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Assessment of Co-occurring Disorders, Levels of Care, and ASAM Requirements
Published in Tricia L. Chandler, Fredrick Dombrowski, Tara G. Matthews, Co-occurring Mental Illness and Substance Use Disorders, 2022
Elizabeth Reyes-Fournier, Tara G. Matthews, Tom Alexander
Phil is a 56-year-old African American man who has recently been arrested for driving under the influence. He is a married father of two boys and owns a power washing company. His wife and his primary care doctor have warned him against drinking. As his diabetes continues to worsen and the pandemic shut down his business temporarily, he has found himself drinking more and more. His arrest followed a car accident in which his car was totaled. His neighbors called emergency services when he crashed into their mailbox and did not get out of the car. Emergency services drove him to the hospital, and a blood test revealed a.30 blood alcohol content (BAC). Phil woke in the hospital to find that he was handcuffed to the bed with no recollection of what had happened. The hospital doctors have advised the police that Phil needs to be detoxed prior to being taken to jail to prevent any dangerous withdrawal symptoms and to stabilize his blood sugar. The police are eager to arrest him as this is not the first time he has been in trouble with the law. Over the past year, he has received a drunk in public charge and a possession of marijuana charge when he was found wandering his neighborhood at 3:00 a.m.
Alcohol Pharmacology and Pharmacotherapy of Alcoholism
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Aman Upaganlawar, Sindhu Ramesh, Ellery Jones, Vishnu Suppiramaniam, Timothy Moore, Muralikrishnan Dhanasekaran
Rapid absorption occurs from the gastrointestinal tract attaining highest blood alcohol concentration (BAC) within 30 min of alcohol intake in the fasting state. Absorption is rapid from small intestine than gastric region and hence delay in the process of gastric emptying due to presence of food particles in the stomach slows ethanol absorption (Wagner et al., 1977).
Alcohol
Published in Jason Payne-James, Richard Jones, Simpson's Forensic Medicine, 2019
Jason Payne-James, Richard Jones
Ethanol is converted into acetaldehyde via the actions of alcohol dehydrogenase resulting in the production of acetic acid and then acetaldehyde. Acetaldehyde is responsible for most of the clinically observed side-effects produced by alcohol. The measured alcohol concentration depends on both weight and sex because these two factors determine the total volume of body water and consequently the BAC. In general terms, the more a person weighs, the larger the volume of water their body will contain. After consuming equal amounts of alcohol, someone who is obese or has a greater proportion of body fat will have a lower BAC than a thin person. Females have more fat tissue than males of the same weight and, therefore, a smaller volume of body water. As a result, the BAC will be slightly higher in women than in men after consuming an equal amount of alcohol.
Prevalence of alcohol among drivers, riders and pedestrians injured in road traffic crashes in Cameroon: a cross-sectional study
Published in International Journal of Injury Control and Safety Promotion, 2022
Yannick Oyono, Hallvard Gjerde, Tara Kelley-Baker, Emmanuel Acha Asongalem, Boris Arnaud Kouomogne Nteungue, Carolle Yanique Tayimetha, Olivier Djouyep Momo, Claude Patrick Biwole Biwole, David Mekolo Owandja, Valerie Ngono, Yaouba Djakari, Johannes G. Ramaekers, Eric Achidi Akum
Breath Alcohol Concentration (BrAC) was determined using an AL 6000 Breathalyzer (AlcoDigital Ltd., West Chiltington, UK). These police-grade instruments were purchased for the purpose of this study and were equipped with pre-calibrated alcohol sensors to ensure their accuracy. The blood alcohol concentration (BAC) was estimated using a blood-to-breath ratio of 2100:1 (Jaffe et al., 2013). A questionnaire was used to collect data on participant’s age, gender, education level, religion, type of road user, professional or non-professional driver, vehicle type, information about the crash (e.g. two-car crash, car, and motorcycle crash, car hitting pedestrian, or roadway departure crash), type and severity of the injury, and data collection site. The injury severity was assessed in accordance with the five-level Canadian Triage and Acuity Scale and categorized as critical, severe, serious, moderate, and minor injury (Beveridge et al., 1998; Bullard et al., 2017).
Variability in antemortem and postmortem blood alcohol concentration levels among fatally injured adults
Published in The American Journal of Drug and Alcohol Abuse, 2021
Naomi Greene, Marissa B. Esser, Roumen Vesselinov, Kimberly M. Auman, Timothy J. Kerns, Margaret H. Lauerman
Excessive alcohol use is responsible for an average of 88,000 deaths each year in the United States and about 1,300 deaths each year in Maryland (1). Approximately half of these deaths are due to binge drinking (1). Binge drinking is defined as consuming 4 or more drinks on an occasion for women or 5 or more drinks on an occasion for men (with 14 grams of alcohol in a standard drink) (2). Consuming this amount of alcohol on an occasion – usually defined as about 2 to 3 hours – generally raises a person’s blood alcohol concentration (BAC) to ≥0.08 g/dL. A BAC of ≥0.08 g/dL is used to define alcohol-impaired driving in all states except Utah, which recently lowered the BAC limit for defining alcohol-impaired driving to ≥0.05 g/dL (3,4). Excessive alcohol consumption, particularly binge drinking, is a risk factor for fatal injuries, including those from motor vehicle crashes, falls, violence, homicide, and suicide (5–8). A dose-response relationship exists between alcohol consumption and injury severity, and the chance of injury-related death generally increases as the level of alcohol consumption increases (9).
Molecular mechanisms of ethanol biotransformation: enzymes of oxidative and nonoxidative metabolic pathways in human
Published in Xenobiotica, 2020
Grażyna Kubiak-Tomaszewska, Piotr Tomaszewski, Jan Pachecka, Marta Struga, Wioletta Olejarz, Magdalena Mielczarek-Puta, Grażyna Nowicka
Another source of ethanol present in the blood may also be intestinal microflora, especially fungi of genera: Candida (Candida albicans, Candida tropicalis, Candida glabrata, Candida krusei) and Saccharomyces (Saccharomyces cerevisiae). In healthy individuals, the blood concentration of alcohol produced by gut microbiome is usually between 0.3 and 2.0 mg/L (on average: 1.0 mg/L). As shown in the studies on the presence of alcohol in blood, in patients undergoing long-term antibiotic therapy, as well as in patients with genetically determined or acquired liver failure, and in case of diabetes, obesity, short bowel syndrome and Crohn’s disease, the development of gut fermentation syndrome, also called auto-brewery syndrome, may occur as a complication of the above-mentioned diseases. In those patients, if a carbohydrate-rich diet is followed, the blood alcohol concentration (BAC) may reach over 30 mg/L. The biological half-life of ethanol (T1/2) in blood is 74 minutes on average and is higher in women than in men. The shortening of this period to ca. 42 min, which occurs in pregnant women, is mainly due to the penetration of a significant amount of ethanol into the foetal water space (Ahmed et al., 2018; Al Saabi et al., 2013; Cordell & McCarthy, 2013; Guo et al., 2018; Jones, 2011; Welch et al., 2016).