Blacking Out: Why It’s More Dangerous Than You Think

“What the hell happened last night?” Whether you’ve asked that question yourself after waking up on your bathroom floor wearing nothing but one sock and a sombrero, or your friends have texted it to you upon waking up at random guy’s house, or even if you’ve just seen The Hangover, then you know what a blackout is. Blacking out from drinking has become so prevalent and normalized on college campuses that it’s used casually in conversation (“Yeah, John was so blackout that he was yelling at people on the street in Spanish”) or as a motive for the night (“I’m trying to black out”). But should we really be so nonchalant about this drinking behavior? Why exactly do we blackout, and what are the implications?

We talked to collegiettes and psychiatrist Linda Smith to find out the real deal behind blacking out. You may regret that time you woke up cradling a bottle of tequila, an empty pizza box, and your broken iPhone—but you won’t regret learning about why it happened and how to prevent it in the future.

What is a blackout?  

“A blackout is alcohol-induced amnesia, wherein the person cannot recall some, or all of the events that occurred while she was intoxicated,” Dr. Smith says. “It is not the same as ‘passing out’, which is loss of consciousness due to excessive alcohol consumption. In a blackout, the individual is conscious and awake, and engaging in activities, but later has only partial or no recall for those activities.”

“Sometimes I will only black out part of the night, and not even realize it until someone mentions something that happened that I have no recollection of,” says Julia*, a junior at the University of Michigan. “Like last Saturday morning, I woke up and thought I knew everything I did the night before until my friend sent me a picture of me sitting in a shopping cart on the lawn of our friend’s house…then I had to have my friend explain the entire night to me. It’s a little scary when that happens just because it makes me wonder how many embarrassing things I’ve done and not remembered,” she says. “Blacking out an entire night is even scarier…if something dangerous happened I wouldn't be in control at all.”

The tricky part about blacking out—whether it’s happening to you or a friend—is that you can appear relatively fine (unlike when you’re completely passed out or throwing up), which may fool others into thinking you are aware of what you’re doing and don't need any help. 

“You can't really tell if someone is having a blackout until the next day when they can't recall what happened,” Dr. Smith says. “Because the short-term memory (of the past several minutes) is still intact, someone in a blackout can still engage in activities and look normal...well, drunk, but awake, and talking, moving about, and making decisions—but not necessarily good ones. People report having engaged in a variety of activities they have no memory of, which could be hazardous in their condition, for example driving, spending money, fighting, vandalism.”

Other risky or unwanted activities include going home with a stranger, wandering off somewhere by yourself, having unprotected sex, losing track of your belongings, saying things you don’t mean (or do mean but regret saying), and more.

Why do blackouts happen?

“Blackouts are associated with consumption of large amounts of alcohol; however, the cause appears to be more related to rapid consumption than to total amount, resulting in a rapid rise in Blood Alcohol Concentration (BAC),” Dr. Smith says. “A large amount of alcohol quickly enters the brain, seriously disrupting the activities of several neurotransmitters in select areas of the brain.”

Scientifically speaking, as Dr. Smith goes on to explain, quickly drinking large amounts of alcohol can shut down your brain’s glutamate receptors. Those receptors are “primarily responsible for encoding and storing short-term memories and transitioning them into long-term (greater than 30 minutes old) memories, that are then sent for storage in other parts of the brain.” Therefore, when the receptors shut down, short-term memories fail to become long-term ones. “This [process] is thought to be the neurophysiological mechanism behind alcohol blackouts (and Rohypnol, or "roofies" as well),” Dr. Smith says.

Another complicated aspect of blackouts is that there is no exact number of drinks that causes them to occur; everyone’s limits are different and other factors, such as the speed of consumption and type of alcohol, have an impact. “I’ve blacked out after four or five shots before, but then other nights I have had more and remember everything,” Kristen*, a senior at the University of Michigan, says. “My friends and I have come to realize that it totally depends on what we’ve had to eat beforehand and how quickly we are taking shots…most of the times I’ve blacked out are when I was hurriedly pregaming before an event.”

According to the Student Health Services at the University of California, San Diego, blackouts tend to start to occur at a BAC of 0.14-0.17, and become increasingly likely as your BAC gets higher. You can use this BAC calculator to estimate what number of drinks in a given time period will result in that BAC range based on your gender and weight.

Yet another problematic fact about blacking out is that, as collegietes, we are most susceptible to them. “Adolescents and young adults appear to be more susceptible to blackouts than other adults, likely because their brains are still maturing and more vulnerable,” Dr. Smith says. “Women in this age group are more susceptible to blackouts than men, and more at risk for long term brain damage from them, with subtle impairments in learning and memory, spatial awareness, and decision-making. It takes less alcohol to produce a blackout, not only because women weigh less, but also because they have lower levels of the enzymes that help metabolize alcohol.”

What are the risks?

So you already know that blacking out puts you at risk of embarrassing yourself (tripping down the steps at a party, butchering karaoke at the bar, or crying for no reason in the corner), but what are the other possible consequences and concerns?

As previously discussed, you may unknowingly engage in unsafe activities that you would not normally do. This can result in more than just a sense of regret the next day.  In the case of unprotected sex, for example, you could end up contracting an STD or getting pregnant. And an unwanted reputation—because, unfortunately, gossip does spread about “that girl” at the party that drunkenly went upstairs with two different guys throughout the night.

We’ve all heard stories about college students going missing after a night out, or getting sexually assaulted or robbed. When you blackout, you put yourself at risk for getting into one of these extremely dangerous, life-threatening situations because you have no control over or recognition of what you are doing. “My friend blacked out at a date party and wandered off from the group,” collegiette Lauren* says. “She ended up passed out on a sidewalk a few blocks away from the venue…thankfully a nice woman found her and helped her get a cab home, but we were all shaken up the next day thinking about all of the horrible things that could have happened if someone else had found her first or if no one had found her at all.”

Since your BAC is elevated when you are blacked out, you are also more likely to get alcohol poisoning. “Individuals having blackouts are 70% more likely to end the night in the emergency room than someone who's had the same amount to drink, but is not having a blackout,” Dr. Smith says.

In addition to all of those risks, there are also long-term health concerns related to blacking out. “Blackouts are associated with the development of alcohol abuse and/or dependence, though they can also occur among social drinkers,” Dr. Smith says. “It is considered to be a sign of early brain damage from alcohol use.” Not to mention the damage done to your liver from frequent blackouts.

How can you prevent a blackout from happening in the first place?

“As blackouts are related to rapid consuming of alcohol, it follows that drinking more slowly would be helpful in avoiding them,” Dr. Smith says. “Your body can process about 1 drink per hour without a rapid rise in BAC.”

Dr. Smith compiled the following list of tips you can rely on when you go out to ensure that you don’t wake up with Mike Tyson’s tiger in your room like the dudes in The Hangover—or worse.

  • Sip your drink, don't gulp.
  • Stick to beer, wine, and/or mixed drinks with plenty of mixer. Shots are too easy to drink too fast; you can imbibe a dangerous amount of alcohol before you are even intoxicated. Drinking games tend to promote rapid drinking, so avoid them, or participate with great caution.
  • Alternate alcoholic drinks with non-alcoholic drinks.
  • Eat before drinking, and continue to eat while drinking; food slows down the absorption rate of alcohol.
  • Stay well hydrated.
  • Don't drink when ill or sleep-deprived—it will take less alcohol to get you drunk, or in a blackout state.
  • Don't mix alcohol with other drugs, or with medications: they may potentiate the effects of alcohol.
  • Plan your night's drinking before you start. Set a drink limit for yourself and stick to it. Know your limits, and count your drinks accurately, allowing for extra large or extra strong drinks. Most blackouts occur when drinking hard liquor alone, or with beer.

What should you do if you or someone you are with blacks out? 

So you’ve learned about all the implications of blacking out and you know ways to prevent it—but, let’s not kid ourselves, you’ll likely encounter someone who is blacked out or experience a blackout yourself throughout the rest of your college career. What should you do if this happens?

If you wake up with a fuzzy recollection of last night (or no recollection at all), try to get as many details about your night as possible from people you were with. That way you can determine if there is anything you need to or can do in the light of day to fix any of your mistakes. For example, if you went home with a guy but don't remember what happened, you’re best off talking to him to figure out if you need to take action, such as getting Plan B. Or, if a friend took care of you all night then you’ll know you owe her a big thank you.

When you’re with someone who seems like they are blacked out or in the process of getting there, you should definitely keep on eye on him or her. “If your friend seems drunk but OK, and then you notice that she is having trouble remembering something that happened an hour ago, she may well be on her way to a blackout, and have a spotty memory for the evening tomorrow,” Dr. Smith says. “Dealing with this is much the same as dealing with any friend whose condition worries you. Try to dissuade her from drinking any further, or at least slowing down. Try to divert her away from risky behaviors, and steer her toward things that are safe and familiar. Make sure she doesn't pass out or require medical attention. Don't hesitate to call 911 if you can't wake her up, her breathing is shallow or irregular, or she has clammy skin, or her color is pale or unusual.”

Blacking out on a regular basis should not be ignored or brushed off as a casual part of drinking that results in funny stories the next morning. Due to all of the risks and dangers of blacking out, it’s important to get help from a professional (such as a doctor, psychiatrist, or therapist) to keep your drinking habits in check. Dr. Smith points out that, “most colleges have health services and counseling centers that offer information, advice, special programs, and /or treatment for substance use issues.”

 

Take advantage of the resources on your campus to make sure that you and your friends are safe. Because as funny as it may be to hear about that girl who woke up on the couch of the 24-hour Starbucks on campus in her dress from last night, blacking out is a serious matter that can have grave consequences—don’t risk it.