Melanie Cole (Host): Alcohol overdose can be very serious and emergent. If left untreated, an alcohol overdose, referred to as alcohol poisoning, can cause a person to choke or suffocate on their own vomit, or worse, they are at risk for death. Welcome to Conversations with MIT Health. I'm Melanie Cole. My guests today are Don Camelio, the Assistant Dean of Student Support and Wellbeing, and the Director of the Office of Community Development and Substance Abuse at MIT, and Dr. Shawn Ferullo. He's the Director of Student Health at MIT Health. Welcome to the show, gentlemen! So, I'd like to start with you, Dr. Ferullo. What is alcohol poisoning? 

Dr. Shawn Ferullo (Guest): Alcohol poisoning is--the easiest way to put it is when the alcohol level becomes high enough or toxic enough that you start getting many of the physiologic effects of alcohol from vomiting, somnolence, sedation, then, of course, the impaired motor function of gait and balance and other functions as well.

Melanie: And, Don, what are some immediate signs that someone's had too much to drink, and actually needs help?

Dr. Don Camelio (Guest): There's really a constellation of symptoms that come together but first you might see somebody who might just look like they're lacking in coordination, maybe having some inability to stand. If you try and talk to them, they're going to be very confused. They might not be making much sense. Next you'll see the speech start to slur a bit, they'll be really difficult to understand. They might actually go in and out of being conscious and that's really a key indicator. If they're not able to maintain consciousness, we'll start to get very, very concerned, because as Shawn mentioned, aspirating vomit is a major concern. If someone has passed out, we're looking for things along the lines of their pulse. If their pulse is slowing down, if they're getting cold or clammy skin and then, obviously, their breathing. If they're breathing in a very shallow manner or very infrequently, we're very, very worried. That means that the system is not operating like it should and that we really want to make sure we get some medical professionals to do an evaluation.

Melanie: Dr. Ferullo, how do you help someone who is very drunk, as a friend? Should the person be allowed to lie down or eat? Can you tell if someone has fallen asleep versus passing out? Does coffee really work? Explain some of this for us.

Dr. Ferullo: I think the easiest answer is that someone should really use their gut, if something doesn't seem right. It can be difficult to ascertain between just someone sleeping and someone passing out. If someone is only sleeping, then they should be able to be aroused. You should be able to wake them up by shaking them or calling their name or other techniques to arouse them versus passing out, where they really have impaired consciousness and won't necessarily respond to stimuli, either verbal or even painful stimuli. You're shaking, rubbing, those sorts of things. I think the being allowed to eat comes down to just where on the spectrum that Don had outlined earlier the patient or the person is. If someone's early in the process, eating food might actually be helpful to put more food in their bellies to absorb some of that alcohol. But, if someone's already had impaired consciousness, impaired speech, and we're really starting to worry about vomiting, then eating could actually be more harmful, with a higher risk of aspiration and vomiting as well.

Melanie: Don, at what point should someone call an ambulance?

Dr. Camelio: Like Shawn said, if their gut indicates that they're concerned about what's going on, call. Call immediately, have someone come out and take a look. If they happen to reach that later part of that symptom scale that I told you about where they are losing consciousness and their breathing is shallow, cool clammy skin, those sorts of things, that's really late in the game. So, we really want to get students to push back their threshold because no one's going to get in trouble. We're going to have someone get out and check them out and also if they don't need any services, if they're in a good enough position to not to be transported to a hospital, then they won't be. But, if they are, we want to get them there as soon as possible so that the person doesn't experience negative outcomes.

Melanie: And then, what about at MIT campus, Don, specifically? What should MIT students do if there is an emergency situation on campus after 11:00 when Urgent Care is closed?

Dr. Camelio: They want to call 617-253-1212. That's going to trigger an emergency response with MIT EMS and MIT police department come out and respond to the situation. We want students to put that number, 617-253-1212 in their phones, have it pre-dialed, and call immediately.

Melanie: So, then, Dr. Ferullo, wrap it up for us about alcohol emergencies, and what you think is the most important information to note if you're with somebody, if you're with friends, and you think somebody has really had seriously too much to drink.

Dr. Ferullo: I think as we outlined earlier and as Don has outlined as well, we really want people to seek help. That's why the Good Samaritan policy is in effect. I think we, as medical professionals and as campus professionals, would like, we don't want the student to feel like it's solely their decision to know if someone is okay or not. That's exactly why we have the resources we do, as Don mentioned: getting the professionals out to do an evaluation. If there's not a need for transport, it will not happen. There won't be specific conduct issues for seeking help and I think the easiest thing is for someone to use their gut if they know something's not right, to not be shy to call and even call early and not wait before someone is really in trouble before they feel that they need to call at that point.

Melanie: And, Don, what resources are available to students who struggle with alcoholism or are concerned about their use of alcohol?

Dr. Camelio: We're fortunate that at MIT, in the Office of Community Development and Substance Abuse, we have lots of different individual and group services that we offer. If someone is experiencing major dependency issues, we have a great relationship with community partners that can provide more engaged outpatient or intensive inpatient services. So, we want people to come in and chat with us so we can help them find the best set of services to meet their needs.

Melanie: Thank you so much gentlemen, for being with us today. It's such important information. Listeners can visit Health.mit.edu for more information and to get connected to one of our providers. That concludes this episode of Conversations with MIT Health. Please remember to subscribe, rate and review this podcast and all the other MIT Health podcasts. . I'm Melanie Cole. Thanks so much for joining us today.