Getting help for addiction to alcohol or drugs can be a daunting task. For many, the process includes taking a look at your own behaviors and asking, “Am I actually an addict or alcoholic?” Many people who do not live with AUD have blacked out from drinking, and many people who do live with AUD are not black out drinkers. In this article we are going to address the following questions:
- What is blacking out?
- Why do I black out when I drink?
- What is the difference between blacking out and passing out?
- What risks are associated with blacking out?
- Does blacking out mean I’m an alcoholic?
- Where I can get help for my drinking?
What is blacking out?
Alcohol-induced amnesia, more commonly referred to as “blacking out” or being “blacked out,” is a term used to describe temporary memory loss that occurs during a period of heavy drinking. Black outs are brought on by a rapid increase in blood alcohol content (BAC) level, which is generally a consequence of binge drinking. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as having five or more drinks within two hours for men, and four or more drinks within two hours for women. Blackouts typically won’t occur until a person’s BAC has reached .14 percent or higher. Drinking to the point of blacking out can be very scary. If you wake up after a night of drinking but can’t remember how you got where you are — whether you are in your own bed or an unexpected place — you might also not remember doing any number of other risky behaviors such as driving your car while intoxicated, engaging in unprotected sex or being sexually assaulted.
Why do I black out when I drink?
As previously noted, blacking out occurs after a bout of binge drinking, which results in a rapid increase in a person’s BAC. But what is happening in your brain during a blackout? Under normal circumstances, your everyday experiences such as having conversations, with whom you had a conversation and what you were doing during that conversation (having dinner for example) are all stored as fragments in the prefrontal cortex of your brain as short-term memories. Neurotransmitters carry those fragments from the prefrontal cortex to another part of the brain, the hippocampus, where those fragments are woven together as a long-term memory. This allows you to contextualize those fragments as a single incident (‘Having dinner with Mom,’ for example). But one of the impacts of increased BAC is blocking the neurotransmitters which carry those memories. Beginning at a BAC of around .14 percent, you might experience a Fragmentary Blackout. In other words, your brain creates isolated memories but is unable to contextualize them or piece them together as a whole. Fragmentary blackouts are conversationally called grey outs or brown outs. It is not uncommon for a person who experienced a brown out to regain partial memories if triggered by a setting or conversation. Raising your BAC further will cause your hippocampus to malfunction, and therefore temporarily block your ability to make new memories at all. This is called En Bloc blacking out. If you experience En Bloc blackout, conversations and reminders about the previous evening will not trigger your memory.
Passing out Vs. Blacking out
Even though you are incapable creating new memories during a black out, many people do not experience unconsciousness, or passing out, until BAC has reached nearly .3 percent. A person in a black out is still capable of having conversations, making decisions and even driving a car.
Consuming alcohol excessively simultaneously causes certain parts of the brain to work less effectively but also increases dopamine and norepinephrine levels. This is why you might feel buzzed or stimulated while drinking, even though alcohol is a depressant. Like our ability to create new memories, our ability to think rationally and make sound decisions lives in the prefrontal cortex, which as mentioned before, is greatly impacted as your BAC rises. A person who has blacked out during the course of an evening might eventually pass out or lose consciousness, but one is not necessarily always correlated with the other. Your gender and genes play a large part in whether or not you are prone to blacking out. One might black out but not pass out, and in less common situations one might pass out without having blacked out.
What are the risks of blacking out?
With inhibitions lowered, someone under the influence of alcohol is at a much higher risk of making dangerous decisions like driving drunk, having unprotected sex, destroying property, getting into arguments or physical fights, or being sexually assaulted. According to the NIAAA, conservatively, 25 percent of women in the United States have experienced sexual assault and that, “approximately one-half of those cases involve alcohol consumption by the perpetrator, victim, or both.” According to the National Highway Traffic Safety Administration, 10,874 Americans died in drunk driving accidents in 2017. It also reported that having a BAC of .15 percent — nearly twice the legal driving limit of .08 percent and the same BAC when blackouts begin — will result in “Substantial impairment in vehicle control, attention to driving task, and in necessary visual and auditory information processing.” Besides physical injury associated with dangerous behavior, a person who recently experienced a black out could also experience mental health disorders such as depression or trauma from the results of a situation, even if the incident itself it not remembered.