Doctors Explain How People Can Get Drunk Without Drinking

You can get drunk even without taking a single drop of alcohol, scientists have established. They say that food ingested can produce alcohol right inside the body.

The scientists who made this discovery say some people can get drunk without drinking because their gut bacteria produce alcohol from food. They have now identified the microbes and biological pathways behind the rare condition known as auto-brewery syndrome (ABS).

From tests, it was discovered that patientsโ€™ gut samples produced far more alcohol than those of healthy people. In one case, a fecal transplant led to long-lasting symptom relief.

The rare and frequently misunderstood condition causes individuals to experience intoxication even though they have not consumed alcohol. The research was conducted by a team at Massachusetts General Brigham in collaboration with researchers from the University of California San Diego and is published in Nature Microbiology.

Auto-brewery syndrome develops when certain microbes in the gut break down carbohydrates and convert them into ethanol which then enters the bloodstream. While normal digestion can create trace amounts of alcohol in anyone, people with ABS can produce levels high enough to cause noticeable intoxication. Although the condition is extremely rare, experts believe it is often missed because of limited awareness, difficulties with diagnosis, and social stigma.

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Many people with ABS spend years without an accurate diagnosis. During that time, they may face social strain, medical complications, and even legal problems linked to unexplained intoxication. Confirming the condition is also challenging because the gold-standard diagnostic approach requires carefully supervised blood alcohol testing, which is not easily accessible in many settings.

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To investigate the biological roots of the disorder, researchers studied 22 people diagnosed with ABS, along with 21 unaffected household partners and 22 healthy control participants. The team compared the makeup and activity of gut microbes across these groups to identify meaningful differences.

Laboratory testing showed that stool samples collected from patients during active ABS flare-ups produced far more ethanol than samples from household partners or healthy controls. This finding highlights the possibility of developing a stool-based test that could make diagnosing the condition easier and more reliable in the future.

According to the co-senior author Elizabeth Hohmann, MD, of the Infectious Disease Division in the Mass General Brigham Department of Medicine. โ€œAuto-brewery syndrome is a misunderstood condition with few tests and treatments. Our study demonstrates the potential for fecal transplantation.

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More broadly, by determining the specific bacteria and microbial pathways responsible, our findings may lead the way toward easier diagnosis, better treatments, and an improved quality of life for individuals living with this rare condition.โ€

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