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medical emergency

Severe Alcohol Intoxication

When When someone is heavily intoxicated, no longer responds when spoken to, has pale-bluish skin, or is breathing irregularly.

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Content is undergoing medical and legal review. Changes possible.

Emergency

Call 112. Calling for help is required by law (German Criminal Code § 323c). levelll cannot promise immunity from criminal or administrative consequences.

Immediate

  1. 1. Recovery position. Head tilted back, airways clear.
  2. 2. Call 112 if the person cannot be woken, breathing becomes shallow, or there is mixed use with other substances.
  3. 3. Keep them warm — blanket, jacket. Intoxicated people get hypothermic quickly.

Don't do

  • Do not leave them alone, not even 'just briefly' — respiratory arrest is possible.
  • Do not induce vomiting. With reduced consciousness there is a risk of aspiration.
  • No coffee, no perking them up with stimulants — it masks the symptoms and is dangerous for the circulation.

Alcohol becomes life-threatening at blood alcohol levels from around 3 ‰ — but this varies greatly between individuals. Mixed use with other depressant substances (benzos, GHB, opioids) or with cocaine/cocaethylene lowers the threshold considerably.

Symptoms in the critical range:

  • Unconsciousness, cannot be woken
  • Irregular or shallow breathing (< 10/min)
  • Cold, clammy skin, blue lips
  • Vomiting without a swallowing reflex
  • Seizures (see separate scenario)

The body breaks down alcohol at about 0.1–0.15 ‰/h — this cannot be sped up. Letting them sleep it off is only okay with stable breathing in the recovery position and with someone present.

When mixed with cocaine, cocaethylene forms, a metabolite with a longer duration of action and higher cardiac toxicity than cocaine alone (see Cocaine-Alcohol Mix).