The temporary state of acute alcohol intoxication results from consuming alcohol faster than the body can metabolize it, causing a rapid increase of ethanol in the bloodstream. This surge acts as a depressant, quickly affecting the central nervous system and interfering with communication pathways between nerve cells. Observable signs of drunkenness are direct manifestations of this disruption in brain function. Alcohol modulates neurotransmitters like GABA and glutamate, which regulate excitability and information processing. The severity of these signs is directly related to the concentration of alcohol circulating throughout the body.
Observable Physical Manifestations
Visible physical changes are often the first signs of significant alcohol consumption. Alcohol causes blood vessels, including capillaries in the face and eyes, to dilate. This leads to noticeable flushing of the skin and a bloodshot appearance in the eyes. This vascular expansion can also disrupt temperature regulation, sometimes causing excessive sweating or clammy skin, which may contrast with a drop in core body temperature.
The eyes are particularly telling, often exhibiting a glassy, watery, or unfocused look. Alcohol affects the muscles controlling eye movement, potentially causing nystagmus—an involuntary, repetitive eye movement. Pupil reaction time to light changes may slow, indicating the central nervous system’s delayed response. Posture may also change, often involving slumped shoulders or difficulty maintaining a straight, upright position.
Impairments in Movement and Communication
The loss of motor control is a hallmark of intoxication, stemming from alcohol’s effect on the cerebellum, the brain region responsible for coordination and balance. This impairment leads to noticeable unsteadiness in walking, often described as staggering or swaying, and a general loss of balance. Fine motor skills are also significantly affected, resulting in clumsiness, fumbling with objects, or difficulty performing precise tasks like handling money or keys.
Communication becomes difficult due to alcohol impairing the motor control of facial muscles used for speech. This results in dysarthria, or slurred speech, characterized by words that are thick, mumbled, or difficult to articulate. The pace and volume of speech may fluctuate; some people speak loudly and boisterously while others become quiet and slow to respond. The combination of slowed reaction time and reduced muscle coordination makes acts like driving dangerous.
Cognitive and Emotional Changes
Alcohol significantly alters mental processing and emotional regulation by interfering with brain chemistry, enhancing the inhibitory effects of GABA and suppressing the excitatory effects of glutamate. This chemical imbalance reduces cognitive function, resulting in impaired judgment and difficulty with decision-making. Simple tasks become more challenging, and a person may struggle to follow a conversation or maintain a train of thought.
Short-term memory is particularly vulnerable; intoxication can lead to memory impairment, including “blackouts” where events are not recorded. Emotional and behavioral shifts are common, often presenting as lowered inhibitions and inappropriate social conduct. Mood swings can occur rapidly, ranging from euphoria and increased friendliness to aggression, sadness, or argumentative behavior.
Recognizing Signs of Severe Intoxication
It is important to differentiate typical drunkenness from severe intoxication, which indicates a potentially life-threatening emergency known as alcohol poisoning. Severe intoxication occurs when alcohol in the bloodstream begins to shut down basic life-support functions in the brain. Signs requiring immediate attention include difficulty remaining conscious, an inability to be roused, or lapsing into a stupor or coma.
Dangerous changes in vital functions include slow breathing (fewer than eight breaths per minute) or irregular breathing with gaps of ten seconds or more. The skin may appear pale, clammy, or have a bluish tint, particularly around the lips and fingernails, indicating poor circulation and hypothermia. Vomiting while unconscious is dangerous, as the depressed gag reflex increases the risk of choking or aspirating vomit. If any of these signs are observed, immediate emergency medical help must be sought by calling 911 or the local emergency service.