How to Tell if Someone is Intoxicated: 5 Signs of Intoxication

A majority of adults in the U.S. drink alcohol, and while most consume it moderately, overindulgence is always a risk. Although many can recognize signs of intoxication, there are still myths and misunderstandings about identifying when someone’s safety might be at risk.

Below, we’re talking about an intoxicated person’s symptoms, what affects your level of inebriation, whether a high tolerance means what you think, and the stages you’re likely to experience as you keep drinking.

Five Ways to Recognize an Intoxicated Person

There are many different signs of drunkenness, and the exact behavior will vary from individual to individual based on their degree of intoxication, temperament, and current activities.

Nevertheless, an intoxicated person’s symptoms fall into five categories that you can pay attention to. Various levels of intoxication will bring changes in their:

1. Speech (slurred, loud, nonsensical, or incoherent; smell of alcohol on breath)
2. Balance (stumbling, swaying, staggering, or difficulty standing up)
3. Coordination (fumbling, spilling, dropping things, or misjudging distances)
4. Appearance (flushed face, droopy eyelids, sweaty skin, disheveled hair or clothing, and/or unfocused, red, or watery eyes)
5. Attitude (moody, aggressive, drowsy, impulsive, illogical, or forgetful)

Does Being Drunk Look the Same on Everyone?

Below, we’ll explore the typical intoxicated person’s behavior at various levels or stages of drunkenness.

However, it’s important to know that there’s no universal way to assess someone’s level of intoxication based on their behavior or symptoms.

There are two reasons for this: the amount of alcohol it takes to reach a certain blood alcohol concentration (BAC) varies by person, and even people at the same BAC can display different symptoms.

Intoxication Rate

Different people require different amounts of alcohol to “get drunk” (i.e., achieve a clinically intoxicated BAC).

The rate at which any individual will become intoxicated depends on many factors, including:

• The number of drinks consumed
• The strength of those drinks
• How quickly the alcohol is ingested
• The individual’s size and body composition
• The individual’s metabolic rate
• The individual’s testosterone levels
• Whether any food was eaten before or during alcohol consumption
• Whether the individual is taking medication that affects alcohol metabolism

You’ll notice that sex/gender isn’t on that list, but due to differences in body size, composition, and hormones, women often have a faster intoxication rate than men.

“Tolerance,” aka Symptom Masking

There’s a common misunderstanding that an individual can achieve a higher “tolerance” (i.e., a lower intoxication rate) by drinking regularly.

This is a myth. An individual’s intoxication rate – which is a function of how quickly alcohol is absorbed and how quickly it is broken down in the body – is only dictated by the factors listed above.

So why do heavy drinkers tend to act less drunk than people who drink infrequently? People who drink regularly and/or in large quantities learn how to compensate for the symptoms of intoxication. In other words, they become skilled at hiding the behavioral cues typical of someone’s level of intoxication.

This does not mean that people with a high tolerance are less dangerous than those with a low tolerance. A person’s reaction time and coordination deteriorate as their blood alcohol level rises. Even if a person is good at masking the obvious symptoms of intoxication, their physical capabilities are compromised.

In fact, people with a high tolerance are arguably more dangerous because it’s difficult for others to tell when they’re impaired.

Levels of Alcohol Intoxication

BAC is a fairly objective measure of someone’s level of intoxication, regardless of their ability to mask their symptoms. The level of impairment changes predictably with BAC, regardless of the intoxicated person’s behavior.

There are four levels of intoxication to consider.

Mild Intoxication

When someone’s BAC is between 0.00% and 0.05%, they should be considered mildly intoxicated. Very low levels (0.02% or below) may be subclinical, meaning impairments are negligible.

Mild intoxication causes modest deficits in speech, coordination, balance, concentration, and other factors. People often experience mild intoxication as relaxation.

Moderate Intoxication

When someone’s BAC is between 0.06% to 0.15%, they are moderately intoxicated and begin experiencing more significant impairments to attention, balance, coordination, and speech. There may be moderate memory impairments and a loss of cautiousness. During this time, there’s an increased risk of aggressive behavior.

While many states consider 0.08% to be the legal driving limit, it’s a good idea to avoid driving over 0.05%. Any degree of moderate intoxication makes you dangerous on the road, and there’s a good chance we’ll see a decrease in the legal limit in the coming decades.

Severe Intoxication

When someone’s BAC is between 0.16% and 0.30%, they are severely intoxicated. Signs of severe intoxication include considerable deficits in speech, memory, balance, coordination, judgment, and reaction speed.

During this time, people may begin exhibiting signs of extreme intoxication, including vomiting, blackouts, or loss of consciousness.

Life-Threatening Intoxication

A BAC of over 0.31% puts your life at risk as the level of alcohol in your bloodstream starts affecting your breathing, heart rate, and consciousness. Individuals are likely to display confusion, inability to walk, vomiting, and difficulty remaining conscious, all of which should be taken seriously as signs of extreme intoxication.

After that, an intoxicated person’s symptoms can easily become life-threatening. Their heart rate and breathing may slow, causing dangerous levels of hypoxia. They may have a delayed or absent gag reflex, which can lead to the aspiration of vomit. Their body temperature may become dangerously low to the point of hypothermia. Seizures are possible.

A BAC of 0.40% or above puts you at risk of coma and death via respiratory arrest.

Stages of Alcohol Intoxication 

Sometimes you’ll hear people talk about the “stages” of intoxication, first described by Kurt Dubowski in 1957. These stages lay out the predicted changes in an intoxicated person’s behavior and mood as they continue to drink.

Stage 1: Sobriety or Subclinical Intoxication

If you drink one or fewer alcoholic drinks each hour, you are either sober or barely inebriated. At this stage, you shouldn't have any noticeable impairments.

Stage 2: Euphoria

Stage 2 is what people normally refer to as “tipsy.” People feel confident, start to lose their inhibitions, become more talkative and animated, and feel slightly euphoric.

People can experience this stage starting with mild intoxication and may remain there well into moderate intoxication (0.03-0.12%). As a result, the euphoric stage may include moderate impairments and compromised judgment.

Stage 3: Excitement

By stage 3, people are visibly drunk, moving from moderately intoxicated to severely intoxicated (0.09-0.25%). During this time, an intoxicated person’s symptoms may include emotional instability, a loss of coordination, a lack of critical judgment, difficulty remembering things, blurry vision, drowsiness, and nausea.

Although the name of this stage is “excitement,” this refers more to the emotional and physical agitation that people experience, rather than the pleasant emotion that’s more prominent in stage 2. The name is somewhat ironic since Stage 3 is when the depressive symptoms of alcohol become prominent

Stage 4: Confusion

Once a person has passed well into severe intoxication, they typically enter the “confused” stage (0.18-0.30%). You may think of this phase as “stumbling drunk,” because coordination is markedly impaired.

People in Stage 4 are likely to have difficulty focusing on the present and following conversations. Their pain threshold is often elevated and combined with a lack of coordination. This may result in serious injury that’s not felt at the time. It’s also highly likely they won’t remember what happens during this time when they sober up.

Stage 5: Stupor

Stage 5 typically occurs while people are moving from severe intoxication to a life-threatening level (0.25-0.40%). You probably refer to this stage as “passed out drunk.”

By the time someone reaches the “stupor” stage, they have significant motor impairments and become insensitive to stimuli. They’re likely to be unable to stand or walk, respond slowly, if at all, and pass in and out of consciousness.

By the time you’re seeing these symptoms, it’s time to ask how to help the intoxicated person. It’s very easy for fatal outcomes to occur once someone reaches a stupor because they begin to lose control of bodily processes.

Intoxicated individuals in the stupor phase should be rolled on their side to prevent the aspiration of vomit and monitored closely for signs of respiratory distress.

Stage 6: Coma

A person is in danger of going into a coma at BACs between 0.35% and 0.45% because their body functions have slowed down significantly.

At this point, urgent medical care is essential.

Stage 7: Death

Individuals are highly likely to die from alcohol poisoning at a BAC of 0.45%, though mortality is still possible at lower levels. Most people cannot maintain their essential bodily functions at this point. Respiratory arrest is the biggest risk.

According to the CDC, nearly 30,000 people a year die from excessive alcohol consumption.

Consequences of Selling or Serving to Intoxicated Persons

Being able to recognize someone’s degree of intoxication is important for everyone, whether you’re selling alcohol for profit or simply hosting a party.

In the U.S., many states have Dram Shop laws that hold businesses liable for any harm inflicted by an overserved customer. That means that not only can the business lose its license and face large fines for overserving violations, but it can also be sued by victims of a drunk driving accident.

Liability doesn’t end at the business level, either. Individual bartenders or sales clerks can and have faced both prison and civil liability for selling alcohol to an already intoxicated person who went on to kill someone from behind the wheel. While the consequences are fines or firings more often than jail time, it’s a real risk in today’s world.

Even party hosts can be held liable in some jurisdictions for allowing party guests to drink too much and get behind the wheel. It’s called social host liability, but even in jurisdictions that don’t have it, legal cases can also be brought against social hosts under negligence laws.

Learn to Serve Responsibly

How do you mitigate the risk of dram shop laws and social host liability? The first step is to educate yourself on the liquor laws that apply in your state, as well as responsible alcohol service.

TIPS courses are designed for commercial venues and their employees, but the skills and knowledge they offer can also be useful to party hosts. TIPS is widely accepted by liquor control commissions around the country as effective, skills-based, responsible alcohol service training. Learners discover how to evaluate someone’s level of intoxication, how to avoid serving alcohol to minors, how to properly check ID, and how to de-escalate situations with people who have been drinking. It’s useful stuff!

TIPS courses can be purchased in bulk by businesses and responsible drinking organizations through TIPS Passports. Get started today!