Massachusetts – Extreme cold during winter weather significantly increases the risk of deadly hypothermia when alcohol is involved, according to physicians, because alcohol masks the body’s natural warning signs as core temperature drops.
Medical experts explain that alcohol causes blood vessels to dilate, sending warm blood toward the skin’s surface. This creates a false sensation of warmth — flushed skin or sweating — while allowing vital heat to escape more rapidly from the body’s core. As a result, internal body temperature can fall to dangerous levels without the person realizing it.
Physicians warn this false warmth is one of the primary reasons alcohol-related hypothermia can become deadly. Alcohol suppresses shivering, dulls the body’s cold-response signals, and impairs judgment. People may remove layers, underestimate exposure time, or remain outdoors longer than is safe during winter conditions.
In Massachusetts communities, the risk increases in specific environments. Areas near transit platforms, parking garages, waterfronts, college campuses, and nightlife corridors are common exposure zones during extreme cold. In Boston, locations near MBTA stations, downtown crossings, the Seaport, Fenway, and Charles River paths can pose heightened risk, while in Worcester, walkable downtown streets, campus-adjacent areas, and outdoor commercial districts create similar dangers.
A major challenge for emergency response is that hypothermia often looks like intoxication. Slurred speech, confusion, loss of coordination, and drowsiness — commonly assumed to be signs of drinking — closely resemble early hypothermia symptoms. That overlap can delay emergency care when minutes matter.
Winter weather conditions further intensify the danger. Wind, snow, ice, and moisture accelerate heat loss, and wet clothing can cause the body to lose heat many times faster, even at temperatures near or slightly above freezing. Alcohol also acts as a diuretic, increasing dehydration and reducing the body’s ability to regulate temperature effectively.
Physicians urge immediate action if a person cannot stand, answer basic questions, appears unusually confused, has cold or pale skin, or stops shivering. In those situations, alcohol should not be assumed to be the cause. Hypothermia is a medical emergency and can be fatal without prompt treatment.
For commuters, students, nightlife workers, and residents moving through Massachusetts cities during winter weather, physicians emphasize a critical warning: feeling warm after drinking does not mean the body is safe from extreme cold.
