Imagine waking up one morning in your bed with an enormous cut across your forehead, needing stitches and not knowing why it was there. Or put yourself in a situation where you awaken on a strange floor with a throbbing, painfully swollen left hand that you cannot move and not knowing where, what, when or why.
Hopefully, you have not experienced a similar incident. But you may know someone who has suffered a "morning after" episode similar to those described.
Unfortunately, these scenarios aren't unusual after an episode of acute alcohol intoxication (sometimes called alcohol poisoning by students).
Alcohol is the most commonly abused intoxicant in the United States. Beer is the fourth most popular beverage by volume, following soft drinks, milk and coffee. It has been estimated that the socioeconomic and medical costs of alcohol abuse in our country are nearly $100 billion. Excessive alcohol consumption is the third leading cause of preventable death (100,000 annually) behind cigarette smoking and obesity.
What is alcohol poisoning?
Alcohol is absorbed from the gastrointestinal tract and detected in the blood within minutes.
Soon thereafter, the concentration of alcohol in the brain is the same as that in the blood. About 25 percent of the consumed alcohol enters the bloodstream directly from the stomach, and the remaining 75 percent enters from the intestines. Absorption is affected by several factors, including food in your digestive system, the rate of drinking, the amount of alcohol you drink, the strength and type of drink and individual variations in metabolism and gender.
Intoxication is measured in terms of blood-alcohol concentration -- the ratio of alcohol to blood in the bloodstream. The most common system for measuring and reporting blood-alcohol levels (BAL) is calculated using the weight of alcohol in milligrams and the volume of blood in deciliters. This yields a blood-alcohol concentration (BAC) that can be expressed as a percentage, such as 0.10 percent alcohol by volume, or as a proportion, such as 100 milligrams per deciliter.
What is considered legal intoxication varies throughout the United States, with blood-alcohol concentrations ranging from 0.08 to 0.10. Each state sets its own legal intoxication level. For example, in Pennsylvania, it is 0.08, and in New Jersey, it is 0.10.
This is approximately two to three "average" drinks; an average drink could be a 12-ounce beer, a 5-ounce glass of wine or 1.5 ounces of 80-proof spirits.
Of course, this can vary based on body weight and gender.
The rule of thumb is that the body is able to metabolize one drink an hour.
As alcohol levels increase, most people begin to feel euphoric; they lose social inhibitions and exhibit outgoing behavior.
Still others become gloomy, sad or even combative. When blood-alcohol levels hit 0.10 to 0.20, sporadic drinkers develop slurred speech, clumsiness, flat mood, drowsiness and nausea. At levels of 0.20 to 0.30, the sporadic drinker develops lethargy, stupor, incoherent speech, blurred vision or vomiting. Coma may occur at levels between 0.30 and 0.40. At levels greater than 0.50, respiratory depression and death occur.
The average lethal dose is 0.45.
For chronic drinkers, a tolerance to alcohol develops due to adaptive changes in the central nervous system; consequently, their symptoms occur at higher blood-alcohol concentrations.
However, they will still have the same concentration levels in their blood as the sporadic drinker.
They may look less drunk -- as if they can "hold their liquor" -- but their blood-alcohol levels will be the same as those of sporadic drinkers.
What happens medically?
Severe acute alcohol intoxication can be fatal and is considered a medical emergency.
Medical symptoms include a depressed level of consciousness, decreased blood pressure and respiratory depression. Besides the amount of alcohol consumed and the timeframe in which it was consumed, other concerns are low blood sugars, meningitis, serious brain injuries and profound liver complications, as these can all either mimic intoxication or coexist with it.
Profound electrolyte abnormalities that require intervention can also occur. In some cases, an airway must be secured by inserting a breathing tube, and sometimes, the content of the stomach must be removed.
"Blackouts" are characterized by amnesia for several hours without loss of consciousness. The person will not remember what occurs during this episode but has no problem with any aspect of memory. Medical professionals will need to obtain as much history about the intoxicated individual as possible to identify the medical problems they will need to manage. As you can imagine, it is not easy or always possible to obtain this information from the patients themselves, so it is helpful if another person accompanies them.
It is not uncommon for the staff of University Health Services to see the aftermath of alcohol and its effects on the lives of Penn State students.
We see a wide variety of problems associated with episodes of acute alcohol intoxication, including sexual transmitted infections, sexual assault, impotence, lacerations, head injuries, broken bones, dental injuries and many other complications.
Alcohol can be very dangerous if not managed with maturity and responsibility. Please think seriously about the responsibility that you are undertaking the next time you take a drink.
It can have a profound effect on your future well-being.
