What affects how long alcohol lasts
NIAAA says the body begins to metabolize alcohol within seconds and proceeds at a steady rate, regardless of how much a person drinks or of attempts to sober up with caffeine or by other means. Most of the alcohol is broken down in the liver. The rate is steady in one person and varies widely, including with liver size, body mass, and genetics. StatPearls on ethanol toxicity says elimination is usually zero-order, approximately 10 to 25 mg/dL eliminated per hour. An archived StatPearls chapter states 20 to 25 mg/dL per hour in most individuals. Neither rate is a time to drive.
NHTSA says more body weight means more body water, which dilutes alcohol and lowers BAC. NHTSA says women generally have less water and more body fat per pound than men, and that alcohol does not enter fat cells as easily, so more remains in women's blood. NIAAA says a woman and a man of the same weight, after the same amount, tend to leave the woman with the higher BAC, because women have proportionally less body water.
NIAAA says an empty stomach increases absorption and blood alcohol compared with a full stomach, and BAC builds if you drink again before earlier drinks are metabolized. MedlinePlus says high-carbohydrate and high-fat foods can slow absorption, and stronger drinks tend to be absorbed faster. NHTSA says food slows absorption, and fast drinking produces a higher BAC than the same alcohol over a longer time.
NIAAA lists age, tolerance, sex, speed of drinking, medications, and food as factors that can turn impairment into an overdose. Opioids or sedative hypnotics, including zolpidem, eszopiclone, diazepam, and alprazolam, can raise that risk, and so can an over-the-counter antihistamine. MedlinePlus says alcohol can strengthen many medicines, so ask a clinician before drinking on any medicine, including an over-the-counter one. NHTSA says some medications and illegal drugs increase impairment and driving risk. NIAAA defines binge drinking as a BAC of 0.08% (0.08 grams of alcohol per deciliter) or higher, typically 4 or more drinks for women or 5 or more for men in about 2 hours.
Sources: The basics: defining how much alcohol is too much; Ethanol toxicity; Ethanol; Alcoholic ketoacidosis (archived); Drunk driving; Alcohol use and safe drinking; Understanding the dangers of alcohol overdose