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: (312) 433-8000 ext. 2051

ALCOHOL TOXICOLOGY and PERFORMANCE LEVELS EFFECTS INDIVIDUAL VARIATION MEASURING BLOOD ALCOHOL CONCENTRATION (BAC) CALCULATIONS for ALCOHOL EVIDENCE for PROSECUTION

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

ALCOHOL TOXICOLOGY and PERFORMANCE Distribution Through body water Ratios based on blood levels (averages) Blood:Serum 1:1.18 Blood:Brain 1:0.75 Blood:Breath 2100:1 Blood:Blood Clot 1:0.77 Blood:Saliva 1:1.12

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

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

ALCOHOL TOXICOLOGY and PERFORMANCE

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, Hg+3 ) or cold

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 >0.05 but not more than 0.079 g/dL BAC = or > 0.08 g/dL BAC When working in jobs in the public sector: 0.00 g/dL BAC

ALCOHOL TOXICOLOGY and PERFORMANCE

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

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.

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.

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.

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

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

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)  

ALCOHOL TOXICOLOGY and PERFORMANCE

ALCOHOL TOXICOLOGY and PERFORMANCE Stages of Intoxication Sobriety < 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

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

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

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

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

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

ALCOHOL TOXICOLOGY and PERFORMANCE Death = and > 0.45 g/dL BAC Death from respiratory paralysis

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

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

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)

ALCOHOL TOXICOLOGY and PERFORMANCE Wt/Dk 1 2 3 4 5 6 7 100 .038 .075 .113 .150 .188 .225 .263 120 .031 .063 .094 .125 .156 .219 140 .027 .054 .080 .107 .134 .161 160 .023 .047 .070 .117 .141 .164 180 .021 .042 .083 .104 .146 200 .019 .056 .131 240 .017 .034 .051 .068 .085 .102 .119 260 .015 .062 .109

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

ALCOHOL TOXICOLOGY and PERFORMANCE

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

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 >0.05 but <0.08 g/dL

ALCOHOL TOXICOLOGY and PERFORMANCE Courtroom Testimony BAC Back Extrapolation Symptoms Possible Alcohol Consumption Conversion of SAC to BAC Drug Interactions

ALCOHOL TOXICOLOGY and PERFORMANCE Courtroom Testimony BAC Back Extrapolation Symptoms Possible Alcohol Consumption Conversion of SAC to BAC Drug Interactions Miscellaneous

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

ALCOHOL TOXICOLOGY and PERFORMANCE QUESTIONS?

ALCOHOL TOXICOLOGY and PERFORMANCE THANK YOU VERY MUCH