Alcohol Intoxication as Described in the DSM-5

Man sitting on the edge of a bathtub while a woman vomits in a toilet

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Alcohol intoxication is the state of drunkenness that people experience after drinking alcohol. It is more often thought of as a normal rite of passage into adulthood or a way to unwind and relax after a busy day than as a mental disorder. But like delirium or psychosis, intoxication is an altered state of mind that can be predicted, diagnosed, and treated. That is why alcohol intoxication is included in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, or DSM-5, the gold standard psychiatric manual that doctors and psychologists use to diagnose mental health issues.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Why Even Occasional Alcohol Intoxication and Moderate Drinking Can Be Problematic

Why should alcohol intoxication be a problem if it is only an occasional occurrence? Another common mistake is to think that alcohol is only a problem if it leads to alcoholism or alcohol use disorder.

In fact, most of the harms that occur as a result of alcohol use are related to alcohol intoxication. Of particular concern are injury and death through accidents, especially motor vehicle accidents that occur when the driver is intoxicated with alcohol, as well as short-term health problems, such as alcohol poisoning, and long-term health consequences, such as cancer and a variety of diseases of organs, such as the liver and the brain. Even moderate drinking can lead to these problems.

Alcohol intoxication is implicated in a large proportion of emergency room cases, including treatment of the physical consequences of intoxication itself.

Common Symptoms of Alcohol Intoxication

So, what are the criteria for alcohol intoxication? Obviously, there has to be evidence that the person has recently consumed alcohol. Beyond that, the person shows impairment of their behavior, mood, or decision-making as a result of their drinking, for example. Examples include becoming sexually inappropriate, aggressive, having mood swings, and taking unnecessary risks.

Unfortunately, one of the ways that judgment is impaired is by choosing to drink and drive, even if the driver has no intention of doing so when sober. For that reason, it is best to leave your car at home or hand over your car keys to someone who will not return them to you under pressure when you are intoxicated.

There is a very distinctive and recognizable pattern of behavior when people are intoxicated with alcohol. One of the most noticeable signs is slurred speech. Alcohol affects the person's ability to speak clearly, so even when the person is trying to speak clearly, the slurring can be detected by people who are not intoxicated.

Alcohol also impairs people's coordination, so they can become clumsy in ways that they are not when they are sober. Combined with the unsteady gait that also occurs, this can increase the risk of someone falling when under the influence of alcohol. One test that police used before breathalyzers became common was to ask the person to walk in a straight line. This is very difficult for someone who is intoxicated.

A less well-known sign of alcohol intoxication is nystagmus, which is a kind of small side-to-side eye movement that happens without the person intending it. If you look at the eyes of someone who is intoxicated with alcohol, they will shift around on their own. Having a person track an object with their eyes was another test that police used to determine whether someone was intoxicated.

Alcohol intoxication will also interfere with people's ability to pay attention properly and to remember events. They may forget important details when intoxicated, and they may forget what they did when they were intoxicated after they have sobered up. At its worst, alcohol intoxication can make people unresponsive to what is happening around them, and they can even lose consciousness. This is a dangerous state to be in, both because of the risks of abuses such as rape and because of the risk of asphyxiation through inhaling vomit. This is a life-threatening condition. If an intoxicated person loses consciousness, put them into the recovery position and call 911.

5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington D.C.: American Psychiatric Association; 2013.

  2. Centers for Disease Control and Prevention. Dietary guidelines for alcohol.

  3. Klein LR, Martel ML, Driver BE, Reing M, Cole JB. Emergency department frequent users for acute alcohol intoxication. West J Emerg Med. 2018;19(2):398-402. doi:10.5811/westjem.2017.10.35052

  4. National Institute on Alcohol Abuse and Alcoholism. Understanding the dangers of alcohol overdose.

  5. Olson KN, Smith SW, Kloss JS, Ho JD, Apple FS. Relationship between blood alcohol concentration and observable symptoms of intoxication in patients presenting to an emergency department. Alcohol Alcohol. 2013;48(4):386-389. doi:10.1093/alcalc/agt042

By Elizabeth Hartney, BSc, MSc, MA, PhD
Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada.