A. Karl Larsen, Jr., Ph.D.

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ALCOHOL TOXICOLOGY and PERFORMANCE

• A. Karl Larsen, Jr., Ph.D.
• Illinois State Police
• Forensic Sciences Command
• Forensic Science Center at Chicago
• ISP/UIC Program Instructor in
• Drug Chemistry and Toxicology
• Toxicology Technical Leader
• Telephone [phone] ext. 2051

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• LEVELS
• EFFECTS
• INDIVIDUAL VARIATION
• MEASURING BLOOD ALCOHOL CONCENTRATION (BAC)
• CALCULATIONS for ALCOHOL
• EVIDENCE for PROSECUTION

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ALCOHOL TOXICOLOGY and PERFORMANCE

• ABSORPTION
• Through mucous membranes (minor)
• Most absorbed in small intestine
• Peak levels reached 30 - 90 minutes
• Dependent on food intake
• Can be absorbed through lungs, but very high
  levels of exposure for extended periods of time
  are needed for blood levels of 0.01 - 0.05 g/dL

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ALCOHOL TOXICOLOGY and PERFORMANCE

• Distribution
• Through body water
• Ratios based on blood levels (averages)
• BloodSerum 11.18
• BloodBrain 10.75
• BloodBreath 21001
• BloodBlood Clot 10.77
• BloodSaliva 11.12

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ALCOHOL TOXICOLOGY and PERFORMANCE

• METABOLISM and EXCRETION
• CH3CH2OH Alcohol Dehydrogenase gt CH3CHO
  Ethanol
  Acetaldehyde
• CH3CHO Aldehyde Dehydrogenase gt CH3COOH
• Acetaldehyde
  Acetic Acid
• 95 of dose metabolized in this manner
• 5 excreted unchanged in urine, feces, breath and
  sweat

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ALCOHOL TOXICOLOGY and PERFORMANCE

• METABOLISM
• Induction of liver enzymes with use
• Second step appears to be rate limiting
• Acetaldehyde can build up in the system

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

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ALCOHOL TOXICOLOGY and PERFORMANCE

• Post Mortem Production of Ethanol
• Through bacterial fermentation of sugar in the
  blood
• Normally levels reached will not exceed 0.05 g/dL
• Prevented with use of preservatives in blood
  tubes (F-1, Hg3 ) or cold

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• LEVELS
• Under 21 years of age 0.00 g/dL BAC
• Over 21 years of age
• not more than 0.05 g/dL BAC
• gt0.05 but not more than 0.079 g/dL BAC
• or gt 0.08 g/dL BAC
• When working in jobs in the public sector
• 0.00 g/dL BAC

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• EFFECTS
• Central Nervous System Depressant
• Loss of judgment
• Loss of inhibition
• Loss of fine motor skills
• Loss of coordination
• Different stages of intoxication

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Think before you drink. Drunk is Dumb (alcohol
  puts the smart part of your brain to
  sleep)
• At .020 light to moderate drinkers begin
  to feel some effects.
• At .040 most people begin to feel relaxed.

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• At .060 judgment is somewhat impaired, people
  are less able to make rational decisions about
  their capabilities (for example, driving).
• At .080 there is a definite impairment of
  muscle coordination and driving skills
  this is legal level for intoxication in most
  states.

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ALCOHOL TOXICOLOGY and PERFORMANCE

• At .10 there is a clear deterioration of reaction
  time and control this is legally drunk in all
  states.
• At .120, vomiting usually occurs. Unless this
  level is reached slowly or a person has developed
  a tolerance to alcohol.
• At .150, balance and movement are impaired. This
  blood-alcohol level means the equivalent of 1/2
  pint of whiskey is circulating in the blood
  stream.

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ALCOHOL TOXICOLOGY and PERFORMANCE

• At .300 many people lose consciousness.
• At .400 most people lose consciousness some
  die.
• At .450, breathing stops this is a fatal dose
  for most people

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ALCOHOL TOXICOLOGY and PERFORMANCE

• Examples of Blood Alcohol Levels in males (160
  lbs) and females (140 lbs). After 3 hours of
  drinking (1 drink 12 oz. of beer)
• Female 4 drinks BAC .08
• Male 5 drinks BAC .076

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ALCOHOL TOXICOLOGY and PERFORMANCE

• One drink is defined as having one-half ounce of
  pure ethyl alcohol (EtOH) each of the following
  is considered "one drink.
• 10 oz to 12 oz of beer (4 to 5 EtOH)
• 8 oz to 12 oz of wine cooler (4 to 6 EtOH)
• 5 oz to 6 oz of table wine (9 to 12 EtOH)
• 2.5 oz of fortified wine (20 EtOH)
• 1.25 oz of 80 proof distilled spirits (40 EtOH)
• 1 oz of 100 proof distilled spirits (50 EtOH)
•  

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ALCOHOL TOXICOLOGY and PERFORMANCE
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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Stages of Intoxication
• Sobriety
• lt 0.05 g/dL BAC
• No obvious physical effects
• Judgment starting to be affected
• Inhibitions starting to lessen
• Driver no more likely to be involved in an
  accident than someone at 0.00 g/dL

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Euphoria
• 0.03 to 0.12 g/dL BAC
• Increased sociability, talkativeness, self
  confidence
• Decreased attention, judgment and inhibitions
• Decreased efficiency in fine motor control

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Excitement
• 0.09 to 0.25 g/dL BAC
• Increased emotional instability
• Inhibitions, critical judgment, sensory response
  time decreased further
• Increased reaction time
• Impaired memory, comprehension
• Muscular incoordination

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Confusion
• 0.18 to 0.30 g/dL BAC
• Exaggerated emotional states
• Disorientation, dizziness and mental confusion,
  muscular incoordination
• Disturbances in perception of time, color,
  motion, distance, form and dimension
• Impaired balance, staggering gait, slurred speech

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Stupor
• 0.27 to 0.40 g/dL BAC
• Apathy ataxia (approaching paralysis)
• Decreased response to sensory stimuli
• Vomiting, incontinence of urine and feces (death
  here due to aspiration of vomit)
• Inability to stand, walk and/or talk
• Impaired consciousness, sleep or stupor

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Coma
• 0.35 to 0.50 g/dL BAC
• Depressed or absent reflexes
• Decreased body temperature
• Complete unconsciousness, coma and anesthesia
• Embarrassment of respiration and circulation,
  possible death

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Death
• and gt 0.45 g/dL BAC
• Death from respiratory paralysis

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Death, but not necessarily
• Lorain, Ohio 49 year old man arrested for DUI
  had a BAC of 0.532 g/dL
• Iowa Worker drank from fuel ethanol storage
  pond, passed out and was later tested. His BAC
  was 0.72 g/dL

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Individual Variation
• No two people respond exactly the same to equal
  amounts of alcohol
• People develop tolerance with chronic use of
  alcohol
• Acute tolerance to alcohol can develop in a short
  period of time

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Measuring BAC
• Field Sobriety Testing
• Psychophysical (Walk and Turn, etc.)
• Horizontal Gaze Nystagmus (HGN)
• Breathalyzer
• Portable Breath Testing devices
• Breathalyzers
• Hospital blood draws (Serum)
• Blood Draws for DUI Kits (Whole Blood)

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Calculations using BAC
• Back Extrapolation - knowing the times of the
  accident and blood draw, we can calculate a BAC
  range for the time of the accident

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Calculations using BAC
• Back Extrapolation - knowing the times of the
  accident
• and blood draw, we can calculate a BAC range for
  the
• time of the accident
• Amount of Alcohol Consumed - with the time course
  of
• alcohol consumption, BAC, weight and sex of the
  individual, we can calculate how much alcohol
  was consumed to reach the BAC found

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Evidence For Prosecution
• DUI Kit
• Medical records if hospital blood draw is to be
  used
• Breathalyzer results and calibrations
• Field Sobriety and/or PBT results
• Probable cause
• To aid in determining impairment if BAC is gt0.05
  but lt0.08 g/dL

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Courtroom Testimony
• BAC
• Back Extrapolation
• Symptoms
• Possible Alcohol Consumption
• Conversion of SAC to BAC
• Drug Interactions

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Courtroom Testimony
• BAC
• Back Extrapolation
• Symptoms
• Possible Alcohol Consumption
• Conversion of SAC to BAC
• Drug Interactions
• Miscellaneous

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• ALCOHOL TOXICOLOGY
• and PERFORMANCE

• Problems with Alcohol
• Diabetic incidents
• Time of consumption
• Post-incident consumption
• Cough syrup consumption
• Chain of Custody issues
• Breathalyzer issues
• Use of serum blood concentration

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ALCOHOL TOXICOLOGY and PERFORMANCE

• QUESTIONS?

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ALCOHOL TOXICOLOGY and PERFORMANCE

• THANK YOU VERY MUCH