Dying of Acute Alcohol Poisoning

Randy was a junior in high school. He and his buddy cut school and went to a friend’s house to do some serious drinking. Incredibly, the friend’s parents were home part of the time and knew (or should have known) what was going on. They had stolen a half-gallon of whiskey from one of their parents’ liquor cabinet. They began to drink.

The drink of choice for killing oneself with alcohol is hard liquor simply because it has a much higher concentration of alcohol than beer or wine does. The alcohol builds up in the bloodstream faster, causing deadly poisoning before the side effects prevent or reduce the intake. It is possible to kill yourself with beer, but the lower concentration (6 percent or 12 proof [1 percent = 2 proof]) requires the consumption of much larger quantities. Before a fatal blood alcohol level is reached, the beer drinker may mercifully vomit or pass out. The same is true of wine, which, at 10 to 12 percent alcohol (20 to 24 proof), requires the drinker to consume a larger quantity than hard liquor. With 80 proof whiskey, 100 proof vodka or tequila, 151 proof rum, or 198 proof grain alcohol (white lightning or Everclear), it is a much shorter journey into oblivion. So when you are matching your friend drink for drink, guzzling several ounces of straight whiskey each time, you need to remember one critical fact. You can drink and absorb alcohol much faster than your liver and other tissues can metabolize and get rid of it, so the level is constantly rising. If it reaches 0.4 percent before you pass out, vomit, or somebody stops you, you may just die. Randy did.

There is a dynamic process going on when you consume alcohol: consumption, absorption, and elimination. Alcohol is absorbed rather quickly and at almost 100 percent efficiency, so consumption is roughly equal to absorption. Elimination is variable, but within a relatively narrow range. The novice drinker can metabolize one to one-and-a-half ounces of alcohol per hour. A veteran drinker, whose liver has had repeated exposures to alcohol and is more efficient, may be able to metabolize half again that much, but there is a limit to how fast alcohol can be cleared from the body. That upper limit may approach two ounces per hour. The blood alcohol level depends on how fast the alcohol is consumed and how strong it is.

When large amounts of highly concentrated alcohol are consumed quickly, the normal stages of drunkenness are passed through, but very rapidly because the drug is being consumed and absorbed at such a high rate. And as a high school junior, you’re not an everyday drinker, so your liver is not habituated. It doesn’t metabolize the alcohol efficiently. Your friend is the same height, but weighs fifteen pounds more, mostly fat. Because alcohol is evenly distributed in tissues, he can drink 15 percent more than you can for each stage of intoxication.

At 0.1 percent blood alcohol level,you are pleasantly buzzed. You feel lighthearted and happy. You’re talkative and funny. All your worries seem trivial, and you have a warm glow. Your lips might feel a little thick, and your balance might not be perfect, but you could probably pass a field sobriety test. You would fail a blood or urine alcohol test and a breathalyzer because the legal limit for alcohol is 0.08 percent. You are feeling good.

At 0.2 percent blood alcohol level as a rookie, you are feeling very drunk. Your speech is slurred, and your walk is quite unsteady. You may see double. You are not as mellow as you were, and you become loud and obnoxious as liquor dissolves normal social restraint. Males may still be able to get an erection, but it probably won’t be a great one. And there might be real difficulty having an orgasm. You’re just plain drunk.

When the blood alcohol level reaches 0.3 percent, most people pass out. If they are lucky enough to be in a temperate environment, a knowledgeable and caring soul may turn their head to the side to prevent them from choking on or aspirating their vomit. If they are unlucky and pass out alone in the cold, they could suffer hypothermia or freeze to death, as alcohol impairs temperature control and dilates capillaries close to the surface of the skin. They quickly lose their core heat to the surrounding cold and suffer hypothermia.

Unconscious, the drunk may vomit, plugging his airway. Worse, the vomit may be aspirated or sucked into his lungs. The effect of stomach acid and food particles is devastating on lung tissue, causing aspiration pneumonia. If not fatal,it may cause severe scarring and permanent reduction of functional lung tissue.

Randy and his friend shared a half-gallon of whiskey. That’s sixty-four ounces of liquor (thirty-two ounces of alcohol), and it killed him. He drank it so fast that he was able to reach 0.4 percent before he passed out, he got sick, or someone stopped him. When he finally did pass out, the alcohol level was so high that it stopped his breathing. Without oxygen, a heart already weakened by high alcohol levels cannot last long, perhaps a minute or two. Then it stops. And tragically, no one recognized what had happened in time to help. So the world lost another young person to alcohol and another bright and promising future that would not be. There was another devastated family, memorial service warning friends about binge drinking, and another obituary chronicling the life of a nice guy, promising student, and gifted athlete.