Drunk 6.0

[Cecile Lilien]

Alcoholintoxication, also known in overdose as alcohol poisoning,[1] commonly described as drunkenness or inebriation,[10] is the behavior and physical effects caused by a recent consumption of alcohol.[6][11] In addition to the toxicity of ethanol, the main psychoactive component of alcoholic beverages, other physiological symptoms may arise from the activity of acetaldehyde, a metabolite of alcohol.[12] These effects may not arise until hours after ingestion and may contribute to the condition colloquially known as a hangover. The term intoxication is commonly used when large amount of alcohol is consumed along with physical symptoms and deleterious health effects.

Symptoms of intoxication at lower doses may include mild sedation and poor coordination.[3] At higher doses, there may be slurred speech, trouble walking, and vomiting.[3] Extreme doses may result in a respiratory depression, coma, or death.[3] Complications may include seizures, aspiration pneumonia, low blood sugar, and injuries or self-harm such as suicide.[3][4] Alcohol intoxication can lead to alcohol-related crime with perpetrators more likely to be intoxicated than victims.[13]

Management of alcohol intoxication involves supportive care.[6] Typically this includes putting the person in the recovery position, keeping the person warm, and making sure breathing is sufficient.[4] Gastric lavage and activated charcoal have not been found to be useful.[6] Repeated assessments may be required to rule out other potential causes of a person's symptoms.[6]

Acute intoxication has been documented throughout history, and alcohol remains one of the world's most widespread recreational drugs.[18][19] Some religions consider alcohol intoxication to be a sin.[5][20]

Alcohol intoxication leads to negative health effects due to the recent drinking of large amount of ethanol (alcohol).[6][21] When severe it may become a medical emergency. Some effects of alcohol intoxication, such as euphoria and lowered social inhibition, are central to alcohol's desirability.[22]

As drinking increases, people become sleepy or fall into a stupor. At very high blood alcohol concentrations, for example above 0.3%, the respiratory system becomes depressed and the person may stop breathing.[23] Comatose patients may aspirate their vomit (resulting in vomitus in the lungs, which may cause "drowning" and later pneumonia if survived). CNS depression and impaired motor coordination along with poor judgment increase the likelihood of accidental injury occurring. It is estimated that about one-third of alcohol-related deaths are due to accidents and another 14% are from intentional injury.[24]

In addition to respiratory failure and accidents caused by its effects on the central nervous system, alcohol causes significant metabolic derangements. Hypoglycaemia occurs due to ethanol's inhibition of gluconeogenesis, especially in children, and may cause lactic acidosis, ketoacidosis, and acute kidney injury. Metabolic acidosis is compounded by respiratory failure. Patients may also present with hypothermia.

Alcohol is metabolized by a normal liver at the rate of about 8 grams of pure ethanol per hour. 8 grams or 10 mL (0.34 US fl oz) is one British standard unit. An "abnormal" liver with conditions such as hepatitis, cirrhosis, gall bladder disease, and cancer is likely to result in a slower rate of metabolism.[25]

Alcohol intoxication is described as a mental and behavioural disorder by the International Classification of Diseases. (ICD-10).[26] Definitive diagnosis relies on a blood test for alcohol, usually performed as part of a toxicology screen. Law enforcement officers in the United States and other countries often use breathalyzer units and field sobriety tests as more convenient and rapid alternatives to blood tests.[27] There are also various models of breathalyzer units that are available for consumer use. Because these may have varying reliability and may produce different results than the tests used for law-enforcement purposes, the results from such devices should be conservatively interpreted.

Many informal intoxication tests exist, which, in general, are unreliable and not recommended as deterrents to excessive intoxication or as indicators of the safety of activities such as motor vehicle driving, heavy equipment operation, machine tool use, etc.

For determining whether someone is intoxicated by alcohol by some means other than a blood-alcohol test, it is necessary to rule out other conditions such as hypoglycemia, stroke, usage of other intoxicants, mental health issues, and so on. It is best if their behavior has been observed while the subject is sober to establish a baseline. Several well-known criteria can be used to establish a probable diagnosis. For a physician in the acute-treatment setting, acute alcohol intoxication can mimic other acute neurological disorders or is frequently combined with other recreational drugs that complicate diagnosis and treatment.

Acute alcohol poisoning is a medical emergency due to the risk of death from respiratory depression or aspiration of vomit if vomiting occurs while the person is unresponsive. Emergency treatment strives to stabilize and maintain an open airway and sufficient breathing while waiting for the alcohol to metabolize. This can be done by removal of any vomit or, if the person is unconscious or has impaired gag reflex, intubation of the trachea.[28]

Alcohol intoxication was found to be prevalent in clinical populations within the United States involving people treated for[8] trauma[32] and in the age group of people aged within their 18th - 24th years (in a study of a group for the years 1999 - 2004).[33] In the United States during the years 2010 - 2012, acute intoxication was found to be the direct cause of an average of 2,221 deaths, in the sample group of those aged within their 15th year or older.[9] The same mortality route is thought to cause indirectly more than 30,000 deaths per year.[5]

A normal liver detoxifies the blood of alcohol over a period of time that depends on the initial level and the patient's overall physical condition. An abnormal liver will take longer but still succeeds, provided the alcohol does not cause liver failure.[34]

A person consuming a dangerous amount of alcohol persistently can develop memory blackouts and idiosyncratic intoxication or pathological drunkenness symptoms.[36] Long-term persistent consumption of excessive amounts of alcohol can cause liver damage and have other deleterious health effects.

Laws on drunkenness vary. In the United States, it is a criminal offense for a person to be drunk while driving a motorized vehicle, except in Wisconsin, where it is only a fine for the first offense.[38] It is also a criminal offense to fly an aircraft or (in some American states) to assemble or operate an amusement park ride while drunk.[39] Similar laws also exist in the United Kingdom and most other countries.

In some countries, it is also an offense to serve alcohol to an already-intoxicated person,[40] and, often, alcohol can only be sold by persons qualified to serve responsibly through alcohol server training.

The blood alcohol content (BAC) for legal operation of a vehicle is typically measured as a percentage of a unit volume of blood. This percentage ranges from 0.00% in Romania and the United Arab Emirates; to 0.05% in Australia, South Africa, Germany, Scotland, and New Zealand (0.00% for underage individuals); to 0.08% in England and Wales, the United States and Canada.[41]

The United States Federal Aviation Administration prohibits crew members from performing their duties within eight hours of consuming an alcoholic beverage, while under the influence of alcohol, or with a BAC greater than 0.04%.[42][43]

Some religious groups permit the consumption of alcohol; some permit consumption but prohibit intoxication; others prohibit any amount of alcohol consumption altogether. Many denominations of Christianity, such as Catholicism, Orthodoxy and Lutheranism, use wine as a part of the Eucharist and permit its consumption, but consider it sinful to become intoxicated.[45]

In the Church of Jesus Christ of Latter-day Saints, alcohol consumption is forbidden,[52] and teetotalism has become a distinguishing feature of its members. Jehovah's Witnesses allow moderate alcohol consumption among its members.

In Buddhism, in general, the consumption of intoxicants is discouraged for both monastics and lay followers. Many Buddhists observe a basic code of ethics known as the five precepts, of which the fifth precept is an undertaking to refrain from the consumption of intoxicating substances[57] (except for medical reasons).[58] In the bodhisattva vows of the Brahmajala Sutra, observed by Mahayana Buddhist communities, distribution of intoxicants is likewise discouraged, as well as consumption.[59]

In Judaism, in accordance with the biblical stance against drinking,[50] drinking wine is restricted for priests.[61] The biblical command to sanctify the Sabbath and other holidays has been interpreted as having three ceremonial meals with wine or grape juice, known as Kiddush.[62][63] A number of Jewish marriage ceremonies end with the bride and groom drinking a shared cup of wine after reciting seven blessings; this occurs after a fasting day in some Ashkenazi traditions. It has been customary and in many cases even mandated to drink moderately so as to stay sober, and only after the prayers are over.[64]

During the Seder on Passover, there is an obligation to drink four ceremonial cups of wine while reciting the Haggadah. It has been assumed as the source of the wine-drinking ritual at communion in some Christian groups.[65] During Purim, there is an obligation to become intoxicated; however, as with many other decrees, this has been avoided in many communities by allowing sleep during the day as a replacement.[66]

During the U.S. Prohibition era in the 1920s, a rabbi from the Reform Judaism movement proposed using grape juice for the ritual instead of wine. Although refuted at first, the practice became widely accepted by orthodox Jews as well.[67]

3a8082e126