabelled drink, drink poured from a container, home-blended drink, drink that is unusually cheap — do not drink it. If it has already been drunk, keep the bottle or the container and be seen the same day, even if everything still feels normal; take the bottle so the doctor knows what was swallowed.

They slept it off and woke up fine in the morning. Is there still any need to be seen?

If it was drink of unknown origin, yes. According to CDC, the harm of methanol poisoning may show nothing at all during a symptom-free interval lasting up to three days after drinking — waking up and feeling normal does not mean being safe. Be seen the same day. And if blurred vision, mist or dancing spots in front of the eyes, loss of sight, fast deep breathing or severe abdominal pain appear, go to emergency care at once.

What needs attention at home after discharge?

Keep the follow-up appointments and take the discharge papers with you, because methanol poisoning can leave lasting effects on the eyes and the nervous system that need watching over time. At home, pay attention to whether they can eat and drink, whether they walk steadily, and whether they are more muddled than before — if things are going backwards, get back in touch. A nurse coming to the house can help with recovery care and watch for these signs alongside the family.