How Breathing Could Sober You Up: The Return of CO2 Therapy
Alcohol poisoning is a deadly emergency. Every year, millions are hospitalized—and hundreds of thousands die—because their bodies can't clear alcohol fast enough.
But what if the solution wasn't just in IV drips or liver function... but in how we breathe?
Enter CO₂ therapy: a century-old idea that's getting a modern revival. By recruiting your lungs to help clean your blood, this approach could dramatically speed up recovery from alcohol intoxication—and may also change how we treat carbon monoxide poisoning and anesthesia recovery.
The Problem with Alcohol in the Blood
When you drink, alcohol enters your bloodstream and spreads throughout your body—brain, liver, heart, and muscles. Once there, it sticks around longer than we'd like.
Traditionally, over 90% of ethanol is broken down by the liver, and it does this at a constant, zero-order rate—meaning it clears alcohol slowly, regardless of how drunk you are. So when someone drinks too much, there's no easy way to speed things up.
Until now.
Breathe It Out: A Forgotten Path to Sobriety
Have you ever wondered why Breathalyzers work? It is because they measure alcohol that's exhaled through your lungs. So, if you want to sober up faster, the idea is simple: breathe faster.
But here's the catch. Hyperventilating causes CO₂ levels in your blood to drop—a condition called hypocapnia. This leads to constricted blood vessels, dizziness, fainting, and other unpleasant symptoms. Interestingly, one reason you may feel so awful during a hangover is that your body is naturally hyperventilating in a desperate attempt to eliminate alcohol more quickly.
This is where controlled hyperventilation—known medically as isocapnic hyperpnea, or more simply, CO₂ therapy—comes in. It may help you sober up faster and reduce the intensity of hangovers. Here's how it works:
- You breathe rapidly (hyperventilate) to push alcohol out of your lungs.
- At the same time, you inhale extra CO₂ to maintain the right balance in your blood.
- This prevents the side effects of hyperventilation and allows your body to detox without distress.
Introducing CO₂ Therapy
Nearly 100 years ago, doctors observed that faster breathing sped up alcohol clearance from the blood [ref1]. In one early study, patients in alcoholic stupors and comas were given a gas mix of 10% CO₂ and 90% oxygen. The results?
- In just 30 minutes, patients showed a 17% drop in blood alcohol—compared to only 2% in untreated controls.
- Comatose patients woke up, turned pink, and began breathing on their own.
The researchers wrote:
"In every case of unarousable alcoholic coma... carbon dioxide-oxygen inhalation caused respirations to become deep and regular almost at once. The patient rapidly turned from a cyanotic cold patient to a pinkish warm one."
What Science Shows
Fast forward to today. A modern pilot study took the concept into the lab [ref2]. Five healthy male volunteers drank vodka (scientifically, of course) and were then monitored under two conditions: normal breathing and controlled hyperventilation (CO₂ therapy).
The results were stunning:
- Those using controlled hyperventilation sobered up three times faster.
- Breathalyzer readings dropped exponentially, following first-order kinetics—meaning the more alcohol in your system, the faster it gets cleared.
- Blood tests showed a 20% difference between venous and arterial alcohol levels, proving the lungs were actively eliminating ethanol.
This could be a game-changer in emergency care—especially for people with liver conditions, where traditional detox is even slower and riskier.
The Lung as a Detox Organ
Whether it's carbon monoxide, anesthetic gases, or alcohol, one thing is becoming clear:
The lungs aren't just for breathing in oxygen—they're powerful detox engines.
With CO₂ therapy, we can activate that natural pathway to accelerate recovery, reduce organ damage, and potentially save lives.
Some of the best ideas in medicine are the ones hiding in plain sight. And this one is as plain as the breath on your lips.
CO₂ therapy is safe, simple, and ready for prime time. It could become a standard tool in emergency rooms—and maybe even ambulances.
So next time someone says there's no quick fix for alcohol poisoning... just remind them to breathe—with a little help from CO₂.
Scientific References
Title: Accelerated ethanol elimination via the lungs
Authors: Klostranec JM, Vucevic D, Crawley AP, Venkatraghavan L, Sobczyk O, Duffin J, Sam K, Holmes R, Fedorko L, Mikulis DJ, Fisher JA.
Journal: Sci Rep. 2020 Nov 12;10(1):19249. doi: 10.1038/s41598-020-76233-9. PMID: 33184355; PMCID: PMC7665168.
Link to full text: Accelerated ethanol elimination via the lungs 
Abstract: Ethanol poisoning is endemic the world over. Morbidity and mortality depend on blood ethanol levels which in turn depend on the balance between its rates of absorption and clearance. Clearance of ethanol is mostly at a constant rate via enzymatic metabolism. We hypothesized that isocapnic hyperpnea (IH), previously shown to be effective in acceleration of clearance of vapour anesthetics and carbon monoxide, would also accelerate the clearance of ethanol. In this proof-of-concept pilot study, five healthy male subjects were brought to a mildly elevated blood ethanol concentration (~ 0.1%) and ethanol clearance monitored during normal ventilation and IH on different days. IH increased elimination rate of ethanol in proportion to blood levels, increasing the elimination rate more than three-fold. Increased veno-arterial ethanol concentration differences during IH verified the efficacy of ethanol clearance via the lung. These data indicate that IH is a nonpharmacologic means to accelerate the elimination of ethanol by superimposing first order elimination kinetics on underlying zero order liver metabolism. Such kinetics may prove useful in treating acute severe ethanol intoxication.
Title: The treatment of acute alcoholism: with ten per cent carbon dioxide and ninety per cent oxygen inhalation
Authors: Robinson LJ, Selesnick S.
Journal: JAMA. 1935;105(22):1734–1738. doi:10.1001/jama.1935.02760480004002
Link to full text: The treatment of acute alcoholism: with ten per cent carbon dioxide and ninety per cent oxygen inhalation
Abstract: For many years the Fifth Medical Service of the Boston City Hospital has been in charge of almost all medical alcoholic patients admitted to this hospital. It is estimated that approximately 700 alcoholic patients are admitted to this service for treatment each year. The opportunity has been present, therefore, to study alcoholism in all its phases. The acute alcoholic patient generally can be given a good prognosis as to recovery. For this reason, even when medical aid is sought for him, he receives little active therapy. In the paralytic stage of acute alcoholic poisoning, however, emergency treatment may be life-saving. Patients in this stage present a picture best described by Sollmann, who states that the symptoms are those of beginning medullary paralysis. Since carbon dioxide increased the respiratory excretion of alcohol, and since the oxidation of alcohol might be increased through the administration of oxygen, it is conceivable that the inhalation of a combination of 10 per cent carbon dioxide and 90 per cent oxygen mixture might accelerate recovery from acute alcoholic coma, especially of the paralytic state with respiratory depression and cyanosis. If it did no more than keep such a patient from dying of respiratory depression, it would, by keeping him alive, enable him to oxidize the alcohol himself. CONCLUSIONS: Acute alcoholic coma with dangerous respiratory depression, paralysis and cyanosis is a medical emergency. Death may be definitely prevented and recovery accelerated by inhalation of a mixture of 10 per cent carbon dioxide and 90 per cent oxygen for a length of time sufficient to reestablish and maintain normal respiration and color even after the inhalation is suspended.
