What are the symptoms of acute alcohol intoxication?

This is the 3863rd article of Da Yi Xiao Hu

In the dark night, there was a knock on the door of the ward. When I opened the door, I saw three uniformed policemen supporting a burly man. It was learned that the burly man stopped a taxi on the road. After getting in the car, he could not tell the specific destination and asked the driver to drive forward. After walking for a while, he said he wanted to urinate. After going to the toilet, he walked straight to the driver's seat and asked the driver to get off. The driver was confused and wanted to refuse, but before he could open his mouth, the driver was dragged out of the car by the arm of the burly man. Facing the burly man, I could only sit in the back seat obediently. I didn't dare to speak in the car and secretly called the police. After the police arrived, they found that the burly man's speech was inconsistent and irrelevant, and he seemed to have mental abnormalities, so he was sent to the hospital for treatment. The burly man walked into the ward, answered questions irrelevantly, spoke in a high voice, was irritable, and behaved strangely. Because the patient had a little smell of alcohol, it could not be ruled out that the patient had problems caused by alcohol.

The next day, the patient's condition improved, he cooperated, was conscious, and his emotions were stable. He reported that he had drunk alcohol on the day of admission and deeply regretted and blamed himself for his behavior. The diagnosis was: acute alcohol poisoning.

Many people in our daily life like to drink, especially men. Alcohol is mainly metabolized by the liver. People with poor liver function may suffer from alcohol poisoning. The harm caused by alcohol poisoning is very serious. Some people may have abnormal behavior, some may induce coronary heart disease, and some may cause cerebral hemorrhage, and even cardiac arrest and sudden death may occur from time to time. So what is acute alcohol poisoning? What are the clinical manifestations?

Acute alcohol poisoning is a state of central nervous system excitement or inhibition caused by drinking excessive alcohol, commonly known as drunkenness.

There are three forms: ordinary drunkenness, pathological drunkenness, and complex drunkenness.

General intoxication

The development of intoxication depends on the concentration of alcohol in the blood and individual tolerance.

Generally speaking, in the absence of obvious addiction, the degree and range of inhibition vary with the amount of alcohol consumed or the alcohol concentration in the blood. For example, an adult weighing 60 kg drinks about 150-250 g of high-proof liquor (about 50 degrees), and his blood alcohol concentration is about 0.06%. This blood alcohol concentration first inhibits the cerebral cortex, causing the subcortex to release, resulting in a sense of relaxation, emotional release, and a euphoric and frivolous feeling; decisions and actions are often made without careful consideration, and speech is often based on impulse without careful consideration, such as "a thousand cups of wine are not enough when meeting a bosom friend, but a single word is too much when talking to a stranger" and "truth comes out after drinking." As the amount of alcohol consumed increases, inhibition further deepens. When drinking about 250-300g of strong liquor and the blood alcohol concentration is about 0.1%, the so-called drunken state occurs, and the inhibition of mental activity, language and motor function deepens: reduced reactivity to surrounding things, dulled senses, impaired judgment and memory, decreased self-control, prone to taking risks, unstable movements, and may be aggressive, provocative, loose associations, taking advantage of the topic, unstable gait, slurred pronunciation, etc. Afterwards, the brain is in a highly inhibited state, and the person is drunk and unable to get up, vomiting, urinating and defecating without any awareness. When the blood alcohol concentration exceeds 0.4%, coma, respiratory and heartbeat inhibition may occur, and the possibility of death is very high.

Pathological drunkenness

The characteristic is that a small amount of drinking causes severe mental disorders. It is an allergic reaction to alcohol by an individual's specific constitution, and the incidence rate is low. After drinking a small amount of alcohol, delirium or a hazy state, extreme excitement, illusions and hallucinations, persecution delusions, aggressive behavior, nervous fear, and convulsions suddenly occur.

Generally, the attack lasts for several hours or a whole day, and often ends with a deep sleep. After waking up, the patient cannot recall the course of the attack.

Complexity of drunkenness

It usually occurs in individuals with organic brain diseases or liver diseases, whose tolerance to alcohol decreases and the disease appears rapidly even when the amount of alcohol consumed is not large.

Its complexity lies in the fact that in addition to the general state of drunkenness, there is a clear disorder of consciousness, manifested as excitement, agitation, violent behavior, and even murder and destruction of property. The duration is often only a few hours, and the patient completely loses memory of the attack afterwards, or has only sporadic memory.

The above are some clinical manifestations of acute alcohol poisoning. If you have any of the above symptoms, you must seek medical treatment in time, otherwise it may cause serious consequences or even death, which is a result that none of us want to happen. It is best not to drink or drink less. If you want to drink, it is best to drink less at a time.

Author: Shanghai Fengxian District Mental Health Center

Psychiatry Department Attending Physician Wang Chunlian

Wang Jinde Attending Physician