Identification and management of acute alcohol intoxication

Eur J Intern Med. 2023 Feb:108:1-8. doi: 10.1016/j.ejim.2022.08.013. Epub 2022 Aug 16.

Abstract

Acute alcohol intoxication (AAI) is a harmful clinical condition, potentially life-threatening, secondary to the intake of large amounts of alcohol. Clinical manifestations of AAI are characterized by behavioural and neurological symptoms, even if its effects involve several organs and apparatus. Moreover, severe alcohol intoxication can produce a global neurological impairment leading to autonomic dysfunction, respiratory depression, coma and cardiac arrest. The evaluation of blood alcohol concentrations (BAC) is useful to confirm the suspicion of intoxication, both for clinical and legal reasons. Most of patients with AAI are referred to Emergency Departments due to behavioural, social, traumatic or clinical complications. Patient's stabilization is the first step in the management of AAI, in order to support vital functions and to prevent complications. Metadoxine represents a useful drug to increase ethanol metabolism and elimination. Given that AAI could represent a sentinel event of chronic alcohol abuse, patients presenting with acute intoxication should be screened for the presence of an underlying alcohol use disorder and referred to and an alcohol addiction unit to start a multidisciplinary treatment to achieve long term alcohol abstinence. The present review will focus on clinical features, diagnostic criteria and treatment strategies of AAI.

Keywords: AUD; Alcohol use disorders; Alcoholic cardiomyopathy; Alcoholic hepatitis; Binge drinking; Blood alcohol concentrations; Mellanby effect.

Publication types

  • Review

MeSH terms

  • Alcohol Drinking
  • Alcoholic Intoxication* / diagnosis
  • Alcoholic Intoxication* / therapy
  • Alcoholism* / complications
  • Alcoholism* / diagnosis
  • Alcoholism* / therapy
  • Blood Alcohol Content
  • Ethanol
  • Humans

Substances

  • Ethanol
  • Blood Alcohol Content