Call 911 if someone who has been drinking is confused, can’t stay awake, is vomiting, has a seizure, is breathing slowly (fewer than 8 breaths a minute) or irregularly, or has clammy, pale or bluish skin: these are signs of alcohol poisoning, not a hangover. Blood alcohol can keep rising after the last drink, even in someone who has passed out, so don’t wait for every sign, and don’t let them sleep it off.1
Key takeaways
- NIAAA lists 10 danger signs of alcohol overdose, including fewer than 8 breaths a minute or 10+ seconds between breaths, and says not to wait for all of them before calling 911.1
- Blood alcohol can keep rising after someone stops drinking or passes out, as alcohol in the gut keeps entering the bloodstream.1
- Cold showers, hot coffee and walking do not reverse alcohol overdose, according to NIAAA, and they could make things worse.1
- CDC counted an average of 2,221 alcohol poisoning deaths a year in 2010–2012 among people 15 and older, about six a day; 76% were men and 76% were adults aged 35 to 64.2
- Mixing alcohol with opioids, sleep medicines or benzodiazepines raises overdose risk even at moderate amounts, and even over-the-counter antihistamines can be dangerous with alcohol.1
Alcohol poisoning vs. a hangover: how can you tell?
A hangover arrives as blood alcohol falls back toward zero. Alcohol poisoning happens while blood alcohol is still dangerously high, and it is a medical emergency.1, 3
Alcohol poisoning (also called alcohol overdose) is a blood alcohol level high enough to affect body functions like breathing and heart rate.4 It can cause permanent brain damage or death.1 A hangover is miserable, but the person is awake and responsive. The gray zone is someone very drunk, semi-awake and starting to vomit: NIAAA lists vomiting itself as a danger sign, so treat it as possible alcohol poisoning and call 911.1 For next-day questions, see normal hangover symptoms and hangover or something else?
| Feature | Hangover | Alcohol poisoning |
|---|---|---|
| Timing | As blood alcohol returns to about zero, usually the next morning | While blood alcohol is high; it can keep rising after drinking stops |
| Alertness | Tired and foggy, but awake and responsive | Confusion or stupor; trouble staying conscious, or can’t be woken |
| Breathing and heart | Normal breathing; blood pressure may be raised | Fewer than 8 breaths a minute, or 10+ seconds between breaths; slow heart rate |
| Skin and temperature | Possibly sweaty | Clammy skin; pale or bluish color; extremely low body temperature |
| Stomach | Nausea, stomach pain | Vomiting; dulled reflexes, such as no gag reflex, raise the risk of choking |
| Other | Headache, thirst, sensitivity to light and sound | Seizures |
| What to do | Rest and time; get care if symptoms are severe or unusual | Call 911 |
What are the signs of alcohol poisoning?
NIAAA’s list of critical signs is short, and any one of them is enough to call for help.1
- Mental confusion or stupor
- Difficulty staying conscious, or being unable to wake up
- Vomiting
- Seizures
- Slow breathing: fewer than 8 breaths per minute
- Irregular breathing: 10 seconds or more between breaths
- Slow heart rate
- Clammy skin
- Dulled responses, such as no gag reflex (the reflex that prevents choking)
- Extremely low body temperature, bluish skin color or paleness
Two points from NIAAA matter most in the moment: don’t wait for the person to have all the symptoms, and remember that a person who has passed out can die.1
In a survey of 306 college students about to turn 21, the most common reason for not helping a peer with these symptoms was believing help wasn’t needed.5 If you’re weighing it, call.
What should you do if someone has alcohol poisoning?
Call 911 first, then keep the person safe from falls and choking until help arrives.1
- Call 911. Don’t wait to see whether things improve. Poison Help (1-800-222-1222, 24/7) can answer questions, but any danger sign means 911 comes first.1, 6
- Stay with them. An intoxicated person left alone can be hurt by falling or choking.1
- Keep them low. Sit them on the ground, upright or partly upright, rather than in a chair.1
- If they’re vomiting, have them lean forward.1
- If they’re unconscious or lying down, roll them onto one side with an ear toward the ground.1
- Stay until help arrives, and tell responders what and how much the person drank, plus any drugs, medicines or health conditions you know about.1
What not to do: coffee, cold showers and “sleeping it off”
None of the home tricks work: “Don’t play doctor—cold showers, hot coffee, and walking do not reverse the effects of alcohol overdose.”1
The most dangerous myth is that someone who has passed out will be fine in the morning. NIAAA calls that assumption dangerous, because blood alcohol can continue to rise while the person is unconscious.1 Your body clears alcohol at a fairly fixed pace, and nothing (coffee, water, cold showers or supplements) has been shown to meaningfully speed it up.3, 7, 8
So skip the “walk it off” lap, don’t give more alcohol, and don’t put them to bed alone in another room.
How much alcohol causes alcohol poisoning?
There’s no single number. Risk climbs with how much and how fast someone drinks, and when alcohol is mixed with other drugs.1
NIAAA defines binge drinking as a pattern that brings blood alcohol to 0.08% or higher, typically five or more drinks for men or four or more for women in about two hours. High-intensity drinking is two or more times those thresholds. Drinking large amounts quickly can overwhelm the body’s ability to break down and clear alcohol.1
Sex matters too: women have less body water pound for pound, so they tend to reach a higher blood alcohol level than a man of the same weight drinking the same amount.9 And one “drink” is often more than one: a 12-ounce craft beer at 10% is two standard drinks.10 See our standard drink guide and how long alcohol stays in your system.
Who’s at higher risk? Drinking games, mixing drugs and younger drinkers
Anything that speeds up drinking or adds a sedative raises the stakes.1
- Fast drinking. Shots, chugging and drinking games are the “too much, too quickly” pattern NIAAA warns about.1
- Alcohol plus other drugs. Opioids such as oxycodone, sleep aids such as zolpidem and benzodiazepines such as alprazolam can cause an overdose even with moderate drinking, and even over-the-counter antihistamines can be dangerous with alcohol.1
- Younger drinkers. Teens and young adults often binge, which puts them at particular risk.1
- Middle-aged men, too. In CDC’s count, three in four alcohol poisoning deaths were adults aged 35 to 64, and three in four were men. Alcohol dependence was a contributing cause in 30.4%.2
Calling for help: medical amnesty and Good Samaritan rules
Fear of getting someone in trouble makes people hesitate, but it shouldn’t decide a medical emergency.
Some colleges have medical-amnesty policies meant to encourage students to call for help, and researchers have urged schools to pair them with teaching students how to recognize alcohol poisoning.5 Legal protections for people who call 911 in an alcohol emergency vary by state, so look up your state’s rules ahead of time. In the moment, make the call.
What you can’t tell from the outside
You can’t see someone’s blood alcohol, and you can’t predict where it will peak.1
Clearance rates vary widely, from about 10 to 35 mg/100 mL per hour.8 You may not know what else they took. That’s why NIAAA says to act on any danger sign rather than wait.1
How to lower the risk next time
The current US Dietary Guidelines say simply: “Consume less alcohol for better overall health.” People who are pregnant, recovering from alcohol use disorder, unable to control their drinking, or taking medicines or with medical conditions that interact with alcohol should avoid it completely.11
If you drink, count standard drinks, eat first, skip drinking games, don’t mix alcohol with sedatives, watch your friends, and never drive after drinking. More in our guide to drinking responsibly; for the morning after, see what actually helps a hangover.
Frequently asked questions
What does alcohol poisoning look like?
Confusion or stupor, trouble staying awake, vomiting, seizures, slow breathing (fewer than 8 breaths a minute), irregular breathing (10 or more seconds between breaths), clammy skin, very low body temperature, or pale or bluish skin. Any one of these is a reason to call 911.1
Can you sleep off alcohol poisoning?
No. Blood alcohol can keep rising after drinking stops, and a person who has passed out can die. Call 911, stay with them, and roll them onto their side if they’re lying down.1
How long does alcohol poisoning last?
You can’t predict it at home. The danger lasts while blood alcohol stays high, and the body clears alcohol at a fairly fixed pace, about 15 mg/100 mL per hour on average. As a rough illustration, someone at 0.30% would need around 20 hours to reach zero. That’s why it needs medical care.1, 8
Should I make someone throw up?
No. NIAAA’s advice is not to “play doctor”: call 911. If the person is vomiting on their own, help them lean forward, or roll them onto their side if they’re lying down, so they don’t choke.1
When should I call 911 for a drunk friend?
As soon as you see any danger sign: confusion, not staying awake, vomiting, a seizure, slow or irregular breathing, or clammy, pale or bluish skin. Don’t wait for all the signs. If you’re unsure, call anyway.1
Sources
- National Institute on Alcohol Abuse and Alcoholism (NIAAA). Understanding the Dangers of Alcohol Overdose. Updated December 2025. NIAAA
- Kanny D, Brewer RD, Mesnick JB, Paulozzi LJ, Naimi TS, Lu H. Vital Signs: Alcohol Poisoning Deaths — United States, 2010–2012. MMWR Morb Mortal Wkly Rep. 2015;63(53):1238–1242. CDC
- NIAAA. Hangovers. Updated December 2025. NIAAA
- Centers for Disease Control and Prevention (CDC). Alcohol Use and Your Health. Page dated January 14, 2025. CDC
- Oster-Aaland L, Lewis MA, Neighbors C, Vangsness J, Larimer ME. Alcohol poisoning among college students turning 21: do they recognize the symptoms and how do they help? Journal of Studies on Alcohol and Drugs, Supplement. 2009;(16):122–130. PMID 19538920. PubMed
- Health Resources and Services Administration (HRSA). Poison Help. Last modified December 11, 2024. HRSA
- Cederbaum AI. Alcohol metabolism. Clinics in Liver Disease. 2012;16(4):667–685. PMID 23101976. PubMed
- Jones AW. Evidence-based survey of the elimination rates of ethanol from blood with applications in forensic casework. Forensic Science International. 2010;200(1–3):1–20. PMID 20304569. PubMed
- NIAAA, Rethinking Drinking. Why do Women Face Higher Risks for Alcohol-Related Consequences? Accessed October 9, 2026. Rethinking Drinking
- NIAAA. What Is A Standard Drink? Updated December 2025. NIAAA
- U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2025–2030. Released January 7, 2026; “Limit Alcoholic Beverages,” p. 4. PDF
- Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA’s National Helpline. Accessed October 9, 2026. SAMHSA
- MedlinePlus (U.S. National Library of Medicine). Alcohol withdrawal. Reviewed January 1, 2025. MedlinePlus
Published by Fuller Health, which makes After Party. This article is general information, not medical advice: talk to a doctor or pharmacist about your own health, medicines and drinking. Last reviewed October 9, 2026. How we research and write.