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The information provided here is meant to educate students so that they can make informed decisions, to understand the possible consequences and outcomes that can result from those decisions, and to know how to recognize signs of an alcohol emergency.

The University of Pittsburgh follows all state, local, and federal laws regarding alcohol. Although information provided here may discuss ways to be safer when consuming alcohol, the University of Pittsburgh does NOT endorse, support, or condone underage drinking in anyway.

Alcohol is classified as a depressant, meaning it suppresses activity in the central nervous system.   It causes impairment to motor coordination, slows reaction times, and also distorts thinking and judgement.   Consuming alcohol in large quantities and/or quickly can result in an alcohol emergency, where alcohol severely impacts the brain and body which can lead to unconsciousness, coma, and even death.

Mixing alcohol with other substances and medications can have harmful effects.   It can put you at risk for a number of negative side effects including making a medication less effective, interacting to make it more harmful or even toxic to the body, and even organ damage.   Always consult with your doctor and pharmacist about possible interactions between alcohol and medications.   Some examples of possible interactions include:

Prescription Medications
can have negative interactions with alcohol. Narcotics, like opioid pain killers, have a significant increased risk of overdose when combined with alcohol due to depressed breathing and oxygen deprivation.   Benzodiazepines, which may be used to treat anxiety and other disorders, are extremely dangerous to combine with alcohol.   This is because they impact the same areas of the brain.   Prescription stimulants, such as those used to treat things like ADHD, can lead to an increased risk of heart problems and issues with concentration when combined with alcohol.   Anti-depressants, especially SSRIs, can lead to worsening feelings of anxiety or depression, feelings of sedation and a slowing of cognitive processes when combined with alcohol.

Over-the-Counter Medications (such as pain relievers, allergy medications, cold & flu medications, etc.)
can all have potential negative interactions when combined with alcohol.   Be sure to consult the label for any medication or supplement, and check with your pharmacist about the possible negative interactions that may occur when combining medications with alcohol.

Mixing with Depressants –
it is dangerous to mix alcohol with other depressants, such as marijuana, benzodiazepines, barbiturates, or sedatives, such as sleeping pills.   Combining depressants multiplies the effects of both drugs and can lead to memory loss, coma or death.

Mixing with Stimulants
is dangerous and can cause a wide range of negative reactions.   Stimulants mask the effects of alcohol which can result in an individual ingesting more alcohol than their body can tolerate.   This can quickly lead to alcohol poisoning or overdose.   Stimulant efficacy may also be negatively affected.   It can result in an individual taking more of a stimulant to reach the desired effect, thus significantly increasing the risks of overdose or other health implications.   Examples of stimulants include amphetamines (ADHD medications), antihistamines (allergy medications), caffeine, cocaine, methamphetamine, and MDMA (ecstasy).

Source: Alcohol.org: An American Addiction Centers Resource, //www.alcohol.org/mixing-with/

Once swallowed, alcohol enters the digestive system where it then enters into the bloodstream.   Approximately 20% of the alcohol is absorbed through the stomach, while the remaining 80% is absorbed through the small intestine.   Alcohol is metabolized and broken down by enzymes in the liver.   The most important point to remember is that the liver can only process approximately one serving of alcohol per hour.   Drinking more than this, will result in your system becoming saturated, and the additional alcohol will accumulate in the blood and body tissues until it can be metabolized.

The National Institute on Alcohol Abuse and Alcoholism defines a standard drink, or one serving of alcohol, as “any beverage containing 0.6 fl oz or 14 grams of pure alcohol.”   It is important to remember that ‘1 drink’ is not one cupful—it is based on the percentage of alcohol in the beverage.   Accurately counting serving sizes is an important part in setting safer limits to stick to a safer blood alcohol concentration (BAC).

Generally speaking, a serving size is considered 12 oz of beer, 5 oz of wine, or 1.5 oz of 80 proof liquor.   It is important to note, though, that if the alcohol is a higher percentage, the fluid volume for serving size will be smaller.   For example, beer is often approximately 4% alcohol, but a micro-brew may have a higher percent of alcohol, meaning the serving size may be smaller than 12 ounces.   It’s important to pay attention to the percentage size to gauge what an accurate serving may be.

When it comes to mixed drinks, it can be very difficult to accurately gauge serving sizes.   Jungle juice, for example, can vary depending on who is mixing it and what is being mixed, which can make it difficult to know how strong the drink is.   As a result, it can be very difficult to accurately track your drinks, which can lead to a high and even dangerous BAC level.

Source: The National Institute on Alcohol Abuse and Alcoholism, //www.niaaa.nih.gov/what-standard-drink

Understanding BAC is a key part of understanding how alcohol affects your body and how too much can lead to an alcohol emergency.   BAC is a measure of the ratio of alcohol in the blood—a BAC of .10 means one-part alcohol for every 1000 parts of blood.

Generally speaking, BAC will differ a little based on a person’s intoxication rate factors.   There is a general formula available to give an estimated BAC level.   These differ based on biological sex and the differences with body chemistry.   We do want to know that we understand that not everyone identifies with their sex at birth, but at present, the standard calculations available use biological sex to calculate BAC levels.   Please note that this is only a general estimate and there are other things that may impact BAC including individual body chemistry, medication or substance use, hormone therapy, drinking on an empty stomach, etc.

To calculate your BAC: Select the appropriate chart**–and then find the row with your approximate weight.   Then select the number of drinks consumed.   The approximate BAC with these charts is assuming consumption is in one hour.   If drinking over a period of more than an hour, you can use the approximate metabolism rate to adjust the calculation by subtracting .015 from the BAC for each additional hour.   Students can pick up a wallet-sized BAC card from the Office of Health Education and Promotion in the Wellness Center, Nordenberg Hall.   There are also a number of BAC calculator apps available for smart phones.

Here is an example of the ranges of BAC and the possible impacts on thinking, feeling and behavior:

• 0.02–0.04%
  May experience light-headedness, relaxation, minor impairment on judgment
• 0.05-0.07%
  Buzzed, euphoria, inhibitions start to lower, minor impairments on reasoning and memory; emotions (good or bad) may be exaggerated
• 0.08-0.10%
  Euphoria may continue, but impairment of balance, speech, vision, reaction times, and judgement are more apparent; self-control may also be impacted
• 0.11%-0.15%
  Depressive effects of alcohol become more pronounced; gross motor movement is impaired, and judgement and perception more severely impacted
• 0.16% -0.19%
  Motor movements and judgment are further impaired; disorientation and blurred vision; nausea possible
• 0.2%-0.24%
  Black out is likely; disorientation; difficulty standing or walking; increased nausea and vomiting
• 0.25-0.30%
  Severe impairment of mental, physical and sensory functions; high likelihood of accident; may pass out suddenly
• 0.31% and up
  – increased risk of coma, respiratory arrest, and death

Remember that alcohol acts like a depressant, so high BAC levels can pose a risk to someone’s health and safety.

There are a number of factors that can affect the way your body responds to alcohol and the way in which it is processed.   Each individual’s response to alcohol is unique and it is important to recognize that any number of these factors can apply.

Food
Eating a large meal prior to consuming alcohol slows the absorption of alcohol into the bloodstream.   If the stomach is empty, alcohol can reach the small intestines in as little as five minutes, where it will be absorbed directly into the bloodstream.   This can result in a dangerously high BAC.   Food will slow the absorption rate, which can help prevent BAC from peaking as high or as quickly.

Substances (including medications)
Mixing substances, including medications with alcohol can have significant risks.   Please see “Is it safe to mix Alcohol with Other Substances or Medications?” for more detailed information.   Always consult your doctor or pharmacist before mixing any medications with alcohol.

Physical and Emotional States
Body chemistry can affect the metabolism rate of alcohol in sometimes unpredictable ways.   If you are ill or recovering from an illness, you could become impaired more quickly.   If you are taking hormones such as birth control or a hormone therapy treatment, you may have a higher BAC.   Symptoms of fatigue and stress are often worsened by alcohol intoxication, as sleep deprivation reduces tolerance and stress can hasten impairment.   Remember that alcohol is a depressant, and will act as such.

Biological Sex
There are several physiological differences between biological males and females, which can impact a person’s reaction to alcohol. I  n general, biological women are more quickly affected by alcohol than males, as they produce an average of 40% less alcohol dehydrogenase, which is the enzyme that metabolizes alcohol.

A hangover is a set of symptoms that occur as a result of excessive alcohol use.   Symptoms that can occur include headache, fatigue, thirst, muscle aches, sensitivity to light and sound, vertigo, nervousness as well as possible nausea and abdominal cramping.   A hangover varies from person to person and can be influenced by a variety of factors, such as dehydration, fatigue, amount and type of alcohol consumed, and food intake.

There are many things believed to be “cures” for hangovers, however, there is no cure—there are only things to help alleviate or minimize some of the symptoms.   Some examples include:

• Have a bite to eat.   Processing alcohol causes low blood sugar and not eating can worsen the effects.
• Hydrate.   Drink plenty of water to rehydrate the body.
• Rest.   Only giving your body time to clear itself of the toxic byproducts of alcohol metabolism and restore immune function will help.

Remember:   the only way to guarantee you will not have a hangover is to not drink alcohol.

Source: The National Institute on Alcohol Abuse and Alcoholism, //www.niaaa.nih.gov/publications/brochures-and-fact-sheets/hangovers

“Blackouts” (aka alcohol-related memory loss) occur when people have no memory of what happened while intoxicated.   Generally speaking, black outs can range in length from as a little as a few minutes to hours.   During a blackout, someone may appear fine to others; however, the next day they cannot remember parts of the night and what they did.

A blackout is NOT the same thing as “passing out,” which happens when people lose consciousness from drinking excessive amounts of alcohol.   Passing out or losing consciousness is a sign of an alcohol emergency and requires IMMEDIATE medical attention.

If someone has passed out, call the Pitt Police (412-624-2121) or 911 to seek immediate medical attention.

Responsible drinking means following all laws and regulations surrounding alcohol, including abstaining from drinking until you are of the legal drinking age.   The legal age to drink in PA is 21.

If someone chooses to drink, the best way to be safe is with moderation and setting safer limits.   The following tips are ways to remain safer and responsible when engaging in drinking behaviors*:

• Eat food before going out and continue to snack throughout the night.
• Pace yourself by sipping your drink and accurately counting your drinks.   Pacing yourself to one drink or less per hour gives your body time to metabolize the alcohol.
• Set and stick to a safer limit.   Setting a personal limit to keep to a lower risk BAC can help reduce risks such as injury, poor judgment, etc.
• Avoid drinking games and pre-gaming.   Drinking a large amount of alcohol in a short amount of time is the most likely way to become dangerously intoxicated.   If you opt to engage in drinking games, substitute with water to prevent losing count or consuming too much too quickly.
• Alternate with non-alcoholic drinks, like water. This not only helps slow your pace, but water will also help keep you hydrated.   Alcohol will cause you to be dehydrated and that can contribute to a hangover the following day.   Staying hydrated can reduce these symptoms and help to process alcohol more effectively.

* Please keep in mind that while the responsible drinking information has been provided, the University of Pittsburgh does not condone or endorse underage drinking of any kind.   Be safe, be smart, and if you choose to drink, only engage in drinking once you are 21.

Alcohol emergencies are serious and can be fatal if not addressed rapidly.   Alcohol poisoning can happen quickly and unexpectedly, and it is critical to know how to recognize someone that needs help and what you can do.

Signs of an Alcohol Emergency
It is critical to understand the signs of an alcohol emergency so that you can take action quickly.   The signs of an alcohol emergency include:

• Passing out, unconscious, unresponsive;
• Heavy vomiting, vomiting while passed out;
• Slow, shallow or irregular breathing;
• Unresponsive or unable to communicate;
• Violent or threatening behaviors;
• Cold, clammy or blue skin;
• Loss of bodily control;
• Seizures;
• Poor awareness of surroundings;
• Difficulty with standing or walking.

What to Do in the event of an Alcohol Emergency
If you think a friend is having an alcohol emergency, call Pitt Police (412) 624-2121 or 911 right away.   Alcohol emergencies require immediate medical attention.

If the person is passed out or unconscious, lay them on their side and hold them there until emergency officials arrive.   NEVER leave someone alone or let them sleep it off.   Be sure that their air way remains open.   Remain with them until help arrives.