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Why Do I Black Out When I Drink?

Getting help for addiction to alcohol or drugs can be a daunting task. For many, the process includes taking a look at your own behaviors and asking, “Am I actually an addict or alcoholic?”

Many people who do not live with AUD have blacked out from drinking, and many people who do live with AUD are not black out drinkers. In this article we are going to address the following questions: 

  • What is blacking out?
  • Why do I black out when I drink?
  • What is the difference between blacking out and passing out?
  • What risks are associated with blacking out?
  • Does blacking out mean I’m an alcoholic?
  • Where I can get help for my drinking?

What is blacking out?

Alcohol-induced amnesia, more commonly referred to as “blacking out” or being “blacked out,” is a term used to describe temporary memory loss that occurs during a period of heavy drinking. Black outs are brought on by a rapid increase in blood alcohol content (BAC) level, which is generally a consequence of binge drinking. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as having five or more drinks within two hours for men, and four or more drinks within two hours for women. Blackouts typically won’t occur until a person’s BAC has reached .14 percent or higher.   Drinking to the point of blacking out can be very scary. If you wake up after a night of drinking but can’t remember how you got where you are — whether you are in your own bed or an unexpected place — you might also not remember doing any number of other risky behaviors such as driving your car while intoxicated, engaging in unprotected sex or being sexually assaulted. 

Why do I black out when I drink?

As previously noted, blacking out occurs after a bout of binge drinking, which results in a rapid increase in a person’s BAC. But what is happening in your brain during a blackout?  Under normal circumstances, your everyday experiences such as having conversations, with whom you had a conversation and what you were doing during that conversation (having dinner for example) are all stored as fragments in the prefrontal cortex of your brain as short-term memories. Neurotransmitters carry those fragments from the prefrontal cortex to another part of the brain, the hippocampus, where those fragments are woven together as a long-term memory. This allows you to contextualize those fragments as a single incident (‘Having dinner with Mom, for example).   But one of the impacts of increased BAC is blocking the neurotransmitters which carry those memories. Beginning at a BAC of around .14 percent, you might experience a Fragmentary Blackout. In other words, your brain creates isolated memories but is unable to contextualize them or piece them together as a whole. Fragmentary blackouts are conversationally called grey outs or brown outs. It is not uncommon for a person who experienced a brown out to regain partial memories if triggered by a setting or conversation.   Raising your BAC further will cause your hippocampus to malfunction, and therefore temporarily block your ability to make new memories at all. This is called En Bloc blacking out. If you experience En Bloc blackout, conversations and reminders about the previous evening will not trigger your memory.  

Passing out Vs. Blacking out

Even though you are incapable creating new memories during a black out, many people do not experience unconsciousness, or passing out, until BAC has reached nearly .3 percent. A person in a black out is still capable of having conversations, making decisions and even driving a car.

Consuming alcohol excessively simultaneously causes certain parts of the brain to work less effectively but also increases dopamine and norepinephrine levels. This is why you might feel buzzed or stimulated while drinking, even though alcohol is a depressant. Like our ability to create new memories, our ability to think rationally and make sound decisions lives in the prefrontal cortex, which as mentioned before, is greatly impacted as your BAC rises. A person who has blacked out during the course of an evening might eventually pass out or lose consciousness, but one is not necessarily always correlated with the other. Your gender and genes play a large part in whether or not you are prone to blacking out. One might black out but not pass out, and in less common situations one might pass out without having blacked out.

What are the risks of blacking out?

With inhibitions lowered, someone under the influence of alcohol is at a much higher risk of making dangerous decisions like driving drunk, having unprotected sex, destroying property, getting into arguments or physical fights, or being sexually assaulted.   According to the NIAAA, conservatively, 25 percent of women in the United States have experienced sexual assault and that, approximately one-half of those cases involve alcohol consumption by the perpetrator, victim, or both.”   According to the National Highway Traffic Safety Administration, 10,874 Americans died in drunk driving accidents in 2017. It also reported that having a BAC of .15 percent — nearly twice the legal driving limit of .08 percent and the same BAC when blackouts begin — will result in “Substantial impairment in vehicle control, attention to driving task, and in necessary visual and auditory information processing.”  Besides physical injury associated with dangerous behavior, a person who recently experienced a black out could also experience mental health disorders such as depression or trauma from the results of a situation, even if the incident itself it not remembered.  


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Where can I get help for my drinking?

If you or a loved one drinks to the point of blacking out frequently and are having trouble controlling your consumption of alcohol, there are many resources available to you.   If you drink alcohol excessively, withdrawal can be dangerous, even deadly. Medical detox from alcohol and other substances such as benzodiazepines and opiates is recommended.  

At TruHealing Centers across the country, we offer a full continuum of addiction treatment services.

Detox deals with your physical dependency on alcohol or drugs before you move onto your other treatment services that focus on relieving the mental aspects of substance use disorder. Medical detox treatment varies from center to center in terms of length of stay, and whether or not your detox will be assisted by medication. A full detox should take place over the course of six to eight days.  Inpatient treatment is the most intensive form of substance use treatment, during which you reside in the same facility in where you are treated. Inpatient services typically last anywhere from 30 to 90 days.  Partial hospitalization programs (PHPand intensive outpatient programs (IOPdo not require you to live in the facility where you receive treatment. In a PHP you will spend no less than four hours a day receiving care in a variety of therapeutic modalities include individual and group counseling sessions. IOP treatment provides similar services, usually no less than three hours per week. IOP is a less intensive than PHP, but more intensive than traditional outpatient services, such as counseling appointments, etc.   Even after the substance use has subsided, stressors, traumas, and even small irritations can trigger the urge to recur drug or alcohol use. For many in recovery, a full continuum of care is recommended, meaning that some form of treatment, usually periodic outpatient appointments to address co-occurring mental health disorders.   Outpatient services along with treatments along with additional support groups help you create a recovery community, a group of people who have faced similar challenges to you and are on a similar path to bettering themselves. More options include attended 12-step recovery meetings such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA).   For more information about Amatus Recovery Centers, contact an admissions specialist at 833 216 3079 and learn which level of care if the right one for you or your loved one. 


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As we continue to grow Amatus Health, the need to stay competitive and differentiate ourselves in unique ways is crucial. Building creative approaches to reach more people will take our company to new heights. This is why I am pleased to announce that we are officially rebranding. Our new national name, TruHealing Addiction & Mental Health Treatment, will eventually replace Amatus Recovery Centers.

You may be asking, “Why are we doing this?” This new name will give us national uniformity and help brand ourselves as a whole, which will be done in phases. You will still see our existing facility names co-branded with TruHealing for the time being.

Healing is what we do. Everyone who comes through our doors is in a moment of profound struggle in their lives. We support them through a life-changing process of healing and recovery, and they leave our facilities changed. This new name is a representation of that process. As mentioned above, it also allows us to have a national brand, which will make us a recognizable name in the addiction and mental health field.

In summation, these changes present an excellent opportunity for our organization to develop our mission, vision, and purpose. I look forward to prosperous growth as we head in a new and positive direction.


Mark signature

Mark Gold
Amatus Health

Dr. Adam Cusner, PhD is an organizational psychologist by training and has brought his decade-plus experience to the healthcare field serving as the Executive Vice President of Operations for a 22-facility portfolio of skilled nursing facilities, assisted living and independent living centers across Ohio and Arizona, with an annual revenue over $250MM. While serving in this position, Dr. Cusner brought accelerated growth to these facilities, while increasing employee retention and workflow optimization. Dr. Cusner has a proven track record in the healthcare industry of providing successful leadership through his financial acumen, strategic planning, interpersonal skills, along with his ability to build strong, effective teams.


Dr. Cusner’s credentials include a Philosophy Doctorate in Organizational Psychology (PhD) from Cleveland State University, a Master of Arts in Psychology (MA) from Boston College with an emphasis on Psychology of Work, a Bachelor of Science in Psychology (BS) from Boston University with an emphasis in Organizational Behavior in Business and is a board-certified Nursing Home Administrator (LNHA). He has published and presented research articles in the field of organizational psychology at national healthcare conferences. Dr. Cusner is completing a book on organizational psychology in the healthcare field, which is expected to be published late early summer 2022. He is also a member of the American Psychological Association (APA), has served as the APA’s Division 17 communications chair, is a member of the Society for Industrial Organizational Psychologists (SIOP), and was selected as a professional reviewer for national conference research presentations.


Dr. Cusner is an advocate for his employees and is drawn to the tie between culture and quality. His extensive strategic and operational skills have delivered a high degree of success across all department levels. Dr. Cusner facilitated the establishment of an in-house financial team to provide billing and collections, accounts payable, vendor management, along with financial reporting. This provided $1.5MM annualized savings. Further, he developed department efficiencies for: Medical Staff recruitment, service-line growth, quality and safety, corporate accountability of budgetary expectations balanced with direct reporting to investor groups.


Dr. Cusner coordinated the financial turnaround of a 300 bed CCRC (skilled nursing, assisted living and an independent living center) in Arizona, which has been epitomized as the most financially challenging state to manage CCRC facilities. Dr. Cusner also strengthened the business growth of the Ohio facilities by 12%. He was recognized by the Governor for demonstrating a “care-conscious approach” during COVID, when Dr. Cusner carefully consolidated facility residents to accommodate staff and improve clinical care. Dr. Cusner demonstrates a results-driven culture by delivering a high-quality level of care and employee engagement.

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Yaffa Atias is the Director of Special Projects at Amatus Health. Atias is a leadership professional with a decade of experience in healthcare. She holds a BA in interdisciplinary studies from Thomas Edison State College, and a Master’s in Healthcare Management with a concentration in project management from Stevenson University. She completed her graduate capstone at Mosaic Community Services, now an affiliate of Sheppard Pratt.


In her role at Amatus, Atias leads and manages interdisciplinary team projects, creates solutions for any operational gaps, and continually strives for quality improvement in all processes. Atias led the organization’s COVID-19 preparedness strategy, resulting in all facilities remaining operational, and in 600 employees being retained as staff without resigning out of fear. In her role so far, she implemented licensure for three new states.


Atias believes Amatus Health and TruHealing stand out because every employee, from corporate to center staff, has a real passion for helping people. Atias shares this passion, “My natural compass always tugged me to behavioral health. I’ve always been fascinated by the human psyche. I have also been intimately privy to those suffering from mental illness and substance use. I later understood that my experiences weren’t unique, and quickly realized how pressing the need really is to effectively prevent and address. Moreover, how life-changing proper intervention truly is.”


Atias was born in Los Angeles, California and grew up in Israel and Maryland.

Melissa McCarthy is the Vice President of Business Development at Amatus Health. With a decade of experience in the behavioral healthcare and addiction treatment industry, McCarthy is passionate about recovery. She has her finger on the pulse of marketing trends, with the end goal of helping businesses grow so they can serve more people in need.


McCarthy has worked at large enterprise recovery centers across the country spearheading business development teams. She has a wide range of experience, including transforming a third-party digital marketing and client acquisition services company into a full-continuum behavioral healthcare provider, managing several successful rebrands, and growing annual revenue fivefold.


As VP of Business Development, McCarthy leads a team of over 20 business development professionals nationwide. She manages client acquisition, coordinates in-service trainings with various referents and hospitals, and presents at conferences on addiction and mental health disorder treatment.


“Sadly, many individuals die waiting for access to life-saving behavioral healthcare services,” says McCarthy. “I am in relentless pursuit of better—better access, better care delivery and better outcomes. I consider it a privilege to work in an environment where miracles unfold daily.”


McCarthy lives in Maryland with her daughter.

Hometown: Saugus, MA


Passions & interests: The greatest passion of mine is being able to dig into the work with men in early recovery. There is nothing better than witnessing and being a part of the change. My journey in long-term recovery has taught me to value the little things in life that I am now able to do. I love to do anything that allows me to be present with my wife, family, and friends. My wife and I enjoy traveling, trying new foods, and taking long motorcycle rides with our friends. If I am not on the road working or with my wife, I am studying or playing softball.


The best part of my job is being able to show up for my team and clients; they all mean the world to me. I get to brainstorm and strategize with tons of different personalities. A lot of the team does not know, but I love learning from them. If I am not learning something about our industry or workplace, I am certainly learning how to effectively collaborate with different types of individuals.


Together, we can change the narrative and be a part of the solution to better treat those trapped in the problem.

Allison was born in Columbus, Ohio and was raised in South Florida. She graduated from the University of Florida’s College of Journalism and Communications. After college, Allison started working at the largest talent agency in the world, William Morris Endeavor. There, she learned marketing from top leaders specializing in global PR and endorsement campaigns, in both the Latin and English markets.


Through strategic public relations and creative campaign concepts, Allison has secured more than 200 national broadcast and print media placements for behavioral healthcare organizations. She brings over 15 years of marketing and PR experience, with a strong background in leading communications strategy for addiction treatment and behavioral healthcare facilities. In her role as VP of Communications, she oversees branding, public relations, social media, marketing, events, and content creation.


In her spare time, she loves cooking, boating, yoga, and traveling. She and her husband Bryan reside in Boca Raton, Florida.

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Avi Burstein is VP of Clinical Services at Amatus Health. He manages all therapeutic programming at all facilities nationwide.


Avi is originally from New York, and graduated from Ferkauf Graduate School of Psychology. He brings over 13 years of experience in the Behavioral Healthcare Industry, in both the public and private sectors. He is passionate about therapeutic communities and the fellowship they foster between patients. Through his work in LGBTQIA, urban, rural, and religiously observant populations, Avi recognizes that each patient is unique. Therefore, he strives to ensure clinical approaches, staffing, administration, and education meet the expectation of each community Amatus Health serves.


“Our work must also include ending the societal stigma surrounding such conditions by building safe and supportive networks that include clients’ families whenever possible,” Avi said. “By valuing change and owning imperfections, we can strive to be better providers and walk through the door of recovery with our clients.”

Avi Burstein is VP of Clinical Services at Amatus Health. He manages all therapeutic programming at all facilities nationwide.


Avi is originally from New York, and graduated from Ferkauf Graduate School of Psychology. He brings over 13 years of experience in the Behavioral Healthcare Industry, in both the public and private sectors. He is passionate about therapeutic communities and the fellowship they foster between patients. Through his work in LGBTQIA, urban, rural, and religiously observant populations, Avi recognizes that each patient is unique. Therefore, he strives to ensure clinical approaches, staffing, administration, and education meet the expectation of each community Amatus Health serves.


“Our work must also include ending the societal stigma surrounding such conditions by building safe and supportive networks that include clients’ families whenever possible,” Avi said. “By valuing change and owning imperfections, we can strive to be better providers and walk through the door of recovery with our clients.”

Marty Markovits is the Chief Information Officer at TruHealing. He oversees the people, processes, and technologies of the whole organization to ensure the business is running smoothly.


Markovits grew up in Brooklyn, NY (which he calls “the greatest city on Earth”) and graduated with a degree in Clinical Psychology from Queens College.


Markovits is a veteran in Information Technology within the healthcare field. He ensures that IT processes are simple, cost-effective, and secure. His expertise spans the entire healthcare domain, from billing and claims, to clinical, to Human Resources. He says, “My passion is to provide fully automated and operationally meaningful Business Intelligence analytics, with absolute data integrity.”

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Hometown: Savannah, GA


Passions & Interests: I spend my time outside of work with my wife and children and am actively involved in various community needs and causes.


The best part of my job is knowing that we are creating a safe, healthy, nonjudgmental environment where people can come and better their lives. There is nothing more satisfying than helping others learn to live again and piece their lives back together as they become strong, productive members of society.

Together, we can bring families back together and promote healing and well-being.


With over 16 years of proven executive leadership and driving company growth, Mark Gold’s momentum for success isn’t slowing down anytime soon. He serves as the CEO of Amatus Health, one of the fastest-growing, behavioral healthcare organizations in the country.

Possessing an excellent handling of clinical compliance and high performance standards, Mark established 14 CARF/JCT accredited addiction and mental health treatment centers and three ancillary healthcare businesses. Mark’s natural leadership skills as well as his creative thought process to generate new revenue strategies make him one of the most sought-after professionals in healthcare. Mark has a track record of leading organizations to outstanding ROI on overall portfolio performance. In addition, his expertise includes workforce planning, growth revenue, high client and investor satisfaction.

Aside from daily business oversight, Mark invests in his staff and helps build their professional development. His commitment to his colleagues and employees toward advancement and inclusiveness helps them achieve goals, builds connections, and provides a competitive advantage in the healthcare field.

Corporate and Charitable Leadership

Mark has been instrumental in building healthy communities and providing access and quality healthcare to underserved populations. His service in the community is a testament to his passion and selfless dedication to the cause of eradicating addictive disorders and stigma.

He launched several prevention and education programs and created the first-ever “Social Justice” scholarship fund of over $750,000.00 to help communities of color into inpatient drug treatment. Mark says, “The best part of my role is the knowledge that what we do impacts countless lives, with far-reaching effects,” he said. “It is incredibly rewarding to be part of a team that guides individuals onto a safe and accessible path to healing and recovery.”

He is a board member of Ahavas Chaim, a non-profit that offers at-risk teenagers crisis intervention and mental health support. He is also a committee member of the organizations Bonei Olam and Chai Lifeline Mid-Atlantic.

Personal and Educational Background

Mark studied Talmudic Law at Yeshiva’s Mir Yerushalayim in Israel. In Mark’s free time, he loves snowboarding, boating, and spending time with his wife and children.