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Concept: Blood alcohol content

427

A rank based social norms model predicts that drinkers' judgements about their drinking will be based on the rank of their breath alcohol level amongst that of others in the immediate environment, rather than their actual breath alcohol level, with lower relative rank associated with greater feelings of safety. This study tested this hypothesis and examined how people judge their levels of drunkenness and the health consequences of their drinking whilst they are intoxicated in social drinking environments.

Concepts: Sociology, Alcohol abuse, Alcoholic beverage, Blood alcohol content, Drinking culture, Alcohol intoxication

49

Despite the long-standing belief in the analgesic properties of alcohol, experimental studies have produced mixed results. This meta-analysis aimed to clarify whether alcohol produces a decrease in experimentally-induced pain and to determine the magnitude of any such effect. PubMed, PsycINFO and Embase databases were searched from inception until 21/4/2016 for controlled studies examining the effect of quantified dosages of alcohol on pain response to noxious stimulation. Eighteen studies involving 404 participants were identified providing alcohol vs. no-alcohol comparisons for 13 tests of pain threshold (N=212) and 9 tests of pain intensity ratings (N=192). Random effects meta-analysis of standardized mean differences (SMD) provided robust support for analgesic effects of alcohol. A mean blood alcohol content (BAC) of approximately 0.08% (3-4 standard drinks) produced a small elevation of pain threshold (SMD=0.35[0.17, 0.54], p=.002), and a moderate-large reduction in pain intensity ratings, (SMD=0.64[0.37, 0.91], p<.0001), or equivalently, a mean reduction of 1.25 points on a 0-10 point pain rating scale. Furthermore, increasing BAC resulted in increasing analgesia, with each .02% BAC increment producing an increase of SMD=.11 for pain threshold and SMD=.20 for reduced pain intensity. Some evidence of publication bias emerged, but statistical correction methods suggested minimal impact on effect size. Taken together, findings suggest that alcohol is an effective analgesic that delivers clinically-relevant reductions in ratings of pain intensity, which could explain alcohol misuse in those with persistent pain despite its potential consequences for long-term health. Further research is needed to corroborate these findings for clinical pain states.

Concepts: Alcohol, Opioid, Effect size, Analgesic, Meta-analysis, Alcoholic beverage, Blood alcohol content, Hangover

44

Alcohol hangover is a growing research area, but differences across the life span have not been assessed. Here, we test the hypothesis that the severity of hangovers depends on age.

Concepts: Alcoholism, Differences, Alcohol abuse, Alcoholic beverage, Vodka, Blood alcohol content, Drinking culture, Hangover

29

This review focuses on 27 studies employing experimental alcohol self-administration (ASA) in humans which were published between 1989 and 2010. Twelve studies enrolling healthy, non-dependent social drinkers (HSD) were aimed at evaluating physiological and behavioral determinants of alcohol-induced reward or modeling situations of increased risk to develop alcohol use disorders. The remaining 15 studies tested the effect of medications such as naltrexone, nalmefene, nicotine, mecamylamine, varenicline, gabapentin, aripiprazole, and rimonabant on ASA. The participants were either HSD or non-treatment-seeking alcoholics (NTSA). In 25 of these studies, the subjects ingested alcohol orally and reached a mean peak blood alcohol concentration (BAC) during baseline conditions between 43 and 47 mg% (0.043-0.047%). Two recent studies employed computer-assisted self-infusion of ethanol (CASE), where subjects press a button to request multiple sequential alcohol exposures intravenously instead of drinking. This method has been demonstrated to be safe and provides increased experimental control of BAC and keeps subjects blind concerning the amount already self-administered. Peak exposures in the CASE studies ranged from 60 to 80 mg% in HSD and up to 240 mg% in NTSA.

Concepts: Alcohol, Ethanol, Alcoholism, Alcohol abuse, Alcohol dehydrogenase, Nicotinic acetylcholine receptor, Blood alcohol content, Hangover

28

The aim of this study was to evaluate the characteristics of traffic offenders with unusually high blood-alcohol concentrations (BAC>0.4g%) when arrested. The BAC that kills one person might be easily tolerated by another, depending on, among other things, the person’s age, pattern of drinking, and the development of tolerance. The archives of two forensic laboratories, one in Sweden and the other in Wisconsin (USA), were searched to find traffic offenders with BACs>0.4g%. The results were compared in relation to the person’s age and gender, mean BAC and the weekday and time of day of the arrest. The mean age (±standard deviation) of N=158 Swedish offenders was 45±9.0y, which was not significantly different from the 43±9.4y in N=233 Wisconsin drivers (p>0.05). Overall there were more men (78%) than women (22%) arrested with BAC’s>0.4g%, although the proportion of women in Wisconsin (35%) was higher than in Sweden (9%) (p<0.001). The mean (median) and highest BAC did not differ between jurisdictions; 0.429g% (0.422) and 0.546g% in Sweden and 0.428g% (0.421g%) and 0.526g% in Wisconsin. In Sweden 40% of the arrests occurred on Fridays and Saturdays, whereas in Wisconsin the arrests of people with such high BAC's were more evenly distributed throughout the week. Forty eight percent of the arrests in Sweden were made between 12 noon and 6pm compared with 37% in Wisconsin. Neither the mean age of offenders nor their mean BAC seemed to depend on the weekday or time of day of the arrest. Attempting to drive with a BAC above 0.4g% verifies the development of an appreciable tolerance to ethanol-induced cognitive and psychomotor impairment. Reaching such a high BAC probably requires continuous heavy drinking over several days as opposed to an evening's binge drinking.

Concepts: Alcoholism, Arithmetic mean, Alcohol abuse, Blood alcohol content, Drinking culture, Binge drinking, Arrest, Law enforcement agency powers

27

Abstract This analysis is an update of a Traffic Tech published by the National Highway Traffic Safety Administration (NHTSA) in March 1992. Drivers with prior driving-while-intoxicated (DWI) convictions are overrepresented in fatal crashes and the relative risk of fatal crash involvement is greater for these repeat DWI offenders. Although it is estimated that 2.1% of licensed drivers had a prior arrest for DWI within the past three years in 2010, 8.0% of intoxicated drivers (blood alcohol concentration [BAC] ≥ .08 g/dL) involved in fatal crashes had at least one prior DWI conviction in the past 3 years during that same year. Drivers with prior DWI convictions are overrepresented in fatal crashes by a factor of 1.62, or are 62% more likely to be in a fatal crash. Similarly, drivers with prior DWI convictions are also overrepresented as drinking drivers in fatal crashes: those with low BACs (.01-.07) by a factor of 2.38 and those with high BACs (.08+) by a factor of 3.81. While repeat DWI offenders are at a substantially higher risk of fatal crash involvement, the vast majority of intoxicated drivers in fatal crashes do not have a DWI conviction in the past three years (11 out of 12) according to the Fatality Analysis Reporting System (FARS) records for the year 2010.

Concepts: Alcohol, Ethanol, Crime, Criminal law, Alcohol law, Blood alcohol content, Road safety, National Highway Traffic Safety Administration

25

Violent behaviour associated with alcohol consumption is frequently reported by different media. Clinical data analysing the correlation between alcohol intoxication, age, gender and violence are scarce. The aim of this study was to evaluate the influence of age, gender and blood alcohol content on violent behaviour under the influence of alcohol under central European conditions. Three hundred patients admitted to the emergency department were included into this study in the time period from January 01. to December 31. 2009. The inclusion criteria were a blood alcohol content (BAC) of ≥10 mmol/l, any traumatic injury and an age ≥16 years. Violence was defined as an evitable act committed by others leading to patient’s hospitalisation. The data were compared with Wilcoxon and χ2-test for proportions. The data were considered as significant if p<0,05. Predictive quality was evaluated by using receiver operating characteristic (ROC) curve. Independent predictors were analyzed by logistic regression analysis. The average age was 36,9±16,9 years (range: 16-84 years), 259 (86%) males and 41 (24%) females. There was a significant difference in gender (odds ratio for gender male 2,88; CI 95%: 1,24-6,67; p<0,001) and age dependent (odds ratio for each year of age 0,94; CI 95%: 0,93-0,96; p<0,0001) violence with no correlation to blood alcohol content found. Logistic regression analysis revealed male gender and young age as an independent predictor for violence. These results clarify the relationship between alcohol, age, gender and violence and have important implications for municipal-level alcohol policies.

Concepts: Logistic regression, Alcohol, Male, Female, Ethanol, Gender, Sex, Blood alcohol content

20

The impact of HIV and its treatment on the effects of alcohol remain unclear. Blood alcohol concentrations have been noted to be higher in HIV infected individuals prior to antiretroviral initiation. Our goal was to compare number of drinks to “feel a buzz or high” among HIV infected and uninfected men, stratified by viral load (VL) suppression. Data includes 1478 HIV infected and 1170 uninfected men in the veterans aging cohort study who endorsed current drinking. Mean (SD) number of drinks to feel a buzz was 3.1 (1.7) overall. In multivariable analyses, HIV infected men reported a lower mean number of drinks to feel a buzz compared to uninfected men (coef = -14 for VL < 500; -34 for VL ≥ 500; p ≤ .05). Men with HIV, especially those with a detectable VL, reported fewer drinks to feel a buzz. Future research on the relationship between alcohol and HIV should consider the role of VL suppression.

Concepts: Antiretroviral drug, HIV, AIDS, HIV/AIDS, Viral load, Cohort study, Blood alcohol content, 1996 albums

19

In last few years it has been a significant increase in the consumption of alcohol combined with energy drink. The aim of this work was to study the effect of this mixture in motor and affective behaviors during an alcohol hangover episode. Male Swiss mice received one of the following treatments: saline + sucrose; saline + energy drink; ethanol + sucrose; ethanol + energy drink. Ethanol dose was 3.8 g/kg BW (i.p.) and energy drink dose was 18 ml/kg BW (gavage) at ZT1 (8 am) (ZT: Zeitgeber time; ZT0: 7 am; lights on). The behavioral tests used were tight rope test to determine motor coordination; hanging wire test to study muscular strength; elevated plus maze and open field tests to evaluate anxiety like-behavior and locomotor activity. Tests were carried out at basal point that matched with lights onset and every 6 hours up to 18 hours after treatments. Hangover onset was established at ZT7 when blood alcohol concentration (BAC) was almost zero. Our results showed that the mixture of alcohol and energy drink altered significantly motor skills. Specifically, a significant decrease was observed in the performance of the animals in the tightrope and hanging wire tests in groups treated with the mixture of alcohol and energy drink. A significant impairment in the anxiety-like behavior was observed mainly at the beginning of alcohol hangover. These findings suggest that energy drink added to alcohol extends motor disabilities observed during an alcohol hangover episode in comparison with animals that received alcohol alone.

Concepts: Psychology, Alcohol, Metabolism, Ethanol, Motor control, Alcoholic beverage, Blood alcohol content, Hangover

14

Previous research demonstrated that urinary ethanol concentrations were significantly lower in hangover resistant individuals compared to drinkers who reported having a hangover. This finding suggests that the rate of ethanol metabolism is faster in drinkers who do not experience an alcohol hangover. This study aimed to directly compare alcohol metabolism after administering a low dose of ethanol to hangover sensitive drinkers and hangover resistant drinkers.

Concepts: Alcohol, Carbon dioxide, Ethanol, Yeast, Alcoholic beverage, Vodka, Blood alcohol content, Hangover