If you see any of these symptoms in someone who has been drinking, get medical help as soon as possible. What To Do Call an ambulance. Roll the person on their side into the recovery position so they will not choke if they vomit. Do not leave the person alone. Stay with them and monitor their breathing until medical help arrives. If you are not sure what to do, it’s always better to be safe than sorry. GET HELP if you suspect an alcohol overdose, even if the person is underage. The Recovery Position If someone passes out from drinking too much, you can help by positioning them in the recovery position so they won’t choke if they vomit. You may not think they have had too much to drink, but they may have combined alcohol with other drugs or may have a medical condition you’re not aware of. FOLLOW THESE STEPS Raise the person’s closest arm above their head. Prepare the person to roll toward you. Gently roll the person’s entire body toward you. Guard the person’s head while you roll them. Tilt the person’s head to maintain an open airway. Tuck the person’s nearest hand under their cheek to help maintain the head’s tilt. Do not leave the person alone. Stay with them until medical help arrives. The exact positioning of the person is less important than the purpose of the recovery position, which is to keep the airway open so fluids (vomit) can drain from the mouth.
Alcohol Withdrawal Syndrome Max Bayard, M.D., Jonah Mcintyre, M.D., Keith R. Hill, M.D., and Jack Woodside, Jr., M.D., East Tennessee State University, James H. Quillen College of Medicine, Johnson City, Tennessee Am Fam Physician. 2004 Mar 15;69(6):1443-1450. The spectrum of alcohol withdrawal symptoms ranges from such minor symptoms as insomnia and tremulousness to severe complications such as withdrawal seizures and delirium tremens. Although the history and physical examination usually are sufficient to diagnose alcohol withdrawal syndrome, other conditions may present with similar symptoms. Most patients undergoing alcohol withdrawal can be treated safely and effectively as outpatients. Pharmacologic treatment involves the use of medications that are cross-tolerant with alcohol. Benzodiazepines, the agents of choice, may be administered on a fixed or symptom-triggered schedule. Carbamazepine is an appropriate alternative to a benzodiazepine in the outpatient treatment of patients with mild to moderate alcohol withdrawal symptoms. Medications such as haloperidol, beta blockers, clonidine, and phenytoin may be used as adjuncts to a benzodiazepine in the treatment of complications of withdrawal. Treatment of alcohol withdrawal should be followed by treatment for alcohol dependence. Withdrawal Symptoms The spectrum of withdrawal symptoms and the time range for the appearance of these symptoms after cessation of alcohol use are listed in Table 2 . Generally, the symptoms of alcohol withdrawal relate proportionately to the amount of alcoholic intake and the duration of a patient’s recent drinking habit. Most patients have a similar spectrum of symptoms with each episode of alcohol withdrawal. Minor withdrawal symptoms can occur while the patient still has a measurable blood alcohol level. These symptoms may include insomnia, mild anxiety, and tremulousness. Patients with alcoholic hallucinosis experience visual, auditory, or tactile hallucinations but otherwise have a clear sensorium. Withdrawal seizures are more common in patients who have a history of multiple episodes of detoxification. Causes other than alcohol withdrawal should be considered if seizures are focal, if there is no definite history of recent abstinence from drinking, if seizures occur more than 48 hours after the patient’s last drink, or if the patient has a history of fever or trauma. Alcohol withdrawal delirium, or delirium tremens, is characterized by clouding of consciousness and delirium. Episodes of delirium tremens have a mortality rate of 1 to 5 percent. 6 Risk factors for developing alcohol withdrawal delirium include concurrent acute medical illness, daily heavy alcohol use, history of delirium tremens or withdrawal seizures, older age, abnormal liver function, and more severe withdrawal symptoms on presentation. Evaluation of the Patient in Alcohol Withdrawal The history and physical examination establish the diagnosis and severity of alcohol withdrawal. Important historical data include quantity of alcoholic intake, duration of alcohol use, time since last drink, previous alcohol withdrawals, presence of concurrent medical or psychiatric conditions, and abuse of other agents. In addition to identifying withdrawal symptoms, the physical examination should assess possible complicating medical conditions, including arrhythmias, congestive heart failure, coronary artery disease, gastrointestinal bleeding, infections, liver disease, nervous system impairment, and pancreatitis. Basic laboratory investigations include a complete blood count, liver function tests, a urine drug screen, and determination of blood alcohol and electrolyte levels.
Symptoms/Disorders ~Common medications and selected brand names ~Some possible reactions with alcohol Angina (chest pain), coronary heart disease Isordil® (isosorbide), nitroglycerine Rapid heartbeat, sudden changes in blood pressure Anxiety Xanax® (alprazolam); Klonopin® (clonazepam); Valium® (diazepam); Ativan® (lorazepam) Drowsiness, dizziness; increased risk for overdose Blood clots Coumadin® (warfarin) Occasional drinking may lead to internal bleeding; heavier drinking may have the opposite effect, resulting in possible blood clots, strokes, or heart attacks Colds, coughs, flu, allergies Benadryl® (diphenhydramine); Tylenol® Cold and Flu (chlorpheniramine); Robitussin AC® (codeine) Drowsiness, dizziness; increased risk for overdose Depression Elavil® (amitriptyline); Anafranil® (clomipramine); Norpramin® (desipramine); Serzone® (nefazodone); Desyrel® (trazodone) Drowsiness, dizziness; increased risk for overdose Diabetes Micronase® (glyburide); Glucophage® (metformin); Orinase® (tolbutamide) Rapid heartbeat, sudden changes in blood pressure; convulsions, coma, death Heartburn, indigestion, sour stomach Tagamet® (cimetidine); Axid® (nizatidine); Zantac® (ranitidine); Reglan® (metoclopramide) Rapid heartbeat, sudden changes in blood pressure (metoclopramide); increased alcohol effect Infections Grisactin® (griseofulvin); Flagyl® (metronidazole); Acrodantin® (nitrofurantoin); Septra® (sulfamethoxazole); Nydrazid® (isoniazid); Seromycin® (cycloserine) Rapid heartbeat, sudden changes in blood pressure; liver damage (isoniazid) Muscle pain Soma® (carisoprodol); Flexeril® (cyclobenzaprine) Drowsiness, dizziness; increased risk of seizures; increased risk for overdose Nausea, motion sickness Antivert® (meclizine); Atarax® (hydroxyzine); Phenergan® (promethazine) Drowsiness, dizziness; increased risk for overdose Pain such as that from headache, fever, muscle ache, arthritis; inflammation Aspirin (salicylates); Advil®, Motrin® (ibuprofen); Tylenol®, Excedrin® (acetaminophen); Vioxx® (rofecoxib); Celebrex® (celecoxib); Naprosyn® (naproxen) Stomach upset, bleeding and ulcers; liver damage (acetaminophen); rapid heartbeat Seizures Klonopin® (clonazepam); phenobarbital; Dilantin® (phenytoin) Drowsiness, dizziness; increased risk of seizures Severe pain from injury; postsurgical care; oral surgery; migraines Fiorinal® with codeine (butalbital and codeine); DarvocetN® (propoxyphene); Vicodin® (hydrocodone); Percocet® (oxycodone) Drowsiness, dizziness; increased risk for overdose Sleep problems Restoril® (temazepam); Prosom™ (estazolam); Sominex® (diphenhydramine) Herbal preparations (Chamomile, Valerian, Lavender) Drowsiness, dizziness Did you know? Many types of medication can make you sleepy. Taking these medicines while drinking can make you even more drowsy, dizzy, and light–headed. You may have trouble concentrating or performing mechanical skills. Mixing alcohol with certain medicines makes it dangerous for you to drive. Combining alcohol with some medicines can lead to falls and serious injuries, especially among older people. Some medications, including many popular painkillers and cough, cold, and allergy remedies, contain more than one ingredient that can react with alcohol. Read the label on your medication bottle to find out exactly what ingredients it contains. Certain medicines contain up to 10 percent alcohol. Cough syrup and laxatives have some of the highest alcohol concentrations. Women and older people are at higher risk for harmful alcoholmedication reactions. Alcohol and medicines can interact harmfully even if they are not taken at the same time.
Alcohol and Athletic Performance http://www.uhs.uga.edu/aod/athletic-performance.html How alcohol affects a person depends on the amount consumed, the environmental context, and individual differences in tolerance . While a small amount of alcohol consumed daily may have a protective effect on the cardiovascular system, chronic heavy alcohol use is associated with a wide range of physiological and societal negative outcomes, which account for approximately 100,000 deaths yearly in the United States. The fitness-oriented individual should be aware of the acute and chronic effects of alcohol on physical performance. Acutely, alcohol can cause negative effects on motor skills and physical performance. Chronically, alcohol abuse may eventually impede physical performance; individuals diagnosed with alcohol dependence have displayed varying degrees of muscle damage and weakness. Alcohol abuse is at least as prevalent in the athletic community as it is in the general population; in fact, the majority of athletes have begun drinking by the end of high school. Both male and female college students have higher rates of binge drinking than non-athletes, and drinking five or more drinks on any one occasion affects the brain and body for several days. How Could Drinking Affect My Athletic Performance? Alcohol has been described as a performance impairing drug. Exercise is a complex activity utilizing many of the body's organ systems; alcohol exerts an effect on most of these systems, including the central nervous system, muscle energy stores and the cardiovascular system. What Happens if I Exercise With an Elevated Blood Alcohol Level? Alcohol has acute effects on motor skills, strength and power, and aerobic performance. Alcohol and motor skills Low amounts of alcohol (0.02-0.05g/dL) result in: decreased hand tremors slowed reaction time decreased hand-eye coordination Moderate amounts of alcohol (0.06-0.10 g/dL) result in: further slowed reaction time decreased hand-eye coordination decreased accuracy and balance impaired tracking, visual search, recognition and response skills Alcohol and strength, power, and short-term performances Alcohol will not improve muscular work capacity and results in: a decrease in overall performance levels slowed running and cycling times weakening of the pumping force of the heart impaired temperature regulation during exercise decreased grip strength, decreased jump height, and decreased 200- and 400-meter run performance faster fatigue during high-intensity exercise Alcohol and aerobic performance Adequate hydration is crucial to optimal aerobic performance. The diuretic property of alcohol can result in: dehydration and significantly reduced aerobic performance impaired 800- and 1500-meter run times increased health risks during prolonged exercise in hot environments Medical Concerns: Alcohol has been linked to exercise-induced anaphylaxis and asthma. Acute ingestion may cause myocardial irritability, resulting in arrhythmias. Consumption before water activities increases the risk of injury. What Happens if I Exercise With a Hangover? Hangovers are caused by alcohol toxicity, dehydration, and the toxic effects of congeners in alcoholic drinks. Hangovers are commonly characterized by a depressed mood, headache, and hypersensitivity to outside stimuli, such as light and sound. These lingering effects of alcohol may lead to decreased athletic performance. Drinking on the day or night before athletic activity hinders physical conditioning progress, and exercising with a hangover has been shown to significantly decrease aerobic performance capacity - by as much as 11%. Regardless of the type of activity, conditioning progress will be impeded. Teammates who do not drink the day before competition will be ahead of the game. What About Chronic (Long-Term) Effects of on Athletic Performance? While low-dose (meaning no more than 2 drinks daily) chronic alcohol consumption may offer some cardio-protective element in the exerciser by increasing HDL-cholesterol or decreasing coronary spasm, alcohol affects the body's every system and is also linked to several pathologies. Heavy, chronic alcohol consumption impairs exercise performance by: impairing the cardiovascular response to exercise causing nutritional deficiencies from alterations in nutrient intake, digestion, absorption, metabolism, physiological effects, turnover, and excretion of nutrients causing myopathy , or muscle damage, wasting, and weakness, in various muscles, including the heart changing the body's hormonal environment, making it less conducive to increasing muscle mass and strength compromising cardiovascular and muscular performance in people with alcoholism Special concerns for women: Women's muscular strength is inversely correlated with total life-time doses of alcohol Women may be more sensitive than men to the toxic effects of alcohol on the heart Athletes are not immune later in life from the potentially serious consequences of chronic alcohol abuse, including liver toxicity, endocrine dysfunction, decreased serum testosterone, seizures, altered lipid metabolism, ulcers, heart disease, diabetes, and bone disorders. Nutritional Aspects of Alcohol and Sports: Alcohol as a Nutrient Each gram of alcohol provides seven kilocalories compared to nine for fat and four each for carbohydrate and protein. Other nutrients may be present, depending on the type of beverage. Beer, for example, has been seen as a good source of many nutrients and has sometimes been used in preparation for endurance events or to replenish nutrients following competition. Many athletes and sports administrators name beer as their preferred alcoholic beverage, and some athletes may still believe that beer is an effective beverage for replacing fluid and supplying high energy. However, beer will actually worsen dehydration due to the diuretic effect of alcohol on the renal system. Beer is inappropriate as a carbohydrate replacement; the 7g of energy per gram of alcohol (ethanol) provides &quot;empty calories&quot; and does not provide available glucose. Acute ingestion of alcohol provides no benefits relative to the energy sources for exercise and in fact may reduce muscle glycogen at rest, impair gluconeogenesis, cause hypoglycemia and decrease leg-muscle glucose uptake. Exercise will not increase alcohol metabolism. In the chronic alcoholic, alcohol replaces the normal macronutrient intake (protein, carbohydrates, and fats) and nutritional deficiency diseases can develop. In fact, alcohol ingestion lowers muscle glycogen levels and will decrease the available fuel for normal aerobic energy production. Alcohol and Injury Athletes who drink alcohol at least once per week have an elevated risk of injury as compared to athletes who do not drink. Consuming alcohol regularly depresses immune functioning and slows the healing process for sports-related injuries. Alcohol-related injuries in sports like cycling, boating, ice skating, snow skiing and swimming are likely related to a decrease in psychomotor functioning and impaired judgment. Nearly 1/3 of college students consume alcohol during participation in recreational boating or swimming, while greater than 50% of young adult drowning victims have detectable post-mortem blood alcohol levels. DEHYDRATION Alcohol is a powerful diuretic that can cause severe dehydration and staggering electrolyte imbalances. Severe dehydration can require several days to a week for full recovery. While dehydrated, an athlete is at greater risk for musculoskeletal injuries including: cramps, muscle pulls, and muscle strains. Also, dehydration can lead to severe brain impairment and even death when coupled with extreme temperatures and intense practices (most notable during two-a-days). Dehydration leads to decreased appetite and muscle wasting (you lose muscle mass). A loss of muscle mass results in a decrease in strength and performance. Decreased food consumption associated with appetite loss will result in fatigue and over training, which may further heighten injury risk. TESTOSTERONE Alcohol, when consumed in amounts typical with binge drinkers (most common among college athletes), can dramatically decrease serum testosterone levels. Decreases in testosterone are associated with decreases in aggression, lean muscle mass, muscle recovery and overall athletic performance. This can also cause testicular shrinkage, breast enlargement, and decreased sperm development in males. In females, this may cause an increase in the production of estradial, (a form of estrogen) which may increase the risk of breast cancer. PERFORMANCE Alcohol will also impair reaction time and mental acuity for up to several days after consumption. The delayed reaction time and reduced mental acuity is of severe consequence to the athlete. Performance will be reduced and injury risk increased. Alcohol consumption will cause a decrease in hand-eye coordination and will impair judgment. Alcohol also interferes with lactic acid breakdown and can result in increased soreness after exercise. Alcohol can also cause nausea, vomiting, and drowsiness for days after consumption. FAT STORAGE Alcohol has seven calories per gram. Fat has nine calories per gram. Alcohol is stored much like fat in the body. Also, alcohol deaminates (destroys) amino acids and stores them as fat. Alcohol consumption, therefore, increases fat storage and adversely effects body composition (increase % body fat). Powerful energy pathways (like glycolysis) are impaired and large amounts of lactic acid are produced, this results in decreased energy, decreased muscle recovery, and increased muscle soreness. Also, alcohol is usually consumed in addition to the person’s normal food intake. Since alcohol has seven calories per gram these extra calories can add up really fast increasing the persons bodyweight and percent body fat.. NUTRITION From the standpoint of bodily health, alcohol can have deleterious effects on the body. Fatty liver, fibrosis, cirrhosis (irreversible liver damage) and gout are common side effects of chronic binge drinking. Alcohol over stimulates cells in the lining of the stomach that produce acid. Increases in acid production are associated with heartburn and ulcer development. Intestinal cells fail to absorb micronutrients (vitamins and minerals), which can lead to electrolyte imbalances and vitamin deficiencies. Alcohol consumption impairs the body’s mechanisms that control blood glucose and may result in hypoglycemia. This may cause serious injury even if it doesn’t last long because it causes the brain and other body tissues to be deprived of glucose needed for energy and normal function. Hypoglycemia is a common cause of low energy on the field and in the classroom. SOCIAL Alcohol acts as a central nervous system depressant and can impair judgment leading to injuries (both to other people and oneself). Alcohol use has been associated with numerous homicides, suicides, fatal auto accidents, and fights resulting in incarceration. Decreased impairment of judgment and decreased inhibition (ability to say, “NO”) has resulted in numerous cases of date rape and other gender related crimes. LONG-TERM USE Long-term alcohol use may lead to weakened heart muscle, impotency, altered brain and nerve functions, elevated triglycerides, fat deposits in the liver, abnormalities in blood-clotting, pancreatitis, liver failure, vitamin deficiencies, skin abnormalities, and even DEATH!!!!! As you can see, alcohol prevents athletes from reaching their ultimate playing potential. If one or more players on a team were to be in this condition during the game, this can have negative effects on the team as a whole. Every member of the team needs to play at his best at all times in order to have a team of champions. Don’t let alcohol abuse be the reason you don’t play at your best! Sleep Alcohol has a detrimental effect on both the quality of sleep and on daytime attention. Sleep problems are common in alcoholics and also in some people who have completely stopped drinking. The effects of alcohol on sleep and attention are complicated to define and have considerable variability in individuals. Alcohol seems to accelerate falling asleep, at least in subjects who do not tend to fall asleep immediately. The negative effects arise later and affect the quality and duration of sleep. Sleep is a complex phenomenon in which there are alternating phases of deep sleep, called paradoxical or REM sleep during which the subject dreams, and slow wave sleep. Undisturbed progression of these two phases of sleep is essential for an individual's well being. Alcohol disturbs or interrupts the sequence of paradoxical sleep and light sleep. Thus alcoholics and some people who have stopped drinking complain about disturbed and fragmented sleep, frightening dreams and insomnia. The disruptive effects of alcohol last well into the night, even when alcohol has been eliminated. This is not a phenomenon specific to alcohol, it is seen with other sedative products. Snoring is abnormally frequent after taking alcoholic drinks in the evening before going to bed. This is due to the relaxing effects of alcohol on the pharyngeal muscles. Daytime repercussions of alcohol's effects on sleep Disturbed sleep or sleep deprivation exacerbate the sedative effects of alcohol during the day. Alcohol consumed late in the evening will noticeably reduce the performance of a subject (attention, dexterity,...) during the following morning. By producing an accumulation of nights of poor sleep, alcohol can disrupt the normal sleep/wake cycle, which is also essential for health and well being. Hence the negative effects of alcohol can have repercussions on daytime performance. Alcohol and attention The sedative action of alcohol has variable degrees of effect on attention, reducing it and producing diminished performance. This action is particularly noticeable in subjects who lack sleep or who tend to be lethargic. Alcohol seems to reduce the ability of an individual to waken, even if consumed in moderate amounts, to the point where driving ability is affected, not just in the hours after consumption, but sometimes for days afterwards.
Sometimes when a person drinks too much, they pass out. This is the body’s way of protecting itself by not allowing the person to drink more. But when someone drinks a lot of alcohol very quickly, they may not pass out in time, and may drink enough to cause them to slip into a coma and die (alcohol overdose).