Q&A: Hypothermia and Alcohol Intoxication

Any tips on writing dialogue featuring a character suffering/recovering from hypothermia? At a glance it seems like hypothermia makes you act kind of like you’re drunk, is that accurate?

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I’m not completely sure. I’ve never seen severe hypothermia first hand, so I’m going off diagnosis guides and making a guess. That said, I have seen a few warnings about potentially misdiagnosing hypothermia as alcohol intoxication, which makes me suspect these are very similar.

This is a little more complex than that, because, from my limited research, alcohol intoxication seems to exacerbate hypothermia. Your body temperature crashes faster, and you stay intoxicated for longer. This is because hypoglycemia (low blood sugar) interacts viciously with hypothermia, and excessive drinking can result in (temporary) hypoglycemia.

If you’re wondering, “if it’s that dangerous, why would anyone drink in the cold?” The answer is fairly simple, alcohol makes you feel warm. This is why there are traditions about consuming hard liquor to endure or recover from the cold. The biological reality is that warmth is an illusion, but the experience led people to believe that alcohol helped dealing with the cold.

To your question about dialog; Hypothermia’s slurred speech and impaired cognitive function could look a lot like alcohol intoxication. However, when it comes to, “acting drunk,” not so much. There’s a number of specific physical symptoms beyond the slurred speech and confusion associated with hypothermia. Hypothermia will result in drowsiness, so no matter what kind of a drunk you normally are, hypothermia will look like a sleepy drunk. Beyond that, there’s shallow breathing, a weak pulse, and of course shivering.

So, hypothermia doesn’t look like alcohol intoxication, however, the slurred speech, mumbling, impaired coordination and cognitive function do. It’s close enough that hypothermia can be mistaken for alcohol intoxication in a cold environment by someone without medical training, but not so close as to say that it’s just drunk in the snow.

-Starke

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