Alcohol Blackout – Signs, Risks & Treatment Programs

Last updated on March 7, 2023

Blackouts occur when a person consumes a great amount of alcohol, either on an empty stomach or in a short period of time. Even though they were conscious at the time, a person who is under the influence of alcohol will have trouble remembering the events that took place while they were intoxicated. Blackouts can happen to anyone, irrespective of sex, age, tolerance levels, or history of alcohol consumption.1

At best, blackouts can lead to embarrassing situations and feelings of discomfort. At worst, they can cause serious health and safety incidents. During a blackout, a person is still able to function, but there is an increased risk of injuries and other accidents. Alcohol blackouts should be seen as a dangerous sign that a person’s drinking has gotten out of hand.1

If you ever woke up after a night out not knowing how you got home, there is a great possibility you’ve experienced an alcohol blackout. In most cases, although blackouts are not considered dangerous in themselves, but if you’ve experienced them on more than one occasion, you should seek professional help before the situation spirals out of control.1

What Is an Alcohol Blackout?

Blackouts are memory gaps that are the result of too much alcohol in the system. These gaps appear because alcohol impairs the brain’s ability to create and store memories. Alcohol intoxication blocks the process of memory consolidation in the small part of the brain called the hippocampus. Hippocampus has an important part in the learning and memory functions of the brain and alcohol prevents it from turning short-term memories into long-term ones.2

If you’re still wondering “What does alcohol blackout actually mean?” Blackouts due to alcohol are essentially episodes of amnesia. They can be classified into 2 categories depending on the severity of impairment – partial and complete blackouts. Partial blackouts are fragmentary blackout episodes when a person can remember certain things but have a blank spot between islands of memory. For this reason, they are also called brownouts or grayouts.3

Complete blackouts are called en bloc blackouts and they refer to a situation in which a person has a complete memory blank and is not able to retrieve large blocks of memory. People who experienced a total blackout have no recollection of events that transpired while they were intoxicated. These severe forms of alcohol blackout can lead to feelings of loss, disorientation, and vulnerability because the person isn’t able to account for their actions.3

What are the Signs & Symptoms of Alcohol Blackouts?

Although people with alcohol blackouts can’t remember what they were doing, they are still able to function and engage in complex activities, which makes it hard to spot the signs and symptoms of an alcohol blackout. A person may look aware and conscious, but their brain is not storing new memories and they may awake to a complete blackout. Available research found that nearly 50% of people who consume alcohol experienced an alcohol blackout at least once.4

Nevertheless, what causes alcohol blackouts? Experiencing an alcohol blackout is not the same as passing out. People tend to confuse one with the other because both are caused by an intake of large amounts of alcohol. The difference between them is that people who pass out fall asleep and lose consciousness completely, while people who black out remain awake and functioning.4

People can realize that they’ve experienced a blackout only after drinking and alcohol intoxication are over. That’s why they can be hard to recognize. A person may be perfectly capable of walking, holding a conversation, or engaging in sexual activities but still remember nothing the day after. There are several signs and symptoms which indicate that an individual has drunk too much and may suffer from a blackout. Look out for signs that a person:5

Gets easily distracted or confused
Became rude or disrespectful towards other people
Started rambling or slurring their words
Shows signs of willingness to engage in risky behavior
Is willing to engage in activities they wouldn’t usually partake in
Consumed too many beverages in a short space of time
Started stumbling, stuttering, or losing their balance

Why Do I Blackout When I Drink Alcohol?

Blackouts that are caused by alcohol can happen to anyone, regardless of their previous experience with alcoholic beverages. Blackouts occur when our blood alcohol concentration (BAC) reaches 0.16. This is a serious level of alcohol intoxication, which in most US states equals twice the legal driving limit. A combination of such a high level of BAC and a possibility of a blackout is what makes these episodes so dangerous.1

Blackouts are more likely to appear when people quickly consume large quantities of alcohol causing their BAC level to rise rapidly. This usually happens if we drink too fast on an empty stomach or if we engage in a binge-drinking or high-intensity drinking episode in a short period. Binge drinking is defined as 5 drinks for a man and 4 for a woman within 2 hours, while high-intensity drinking implies at least twice as much alcohol consumed within the same timeframe.1

There are certain factors that may influence alcohol blackouts. If you are taking sleeping or anti-anxiety pills, you may be susceptible to experiencing an alcohol blackout at much lower levels of BAC, so it’s advisable to practice caution and restraint when drinking. If you want to learn more about blackouts, the interaction of alcohol and medication, or any topic related to alcoholism, hotlines are an easy way to get fully informed.1

What are the Effects of Alcohol Blackouts?

The fact that blackouts usually happen to individuals who consumed large amounts of alcohol represents a warning that their alcohol intake is becoming excessive. Either they drink too quickly, or they’ve developed alcohol tolerance that is increasing their ethanol consumption.6

Short-term effects of alcohol blackouts are related to behavioral issues that are caused by alcohol intoxication. At higher levels of BAC, people are more susceptible to engaging in risky behavior that can lead to accidents with unwanted and unforeseen consequences. Problems with the law, sexual choices that may endanger our health, and reckless or extravagant expenditures are just some of the possible short-term effects of being blackout drunk.7

Long-term or severe alcohol use may lead to a worsening of symptoms and a person’s overall health. People who suffer from regular blackouts have gotten to the point where their bodies can hold large amounts of alcohol without passing out. This level of alcohol intake is known to cause numerous long-term issues. Excessive consumption of alcohol is called alcohol use disorder (AUD). People with AUD have an increased chance of developing serious health conditions, including:8

Arrhythmia
Hypertension
Weakened immunity
Cardiomyopathy
Pancreatitis
Stroke
Liver damage including liver cancer
Various forms of cancer including mouth, bowel, and breast cancer

How Long Do Alcohol Blackouts Last?

Alcohol-induced blackouts can occur in people who don’t suffer from chronic or serious alcohol use disorder. Fragmentary blackouts can last for a couple of seconds when a person forgets what they were talking about 5 minutes before, or they can involve black spots that last for minutes and even a couple of hours. People with fragmentary blackouts may be able to recoup some of their lost memory and recall forgotten events with the help of relevant cues.9

People who experience en bloc memory impairments have trouble remembering when their blackouts started because they usually have a rapid onset. Measuring how long they last is not easy because most individuals fall asleep before they are over. Blackouts are usually over by the time people wake up because sleeping provides the body with the time it needs to process the alcohol. Once the brain is free of alcohol, it’s able to restore its functioning and start storing new memories once again.9

What Happens to Your Body When You Blackout?

Blackouts happen when large amounts of alcohol enter the bloodstream and the body is unable to deal with the sudden inflow of ethanol in the brain. Blackouts won’t cause the erasure of previous memories; they just stop new memories from being created. Part of the brain that has an important role in storing and creating new memories is called the hippocampus.7

Besides memories, the hippocampus regulates learning and spatial navigation. It’s located deep within the forebrain and is an important part of the limbic system. The hippocampus is a plastic and vulnerable structure that can get easily damaged by different kinds of substances and stimuli. No matter how severe your AUD is, the hippocampus can’t develop alcohol tolerance, which makes it vulnerable to alcohol intoxication.7

How to Stop Blacking Out When Drinking Alcohol?

Since it’s hard to recognize when a person is experiencing an alcohol blackout, the best way to ensure you won’t suffer from a blackout is to abstain from drinking alcoholic beverages. If this is not an option, you can lower the chances of a blackout by limiting your intake to one or two drinks. Keep in mind that even though blackouts usually happen when people are heavily intoxicated, they are unpredictable and are known to happen at low levels of BAC.10

If you wish to avoid blacking out, try one of these tips:11

Eat something so you won’t start drinking on an empty stomach
Remember to drink some water between alcoholic beverages
Don’t drink too fast and try to keep a track of your alcohol intake
Limit the number of drinks so you won’t run the risk of a blackout or alcohol poisoning

While these tips may help, there are no proven ways to avoid blacking out when drunk. How people deal with the experience of an alcohol blackout will play a major role in determining their relationship to alcohol. People who are unable to change their alcohol consumption patterns and reduce the amounts they consume should seek professional help for possible signs of the early stage of alcoholism.1

Treatment Options for Alcohol Blackouts

Before brain science developed to the point of being able to study specific processes within the brain, blackouts were considered one of the best indicators of alcoholism. Today we know that blackouts aren’t limited to severe alcoholics and can happen for a variety of reasons to people who don’t necessarily suffer from AUD.12

However, blackouts that are caused by rapid or excessive use of alcohol are a sign that a person has reached a point where their alcohol consumption is starting to influence their ability to function. Since alcoholism is primarily a mental health issue that impacts people’s behavioral patterns, experiencing repeated episodes of blacking out shows that certain changes have to be made before it’s too late.7

Being a mental health condition, alcoholism requires a whole-patient approach to treatment that takes into account various factors that made people resort to drinking in the first place. No two cases of AUD are the same and they require personalized treatment that will be adjusted to meet the specific needs of each individual patient.13

Several proven treatment methods have shown great results over the years in fighting alcohol addiction issues. Most of these treatments can be adjusted in terms of duration, intensity, and treatment setting. This gives each patient the chance to choose the program that fits their medical needs and is within the scope of what they can afford.13

Some of the most popular rehab options are:14

Alcohol detox – Detox uses proven medication to remove alcohol toxins from the system enabling the patient to get clean before starting their rehab process. Detoxification is especially beneficial for severe users who are in danger of going through a dangerous alcohol withdrawal if they suddenly stop drinking.
Various behavioral therapies – Most treatment procedures incorporate some type of behavioral therapy in their rehab program. Some of the most popular behavioral therapies include Cognitive behavioral therapy (CBT), Dialectical behavior therapy (DBT), Motivational Enhancement Therapy, (MET), Motivational Interviewing, and Art therapy.
Inpatient recovery – Inpatient treatment provides the highest level of care since patients spend their days and nights inside a rehab center. This allows medical professionals to monitor their condition 24/7 and adjust treatment according to their progress. In addition to the highest level of medical care, rehab centers offer a structured environment and peer support that helps patients achieve full recovery from underlying issues that were the cause of alcohol addiction.
Outpatient rehab programs – They are a very adaptable form of treatment that can be delivered in a variety of settings and adjusted in terms of intensity. Intensive outpatient treatment (IOT) is usually reserved for patients who need inpatient treatment but are unable to commit to staying inside a rehab center for the duration of the treatment.
Medication-assisted treatment (MAT) – MAT combines FDA-approved medications that are designed to tackle stubborn forms of alcohol use disorder with counseling and behavioral treatments to achieve whole-person recovery and enable patients to lead self-directed lives.
Co-occurring disorders treatment (COD) – COD, also known as dual diagnosis, is a condition that is characterized by the presence of one or more mental health issues in addition to an existing alcohol use disorder. These conditions tend to influence and exacerbate each other so they have to be treated simultaneously in a specialized program.
12-Step programs – Probably the most famous 12-step treatment is Alcoholics Anonymous, which has a long tradition in dealing with AUD and has repeatedly shown great results in helping people overcome all types of alcoholic addiction. It utilizes the healing power of faith in the higher being as a way of helping people quit substance use and achieve their true potential.