The only true way to get sober is to wait.
The Fixed Rate of Alcohol Metabolism
Sobering up, in a physiological sense, means lowering the concentration of ethanol in the bloodstream, known as the Blood Alcohol Concentration (BAC). Alcohol is a central nervous system depressant that slows down brain activity, leading to impaired judgment, coordination, and reaction time. The body’s ability to process and eliminate this substance is governed by a fixed metabolic pathway in the liver.
The detoxification process relies on two main enzymes: Alcohol Dehydrogenase (ADH) and Aldehyde Dehydrogenase (ALDH). ADH converts ethanol into the toxic compound acetaldehyde, which ALDH then rapidly converts into harmless acetate. This enzymatic process operates at a constant pace, which is why time is the only factor that reduces BAC.
For the average person, the liver metabolizes alcohol at a steady rate of approximately 0.015% to 0.016% BAC per hour. This rate is not dependent on the amount of alcohol consumed because the enzymes become saturated quickly. While factors like body weight, sex, and food intake influence how quickly a person’s BAC rises by affecting absorption, they have no impact on the rate of clearance once the alcohol is in the bloodstream.
Debunking Common Quick Fixes
Many popular remedies are mistakenly believed to accelerate the sobering process, but they fail because they do not affect the liver’s fixed metabolic rate. Drinking strong black coffee, for example, only introduces caffeine into the system. This stimulant may mask the depressant effects of alcohol, making a person feel more alert, but their BAC remains high and impairment is unchanged.
Taking a cold shower is another common myth that relies on the shock of cold water for alertness. This sudden exposure can be dangerous, potentially causing a person’s body temperature to drop further, especially since alcohol already lowers body temperature. A cold shower provides a temporary jolt that confuses alertness with actual sobriety, but it does not remove alcohol from the blood.
Engaging in strenuous exercise or trying to “sweat out” the alcohol is also ineffective. While a small percentage of alcohol is eliminated through breath, sweat, and urine, the vast majority is processed by the liver. Exercise can lead to further dehydration, and physical exertion does not speed up the enzymatic breakdown of ethanol. Similarly, attempting to vomit only removes unabsorbed alcohol remaining in the stomach, which is useless if the alcohol has already been absorbed into the bloodstream.
Actions That Support the Waiting Period
Since the liver cannot be sped up, effective actions focus on managing the symptoms of intoxication and supporting the body while it metabolizes the alcohol. Prioritizing hydration is important, as alcohol is a diuretic that increases urine production and leads to significant fluid loss. Drinking water or electrolyte-rich beverages helps counter dehydration and associated discomforts, such as headaches, but this does not alter the BAC.
Consuming bland, easily digestible food can help settle the stomach and manage nausea. If a person is still drinking, eating can slow the rate of future alcohol absorption by delaying gastric emptying, though it will not reduce the BAC from alcohol already absorbed.
Rest and sleep are the most constructive actions, allowing the body to recover from the stress of processing alcohol. Allowing the body to enter a state of repose ensures that energy is directed toward recovery while the liver completes its work.
Recognizing Dangerous Levels of Intoxication
When a person consumes alcohol faster than their liver can process it, their BAC can rise to dangerous levels, leading to acute alcohol intoxication, commonly known as alcohol poisoning. Alcohol poisoning is a medical emergency that requires immediate intervention because the high level of alcohol begins to shut down basic life-support functions, such as breathing and heart rate.
Signs that require urgent medical attention include mental confusion, stupor, and an inability to be roused. Other warning signs are:
- Seizures.
- Slow or irregular breathing (fewer than eight breaths per minute or gaps of more than ten seconds between breaths).
- A low body temperature leading to hypothermia.
- Vomiting while unconscious, which is particularly hazardous due to the risk of aspiration.
If any of these severe signs are present, it is imperative to call emergency services immediately. Never assume a person can simply “sleep off” alcohol poisoning. While waiting for help to arrive, turn the person onto their side to prevent choking on vomit and stay with them to monitor their symptoms.