Source: Doering PL, Li RM. Substance-Related
Disorders: Alcohol, Nicotine, and Caffeine. In: DiPiro JT, Talbert
RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy:
A Pathophysiologic Approach. 8th ed. http://accesspharmacy.com/content.aspx?aid=7987625.
Accessed June 11, 2012.
- Acute detoxification and withdrawal after chronic alcohol
abuse a serious condition that can require hospitalization and adjunctive
pharmacotherapy. Death may ensue if blood alcohol concentration
(BAC) high enough.
- Alcohol absorption begins in stomach within 5–10
minutes of ingestion.
- Peak concentrations usually achieved 30–90 minutes
after finishing last drink.
- Alcohol metabolized by alcohol dehydrogenase to acetaldehyde,
which is further metabolized to carbon dioxide and water by aldehyde
- There is 14 g of alcohol in 12 oz of beer, 4 oz of wine, or
1.5 oz (one shot) of 80-proof whiskey. This amount increases BAC
by 20–25 mg/dL (4.3–5.4 mmol/L)
in healthy 70-kg man. Deaths from alcohol intoxication generally
occur when BACs >500 mg/dL (87–109 mmol/L).
- Alcohol withdrawal includes 2 main components:
- History of cessation or reduction in heavy and prolonged alcohol
- Presence of two or more of symptoms of alcohol withdrawal.
- Slightly more than half of Americans (approximately 129
million people) aged 12 or older reported being current drinkers
of alcohol in a 2008 survey.
- 23.3% (58.1
million) participated in binge drinking.
- 6.9% reported heavy drinking.
- Signs and symptoms of alcohol intoxication:
- Impaired judgment
- Respiratory depression
- Signs and symptoms of alcohol withdrawal:
- Table 1 relates effects of alcohol
Table 1. Specific Effects
of Alcohol Related to Blood Alcohol Concentration |Favorite Table|Download (.pdf)
Table 1. Specific Effects
of Alcohol Related to Blood Alcohol Concentration
|BAC (%)a [mmol/L]||Effect|
|0.02–0.03 [4–8]||No loss of coordination, slight euphoria, and loss of shyness.|
|0.04–0.06 [9–14]||Feeling of well-being, relaxation, lower inhibitions, sensation
of warmth. Euphoria. Some minor impairment of reasoning and memory,
lowering of caution.|
|0.07–0.09 [15–21]||Slight impairment of balance, speech, vision, reaction time,
and hearing. Euphoria. Judgment and self-control reduced; caution, reason,
and memory impaired. Illegal to operate a motor vehicle in some
states at this level.|
|0.10–0.125 [22–27]||Significant impairment of motor coordination and loss of
good judgment. Speech can be slurred; balance, vision, reaction
time, and hearing impaired. Euphoria. Illegal to operate a motor
vehicle at this level of intoxication.|
|0.13–0.15 [28–34]||Gross motor impairment and lack of physical control. Blurred vision
and major loss of balance. Euphoria reduced, and dysphoria beginning
|0.16–0.20 [35–43]||Dysphoria (anxiety, restlessness) predominates; nausea can appear.
Drinker has appearance of “sloppy drunk.”|
|0.25 ||Needs assistance in walking; total mental confusion. Dysphoria with
nausea and some vomiting.|
|0.30 ||Loss of consciousness.|
|⩾0.40 [>87]||Onset of coma, possible death caused by respiratory arrest.|