Drunkenness
Encyclopedia
Alcohol intoxication is a physiological state that occurs when a person has a high level of ethanol
(alcohol) in his or her blood
.
Common symptom
s of alcohol intoxication include slurred speech, euphoria
, impaired balance, loss of muscle coordination (ataxia
), flushed face, vomiting, reddened eyes, reduced inhibition
, and erratic behavior. In severe cases, it can cause coma
or death
.
Toxicologists
use the term “alcohol intoxication” to discriminate between alcohol and other toxin
s.
Acute alcohol intoxication results from a very high level of alcohol
in the blood. This term is used by health care provider
s, often in emergencies.
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Alcohol is metabolized by a normal liver
at the rate of about one ounce (one "highball
", a normal beer, a regular sized glass of wine) every 90 minutes. An "abnormal" liver with conditions such as hepatitis
, cirrhosis
, gall bladder disease, and cancer
will have a slower rate of metabolism.
Ethanol
is metabolised to acetaldehyde
by alcohol dehydrogenase
(ADH), which is found in many tissues, including the gastric mucosa. Acetaldehyde is metabolised to acetate by acetaldehyde dehydrogenase (ALDH), which is predominantly found in liver mitochondria. Acetate is used by the muscle cells to produce acetyl-CoA
using the enzyme acetyl-CoA synthetase, and the acetyl-CoA is then used in the citric acid cycle
. It takes roughly 90 minutes for a healthy liver to metabolize a single ounce, approximately one hour per standard unit.
Ethanol's acute effects are largely due to its nature as a central nervous system depressant, and are dependent on blood alcohol concentrations:
As drinking increases, people become sleepy, or fall into a stupor
. After a very high level of consumption, the respiratory system becomes depressed and the person will stop breathing. The most important thing for friends who witness someone "passing out" from too much alcohol is to get them emergency medical treatment. 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 co-ordination along with poor judgement increases the likelihood of accidental injury occurring. It is estimated that about one third of alcohol-related deaths are due to accidents (32%), and another 14% are from intentional injury.
In addition to respiratory failure and accidents caused by 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 renal failure
. Metabolic acidosis is compounded by respiratory failure. Patients may also present with hypothermia.
systems in the brain. However, molecular pharmacology studies have shown that alcohol has only a few primary targets. In some systems these effects are facilitatory and in others inhibitory.
Among the neurotransmitter systems with enhanced functions are: GABAA, glycine
, serotonin
, nicotinic acetylcholine receptors.
Among those that are inhibited are: NMDA
, dihydropyridine-sensitive L-type Ca2+ channels and G-protein-activated inwardly rectifying K+ channels.
The result of these direct effects are a wave of further indirect effects involving a variety of other neurotransmitter
and neuropeptide
systems, leading finally to the behavioural or symptomatic effects of alcohol intoxication.
relies on a blood test for alcohol, usually performed as part of a toxicology
screen.
Law enforcement officers often use breathalyzer
units and field sobriety tests as more convenient and rapid alternatives to blood tests. The reliability of field sobriety tests is somewhat questionable, although they are commonly used in various jurisdictions.
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 are generally 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 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.
, inexperience with controlling the amount of alcohol consumed, lack of self-control, and so on.
Also:
Additional medication
may be indicated for treatment of nausea
, tremor
, and anxiety
.
.
People who have been drinking heavily for several days or weeks may have withdrawal
symptoms after the acute intoxication has subsided.
A person who consumes a dangerous amount of alcohol persistently can develop memory blackouts and idiosyncratic intoxication or pathological drunkenness symptoms.
Long-term persistent consumption of excessive amounts of alcohol can cause liver damage and have other deleterious health effects.
, for example, it is a criminal offense for a person to be drunk while driving a motorized vehicle (driving under the influence
), operating an aircraft, or (in some states) assembling or operating an amusement park
ride. This is also the case in the United Kingdom
and many other countries. In some countries it is also an offense to serve alcohol to an already intoxicated person and often alcohol can only be sold by staff qualified to serve responsibly through alcohol server training
.
The blood alcohol content (BAC) for legal operation of a vehicle
is typically measured as a percent of unit volume of blood. This ranges from a low of 0.00% in Romania and the United Arab Emirates, to 0.05% in Australia, South Africa and Germany, to 0.08% in the United Kingdom, the United States, and New Zealand.
Additionally, the U.S. Federal Aviation Administration
prohibits crewmembers from performing their duties with a BAC greater than 0.04%, within 8 hours of consuming an alcoholic beverage or while under the influence of alcohol.
In the UK, US, and Australia, people can be arrested for public intoxication
, being "drunk and disorderly" or being "drunk and incapable". There are also often legal penalties for the sale of alcoholic beverages to intoxicated persons.
, there is a prohibition on the consumption of grape
-based alcoholic beverages, and intoxication is considered as an abomination in the Hadith
. Islam
ic schools of law (Madh'hab) have interpreted this as a strict prohibition of the consumption of all types of alcohol and declared it to be haraam
("forbidden"), although other uses may be permitted.
Some Protestant
Christian
denominations prohibit the drinking of alcohol based upon Biblical passages which condemn drunkenness (for instance, Proverbs
23:21, Isaiah
28:1, Habakkuk
2:15.), but others allow moderate use of alcohol. In some Christian groups, wine is part of the rite of communion (see Christianity and alcohol). However, in The Church of Jesus Christ of Latter-day Saints, alcohol consumption is forbidden, to the point where teetotalism
has become a distinguishing feature of its members.
In Buddhism
, the consumption of intoxicants is generally discouraged for both monastics and lay followers. Many followers of Buddhism observe a code of conduct known as the Five Precepts, of which the fifth precept prohibits consumption of intoxicating substances (except for medical reasons). In the Bodhisattva Vows
of the Brahma Net Sutra, observed by some monastic communities and some lay followers, distribution of intoxicants is likewise discouraged as well as consumption.
In Vaishnavism
, specifically Gaudiya Vaishnavism
, one of the four regulative principles forbids the taking of intoxicants, including alcohol.
Ethanol
Ethanol, also called ethyl alcohol, pure alcohol, grain alcohol, or drinking alcohol, is a volatile, flammable, colorless liquid. It is a psychoactive drug and one of the oldest recreational drugs. Best known as the type of alcohol found in alcoholic beverages, it is also used in thermometers, as a...
(alcohol) in his or her blood
Blood alcohol content
Blood alcohol content , also called blood alcohol concentration, blood ethanol concentration, or blood alcohol level is most commonly used as a metric of alcohol intoxication for legal or medical purposes....
.
Common symptom
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s of alcohol intoxication include slurred speech, euphoria
Euphoria
Euphoria is an emotional and mental state defined as a sense of great elation and well being.Euphoria may also refer to:* Euphoria , a genus of scarab beetles* Euphoria, a genus name previously used for the longan and other trees...
, impaired balance, loss of muscle coordination (ataxia
Ataxia
Ataxia is a neurological sign and symptom that consists of gross lack of coordination of muscle movements. Ataxia is a non-specific clinical manifestation implying dysfunction of the parts of the nervous system that coordinate movement, such as the cerebellum...
), flushed face, vomiting, reddened eyes, reduced inhibition
Disinhibition
Disinhibition is a term in psychology used to describe a lack of restraint manifested in several ways, including disregard for social conventions, impulsivity, and poor risk assessment. Disinhibition affects motor, instinctual, emotional, cognitive and perceptual aspects with signs and symptoms...
, and erratic behavior. In severe cases, it can cause coma
Coma
In medicine, a coma is a state of unconsciousness, lasting more than 6 hours in which a person cannot be awakened, fails to respond normally to painful stimuli, light or sound, lacks a normal sleep-wake cycle and does not initiate voluntary actions. A person in a state of coma is described as...
or death
Death
Death is the permanent termination of the biological functions that sustain a living organism. Phenomena which commonly bring about death include old age, predation, malnutrition, disease, and accidents or trauma resulting in terminal injury....
.
Toxicologists
Toxicology
Toxicology is a branch of biology, chemistry, and medicine concerned with the study of the adverse effects of chemicals on living organisms...
use the term “alcohol intoxication” to discriminate between alcohol and other toxin
Toxin
A toxin is a poisonous substance produced within living cells or organisms; man-made substances created by artificial processes are thus excluded...
s.
Acute alcohol intoxication results from a very high level of alcohol
Alcoholic beverage
An alcoholic beverage is a drink containing ethanol, commonly known as alcohol. Alcoholic beverages are divided into three general classes: beers, wines, and spirits. They are legally consumed in most countries, and over 100 countries have laws regulating their production, sale, and consumption...
in the blood. This term is used by health care provider
Health care provider
A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....
s, often in emergencies.
Pathophysiology
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...
at the rate of about one ounce (one "highball
Highball
Highball is a type of alcoholic drinkHighball may also refer to:* Highball glass, a drinking vessel* Highball Wilson , professional baseball pitcher* the British Highball bouncing bomb project from World War 2...
", a normal beer, a regular sized glass of wine) every 90 minutes. An "abnormal" liver with conditions such as hepatitis
Hepatitis
Hepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat- , meaning liver, and suffix -itis, meaning "inflammation"...
, cirrhosis
Cirrhosis
Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules , leading to loss of liver function...
, gall bladder disease, and cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
will have a slower rate of metabolism.
Ethanol
Ethanol
Ethanol, also called ethyl alcohol, pure alcohol, grain alcohol, or drinking alcohol, is a volatile, flammable, colorless liquid. It is a psychoactive drug and one of the oldest recreational drugs. Best known as the type of alcohol found in alcoholic beverages, it is also used in thermometers, as a...
is metabolised to acetaldehyde
Acetaldehyde
Acetaldehyde is an organic chemical compound with the formula CH3CHO or MeCHO. It is one of the most important aldehydes, occurring widely in nature and being produced on a large scale industrially. Acetaldehyde occurs naturally in coffee, bread, and ripe fruit, and is produced by plants as part...
by alcohol dehydrogenase
Alcohol dehydrogenase
Alcohol dehydrogenases are a group of dehydrogenase enzymes that occur in many organisms and facilitate the interconversion between alcohols and aldehydes or ketones with the reduction of nicotinamide adenine dinucleotide...
(ADH), which is found in many tissues, including the gastric mucosa. Acetaldehyde is metabolised to acetate by acetaldehyde dehydrogenase (ALDH), which is predominantly found in liver mitochondria. Acetate is used by the muscle cells to produce acetyl-CoA
Acetyl-CoA
Acetyl coenzyme A or acetyl-CoA is an important molecule in metabolism, used in many biochemical reactions. Its main function is to convey the carbon atoms within the acetyl group to the citric acid cycle to be oxidized for energy production. In chemical structure, acetyl-CoA is the thioester...
using the enzyme acetyl-CoA synthetase, and the acetyl-CoA is then used in the citric acid cycle
Citric acid cycle
The citric acid cycle — also known as the tricarboxylic acid cycle , the Krebs cycle, or the Szent-Györgyi-Krebs cycle — is a series of chemical reactions which is used by all aerobic living organisms to generate energy through the oxidization of acetate derived from carbohydrates, fats and...
. It takes roughly 90 minutes for a healthy liver to metabolize a single ounce, approximately one hour per standard unit.
Ethanol's acute effects are largely due to its nature as a central nervous system depressant, and are dependent on blood alcohol concentrations:
- 20–99 mg/dL - Impaired coordination and euphoriaEuphoriaEuphoria is an emotional and mental state defined as a sense of great elation and well being.Euphoria may also refer to:* Euphoria , a genus of scarab beetles* Euphoria, a genus name previously used for the longan and other trees...
- 100–199 mg/dL - AtaxiaAtaxiaAtaxia is a neurological sign and symptom that consists of gross lack of coordination of muscle movements. Ataxia is a non-specific clinical manifestation implying dysfunction of the parts of the nervous system that coordinate movement, such as the cerebellum...
, poor judgement, labile mood - 200–299 mg/dL - Marked ataxia, slurred speech, poor judgement, labile mood, nausea and vomiting
- 300–399 mg/dL - Stage 1 anaesthesia, memory lapse, labile mood
- 400+ mg/dL - Respiratory failure, coma and death
As drinking increases, people become sleepy, or fall into a stupor
Stupor
Stupor is the lack of critical cognitive function and level of consciousness wherein a sufferer is almost entirely unresponsive and only responds to base stimuli such as pain. This is often mistaken for delirium and treated with Haldol and or other anti-psychotic drugs...
. After a very high level of consumption, the respiratory system becomes depressed and the person will stop breathing. The most important thing for friends who witness someone "passing out" from too much alcohol is to get them emergency medical treatment. Comatose patients may aspirate their vomit (resulting in vomitus in the lungs, which may cause "drowning" and later pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...
if survived). CNS depression and impaired motor co-ordination along with poor judgement increases the likelihood of accidental injury occurring. It is estimated that about one third of alcohol-related deaths are due to accidents (32%), and another 14% are from intentional injury.
In addition to respiratory failure and accidents caused by effects on the central nervous system, alcohol causes significant metabolic derangements. Hypoglycaemia occurs due to ethanol's inhibition of gluconeogenesis
Gluconeogenesis
Gluconeogenesis is a metabolic pathway that results in the generation of glucose from non-carbohydrate carbon substrates such as lactate, glycerol, and glucogenic amino acids....
, especially in children, and may cause lactic acidosis
Lactic acidosis
Lactic acidosis is a physiological condition characterized by low pH in body tissues and blood accompanied by the buildup of lactate especially D-lactate, and is considered a distinct form of metabolic acidosis. The condition typically occurs when cells receive too little oxygen , for example...
, ketoacidosis
Ketoacidosis
Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and β-hydroxybutyrate....
and acute renal failure
Renal failure
Renal failure or kidney failure describes a medical condition in which the kidneys fail to adequately filter toxins and waste products from the blood...
. Metabolic acidosis is compounded by respiratory failure. Patients may also present with hypothermia.
Pharmacology
In the past alcohol was believed to be a non-specific pharmacological agent, affecting many neurotransmitterNeurotransmitter
Neurotransmitters are endogenous chemicals that transmit signals from a neuron to a target cell across a synapse. Neurotransmitters are packaged into synaptic vesicles clustered beneath the membrane on the presynaptic side of a synapse, and are released into the synaptic cleft, where they bind to...
systems in the brain. However, molecular pharmacology studies have shown that alcohol has only a few primary targets. In some systems these effects are facilitatory and in others inhibitory.
Among the neurotransmitter systems with enhanced functions are: GABAA, glycine
Glycine
Glycine is an organic compound with the formula NH2CH2COOH. Having a hydrogen substituent as its 'side chain', glycine is the smallest of the 20 amino acids commonly found in proteins. Its codons are GGU, GGC, GGA, GGG cf. the genetic code.Glycine is a colourless, sweet-tasting crystalline solid...
, serotonin
Serotonin
Serotonin or 5-hydroxytryptamine is a monoamine neurotransmitter. Biochemically derived from tryptophan, serotonin is primarily found in the gastrointestinal tract, platelets, and in the central nervous system of animals including humans...
, nicotinic acetylcholine receptors.
Among those that are inhibited are: NMDA
NMDA
N-Methyl-D-aspartic acid or N-Methyl-D-aspartate is an amino acid derivative which acts as a specific agonist at the NMDA receptor mimicking the action of glutamate, the neurotransmitter which normally acts at that receptor...
, dihydropyridine-sensitive L-type Ca2+ channels and G-protein-activated inwardly rectifying K+ channels.
The result of these direct effects are a wave of further indirect effects involving a variety of other neurotransmitter
Neurotransmitter
Neurotransmitters are endogenous chemicals that transmit signals from a neuron to a target cell across a synapse. Neurotransmitters are packaged into synaptic vesicles clustered beneath the membrane on the presynaptic side of a synapse, and are released into the synaptic cleft, where they bind to...
and neuropeptide
Neuropeptide
Neuropeptides are small protein-like molecules used by neurons to communicate with each other. They are neuronal signaling molecules, influence the activity of the brain in specific ways and are thus involved in particular brain functions, like analgesia, reward, food intake, learning and...
systems, leading finally to the behavioural or symptomatic effects of alcohol intoxication.
Diagnosis
Definitive diagnosisMedical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...
relies on a blood test for alcohol, usually performed as part of a toxicology
Toxicology
Toxicology is a branch of biology, chemistry, and medicine concerned with the study of the adverse effects of chemicals on living organisms...
screen.
Law enforcement officers often use breathalyzer
Breathalyzer
A breathalyzer or breathalyser is a device for estimating blood alcohol content from a breath sample...
units and field sobriety tests as more convenient and rapid alternatives to blood tests. The reliability of field sobriety tests is somewhat questionable, although they are commonly used in various jurisdictions.
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 are generally 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 out other conditions such as hypoglycemia
Hypoglycemia
Hypoglycemia or hypoglycæmia is the medical term for a state produced by a lower than normal level of blood glucose. The term literally means "under-sweet blood"...
, stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
, 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.
Epidemiology
Common causes for excessive alcohol consumption include depression, alcoholismAlcoholism
Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing...
, inexperience with controlling the amount of alcohol consumed, lack of self-control, and so on.
Signs and symptoms
The signs and symptoms of alcohol poisoning include:- confusion
- vomiting
- dangerous anger
- seizures (fits)
- slow breathing (fewer than eight breaths a minute)
- pale, bluish skin
- cold and clammy skin
Management
Emergency treatment for acute alcohol intoxication strives to stabilize the patient and maintain a patent airway and respiration, while waiting for the alcohol to metabolize:Also:
- Protect vital signsVital signsVital signs are measures of various physiological statistics, often taken by health professionals, in order to assess the most basic body functions. Vital signs are an essential part of a case presentation. The act of taking vital signs normally entails recording body temperature, pulse rate ,...
by monitoring ABCs, or Airway, Breathing, and Circulation; that is, if the person is thought to be at risk for severe respiratory depression, consider an endotracheal tube to protect the airway and assist with breathing. - Protect the airway from aspirating stomachStomachThe stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...
contents that could cause aspiration pneumoniaAspiration pneumoniaAspiration pneumonia is bronchopneumonia that develops due to the entrance of foreign materials into the bronchial tree, usually oral or gastric contents...
. - Treat hypoglycaemia (low blood sugar) with 50ml of 50% dextrose solution and saline flush, as ethanol induced hypoglycaemia is unresponsive to glucagon.
- Administer the vitamin thiamineThiamineThiamine or thiamin or vitamin B1 , named as the "thio-vitamine" is a water-soluble vitamin of the B complex. First named aneurin for the detrimental neurological effects if not present in the diet, it was eventually assigned the generic descriptor name vitamin B1. Its phosphate derivatives are...
to prevent Wernicke-Korsakoff syndromeWernicke-Korsakoff syndromeWernicke–Korsakoff syndrome is a manifestation of thiamine deficiency, or beriberi. This is usually secondary to alcohol abuse...
, which can cause a seizureSeizureAn epileptic seizure, occasionally referred to as a fit, is defined as a transient symptom of "abnormal excessive or synchronous neuronal activity in the brain". The outward effect can be as dramatic as a wild thrashing movement or as mild as a brief loss of awareness...
(more usually a treatment for chronic alcoholism, but in the acute context usually co-administered to ensure maximal benefit). - Check urea and electrolytes to guide fluid replacement.
- Apply haemodialysis if the blood concentration is dangerously high (>400 mg%), and especially if there is metabolic acidosis.
- Provide oxygen therapy as needed via nasal cannula or non-rebreather mask.
Additional medication
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
may be indicated for treatment of nausea
Nausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...
, tremor
Tremor
A tremor is an involuntary, somewhat rhythmic, muscle contraction and relaxation involving to-and-fro movements of one or more body parts. It is the most common of all involuntary movements and can affect the hands, arms, eyes, face, head, vocal folds, trunk, and legs. Most tremors occur in the...
, and anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
.
Prognosis
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 succeed, provided the alcohol does not cause liver failureLiver failure
Acute liver failure is the appearance of severe complications rapidly after the first signs of liver disease , and indicates that the liver has sustained severe damage . The complications are hepatic encephalopathy and impaired protein synthesis...
.
People who have been drinking heavily for several days or weeks may have withdrawal
Alcohol withdrawal syndrome
-Protracted withdrawal:A protracted alcohol withdrawal syndrome occurs in many alcoholics where withdrawal symptoms continue beyond the acute withdrawal stage but usually at a subacute level of intensity and gradually decreasing with severity over time. This syndrome is also sometimes referred to...
symptoms after the acute intoxication has subsided.
A person who consumes a dangerous amount of alcohol persistently can develop memory blackouts and idiosyncratic intoxication or pathological drunkenness symptoms.
Long-term persistent consumption of excessive amounts of alcohol can cause liver damage and have other deleterious health effects.
Legal
Laws on drunkenness vary between countries. In the United StatesUnited States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
, for example, it is a criminal offense for a person to be drunk while driving a motorized vehicle (driving under the influence
Driving under the influence
Driving under the influence is the act of driving a motor vehicle with blood levels of alcohol in excess of a legal limit...
), operating an aircraft, or (in some states) assembling or operating an amusement park
Amusement park
thumb|Cinderella Castle in [[Magic Kingdom]], [[Disney World]]Amusement and theme parks are terms for a group of entertainment attractions and rides and other events in a location for the enjoyment of large numbers of people...
ride. This is also the case in the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
and many other countries. In some countries it is also an offense to serve alcohol to an already intoxicated person and often alcohol can only be sold by staff qualified to serve responsibly through alcohol server training
Alcohol Server Training
Alcohol server training is a form of occupational education typically provided to servers, sellers and consumers of alcohol to prevent intoxication, drunk driving and underage drinking...
.
The blood alcohol content (BAC) for legal operation of a vehicle
Vehicle
A vehicle is a device that is designed or used to transport people or cargo. Most often vehicles are manufactured, such as bicycles, cars, motorcycles, trains, ships, boats, and aircraft....
is typically measured as a percent of unit volume of blood. This ranges from a low of 0.00% in Romania and the United Arab Emirates, to 0.05% in Australia, South Africa and Germany, to 0.08% in the United Kingdom, the United States, and New Zealand.
Additionally, the U.S. Federal Aviation Administration
Federal Aviation Administration
The Federal Aviation Administration is the national aviation authority of the United States. An agency of the United States Department of Transportation, it has authority to regulate and oversee all aspects of civil aviation in the U.S...
prohibits crewmembers from performing their duties with a BAC greater than 0.04%, within 8 hours of consuming an alcoholic beverage or while under the influence of alcohol.
In the UK, US, and Australia, people can be arrested for public intoxication
Public intoxication
Public intoxication, also known as "drunk and disorderly", is a summary offense in many countries rated to public cases or displays of drunkenness...
, being "drunk and disorderly" or being "drunk and incapable". There are also often legal penalties for the sale of alcoholic beverages to intoxicated persons.
Religious views
Some religious groups permit the consumption of alcohol, some permit consumption but prohibit intoxication, and some prohibit alcohol consumption altogether. In the Qur'anQur'an
The Quran , also transliterated Qur'an, Koran, Alcoran, Qur’ān, Coran, Kuran, and al-Qur’ān, is the central religious text of Islam, which Muslims consider the verbatim word of God . It is regarded widely as the finest piece of literature in the Arabic language...
, there is a prohibition on the consumption of grape
Grape
A grape is a non-climacteric fruit, specifically a berry, that grows on the perennial and deciduous woody vines of the genus Vitis. Grapes can be eaten raw or they can be used for making jam, juice, jelly, vinegar, wine, grape seed extracts, raisins, molasses and grape seed oil. Grapes are also...
-based alcoholic beverages, and intoxication is considered as an abomination in the Hadith
Hadith
The term Hadīth is used to denote a saying or an act or tacit approval or criticism ascribed either validly or invalidly to the Islamic prophet Muhammad....
. Islam
Islam
Islam . The most common are and . : Arabic pronunciation varies regionally. The first vowel ranges from ~~. The second vowel ranges from ~~~...
ic schools of law (Madh'hab) have interpreted this as a strict prohibition of the consumption of all types of alcohol and declared it to be haraam
Haraam
Haraam is an Arabic term meaning "forbidden", or "sacred". In Islam it is used to refer to anything that is prohibited by the word of Allah in the Qur'an or the Hadith Qudsi. Haraam is the highest status of prohibition given to anything that would result in sin when a Muslim commits it...
("forbidden"), although other uses may be permitted.
Some Protestant
Protestantism
Protestantism is one of the three major groupings within Christianity. It is a movement that began in Germany in the early 16th century as a reaction against medieval Roman Catholic doctrines and practices, especially in regards to salvation, justification, and ecclesiology.The doctrines of the...
Christian
Christian
A Christian is a person who adheres to Christianity, an Abrahamic, monotheistic religion based on the life and teachings of Jesus of Nazareth as recorded in the Canonical gospels and the letters of the New Testament...
denominations prohibit the drinking of alcohol based upon Biblical passages which condemn drunkenness (for instance, Proverbs
Book of Proverbs
The Book of Proverbs , commonly referred to simply as Proverbs, is a book of the Hebrew Bible.The original Hebrew title of the book of Proverbs is "Míshlê Shlomoh" . When translated into Greek and Latin, the title took on different forms. In the Greek Septuagint the title became "paroimai paroimiae"...
23:21, Isaiah
Book of Isaiah
The Book of Isaiah is the first of the Latter Prophets in the Hebrew Bible, preceding the books of Ezekiel, Jeremiah and the Book of the Twelve...
28:1, Habakkuk
Book of Habakkuk
The Book of Habakkuk is the eighth book of the 12 minor prophets of the Hebrew Bible. It is attributed to the prophet Habakkuk, and was probably composed in the late 7th century BC. A copy of chapters 1 and 2 is included in the Habakkuk Commentary, found among the Dead Sea Scrolls.Chapters 1-2...
2:15.), but others allow moderate use of alcohol. In some Christian groups, wine is part of the rite of communion (see Christianity and alcohol). However, in The Church of Jesus Christ of Latter-day Saints, alcohol consumption is forbidden, to the point where teetotalism
Teetotalism
Teetotalism refers to either the practice of or the promotion of complete abstinence from alcoholic beverages. A person who practices teetotalism is called a teetotaler or is simply said to be teetotal...
has become a distinguishing feature of its members.
In Buddhism
Buddhism
Buddhism is a religion and philosophy encompassing a variety of traditions, beliefs and practices, largely based on teachings attributed to Siddhartha Gautama, commonly known as the Buddha . The Buddha lived and taught in the northeastern Indian subcontinent some time between the 6th and 4th...
, the consumption of intoxicants is generally discouraged for both monastics and lay followers. Many followers of Buddhism observe a code of conduct known as the Five Precepts, of which the fifth precept prohibits consumption of intoxicating substances (except for medical reasons). In the Bodhisattva Vows
Bodhisattva vows
The Sanskrit term Bodhisattva is the name given to anyone who, motivated by great compassion, has generated bodhichitta, which is a spontaneous wish to attain Buddhahood for the benefit of all sentient beings. What makes someone a Bodhisattva is her or his dedication to the ultimate welfare of...
of the Brahma Net Sutra, observed by some monastic communities and some lay followers, distribution of intoxicants is likewise discouraged as well as consumption.
In Vaishnavism
Vaishnavism
Vaishnavism is a tradition of Hinduism, distinguished from other schools by its worship of Vishnu, or his associated Avatars such as Rama and Krishna, as the original and supreme God....
, specifically Gaudiya Vaishnavism
Gaudiya Vaishnavism
Gaudiya Vaishnavism is a Vaishnava religious movement founded by Chaitanya Mahaprabhu in India in the 16th century. "Gaudiya" refers to the Gauḍa region with Vaishnavism meaning "the worship of Vishnu"...
, one of the four regulative principles forbids the taking of intoxicants, including alcohol.
See also
- Short-term effects of alcoholShort-term effects of alcoholShort-term effects of alcohol on the human body can take many forms. The drug alcohol, to be specific ethanol, is a central nervous system depressant with a range of side-effects. The amount and circumstances of consumption play a large part in determining the extent of intoxication; for example,...
- Long-term effects of alcoholLong-term effects of alcoholThe long term effects of alcohol range from possible health benefits for low levels of alcohol consumption to severe detrimental effects in cases of chronic alcohol abuse...
- Alcohol and sexAlcohol and sexAlcohol consumption has a number of effects on sexual intercourse and sexual behavior. The effects of alcohol are a balance between its suppressive effects on sexual physiology, which will decrease sexual activity, and its suppression of psychological inhibitions, which will increase the desire for...
- Alcohol flush reactionAlcohol flush reactionAlcohol flush reaction or Oriental Flushing Syndrome is a condition in which the face and/or body experiences flushes or blotches, due to an accumulation of acetaldehyde...
External links
- Alcohol Poisoning: NHS Choices