Principles And Pitfalls in Alcohol Toxicity, Part 2

AlcoholThe amount of alcohol which should have been absorbed normally through the small intestine at a certain point in time, will be significantly delayed if that same individual has a disease of the stomach, or medications or food which prevent the emptying of the stomach alcohol into the small intestine, and therefore delaying the absorption of alcohol from the small intestine. While the absorption of alcohol from the stomach is dependent on food among others, the absorption from the small intestine is rapid, and is not affected by food presence. From the stomach and intestine alcohol will be distributed via the blood to all body organs including the lungs. This is the basis for extrapolating from alcohol breath measurements into blood alcohol content (BAC). The alcohol breath testing is based on a concept that the ratio between the air that we exhale and blood alcohol is 1/2100. This, however, has not reached scientific acceptance, and data showing figures from 1/1500 to 1/3000 have been published in the scientific literature. Therefore, there is an individual variation, which cannot be determined with the methodology utilized today and therefore cannot be simply and routinely applied to breath testing (1).

Factors Determining Alcohol Absorption

Body Water
Alcohol is absorbed into the water of body fluids. The concentration of alcohol within an individual depends on the amount of body water contained in the individual’s body. An individual with a total body water which is large will be able to dilute and absorb more alcohol than an individual with a smaller volume of body water. Body water content varies and ranges from 55 to 68% (2).

1. Karch, Steven B. Drug Abuse Handbook Steven B. Karch, editor. CRC Press 1997 pgs.1152
2. Winek, Charles; Esposito, Francis “Blood Alcohol Concentrations: Factors Affecting Predictions” pgs. 34-61.

About Nachman Brautbar, M.D., F.A.C.P.

Experienced in internal medicine, toxicology, occupational medicine, alcohol, drugs, and nephrology, with a specialization in toxicology; evaluation, analysis & interpretation of urine drug/alcohol tests; drug/alcohol concentrations in the blood; findings in blood and urine samples; assessment of driving under the influence. His list of academic appointments includes Associate Professor of Pharmacology and Medicine, and Clinical Professor of Medicine at the University of Southern California, School of Medicine. Dr. Brautbar is a peer reviewer for the Department of Human Health Services, earlier Agency for Toxic Substances and Disease Registry (ATSDR). Dr. Brautbar has been on the faculty of the National Judicial College and has lectured to judges on the issue of scientific evidence. He has been a visiting professor at national and international scientific institutions and centers such as Yale, Harvard, Mayo Clinic, and NIH. Dr. Brautbar is a fellow of the Collegium Ramazzini. Dr. Brautbar has testified in the California State Senate and the United States Senate on toxic groundwater contamination.

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