Blood Alcohol Research Articles

The Relationship between Body Mass Index and Level of Response to Alcohol Across the Spectrum of Alcohol Use: Total Body Water and Beyond.

A low level of response (LR) to alcohol is a known risk factor for alcohol use disorder (AUD). Although higher total body water (TBW) is associated with lower blood alcohol concentrations and reduced responses following alcohol consumption, the relationship between morphometric measures such as body mass index (BMI) and LR is less clear. This study aimed to examine the relationship between BMI and LR to alcohol, and the contribution of TBW to this relationship. Participants (n=1,086) enrolled in the NIAAA Natural History Protocol were assessed for LR to alcohol using the Self-Rating of the Effects of Alcohol (SRE) Questionnaire. BMI was estimated using height and weight, and TBW was estimated from height, weight, age and sex. Participants were categorized based on BMI into 3 groups: normal weight (18.5-25.0 kg/m2; n=430), overweight (25.0-30.0 kg/m2; n=403), and obese (≥30.0 kg/m2; n=253). Associations between BMI group and SRE scores for the most recent three-month period (SRE-Recent), and the effect of TBW, were analyzed using ANOVA. Linear regression analysis was conducted to estimate the proportion of variation in SRE-Recent explained by BMI and TBW. BMI category was associated with LR, with the normal weight group showing higher responses (lower SRE-Recent scores) to alcohol than the overweight or obese groups. After controlling for TBW, the relationship became non-significant. Linear regression models confirmed these findings. Higher BMI is associated with lower LR to alcohol. However, TBW seems to account for this relationship, suggesting that concentrations achieved following alcohol consumption may be the primary determinant of BMI-related differences in LR. Future work should replicate these findings and examine these relationships throughout the lifespan and in individuals with AUD.

Effects of alcohol consumption on gambling warning message recall and recognition.

To understand the influence of acute alcohol consumption on the recall and recognition of warning messages. Participants (n = 82) were randomly assigned to a condition where they consumed alcoholic beverages (target blood alcohol concentrations of 0.06%-0.08%) or a condition where they consumed juice. Participants in both conditions then gambled on preprogrammed slot machines in a casino-themed room with four pop-up warning messages appearing twice each. After the gambling session, participants in both conditions completed a filler task followed by free recall and recognition assessments. Most participants (81%) recalled the gist, or the general idea, of the warning messages. However, participants in the alcohol condition underestimated the total number of messages they viewed to a significantly greater extent than those in the juice condition. Participants in the alcohol condition were also significantly less accurate in recognizing messages than participants in the juice condition. Participants in the juice condition were significantly more likely to recall the self-appraisal message than participants in the alcohol condition. There were no other significant differences in the recall of specific messages between conditions. Individuals who are moderately intoxicated are just as likely as nonintoxicated individuals to understand the general idea of warning messages but may have greater difficulty recalling specific details within those messages. Those who are intoxicated may have difficulties engaging in self-appraisal, indicating that messages that are focused on the financial consequences of gambling may be more impactful. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Post-COVID metabolic enzyme alterations in K18-hACE2 mice exacerbate alcohol-induced liver injury through transcriptional regulation.

Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), poses a significant threat to global public health. Despite reports of liver injury during viral disease, the occurrence and detailed mechanisms underlying the development of secondary exogenous liver injury, particularly in relation to changes in metabolic enzymes, remain to be fully elucidated. Therefore, this study was aimed to investigate the mechanisms underlying SARS-CoV-2-induced molecular alterations in hepatic metabolism and the consequent secondary liver injury resulting from alcohol exposure. We investigated the potential effects of SARS-CoV-2 infection on alcohol-induced liver injury in Keratin 18 promoter-human angiotensin converting enzyme 2 (K18-hACE2) transgenic mice. Mice were intranasally infected with 1×102 PFU of SARS-CoV-2. Following a 14 d recovery period from infection, the recovered mice were orally administered alcohol at 6 g/kg. Prior SARS-CoV-2 infection aggravated alcohol-induced liver injury based on increased alanine aminotransferase levels and cytoplasmic vacuolation. Interestingly, infected mice exhibited lower blood alcohol levels and higher levels of acetaldehyde, a toxic alcohol metabolite, compared to uninfected mice after the same period of alcohol consumption. Along with alterations of several metabolic process-related terms identified through RNA sequencing, notably, upregulation of cytochrome P450 2E1 (CYP2E1) and CYP1A2 was observed in infected mice compared to control value prior to alcohol exposure, with no significant impact of SARS-CoV-2 on intestinal damage. Tumor necrosis factor-alpha persistently showed upregulated expression in the infected mice; it also enhanced aryl hydrocarbon receptor and Sp1 expressions and their binding activity to Cyp1a2 and Cyp2e1 promoters, respectively, in hepatocytes, promoting the upregulation of their transcription. Our findings suggest that SARS-CoV-2 infection exacerbates alcohol-induced liver injury through the transcriptional activation of Cyp1a2 and Cyp2e1, providing valuable insights for the development of clinical recommendations on long COVID.

Alcohol and emotion: Analyzing convergence between facially expressed and self-reported indices of emotion under alcohol intoxication.

Emotion measurement is central to capturing acute alcohol reinforcement and so to informing models of alcohol use disorder etiology. Yet our understanding of how alcohol impacts emotion as assessed across diverse response modalities remains incomplete. The present study leverages a social alcohol-administration paradigm to assess drinking-related emotions, aiming to elucidate impacts of intoxication on self-reported versus behaviorally expressed emotion. Participants (N = 60; Mage = 22.5; 50% male; 55% White) attended two counterbalanced laboratory sessions, on one of which they were administered an alcoholic beverage (target blood alcohol content .08%) and on the other a nonalcoholic control beverage. Participants in both conditions were accurately informed of beverage contents and consumed study beverages in assigned groups of three while their behavior was videotaped. Emotion was assessed via self-report as well as continuous coding of facial muscle movements. The relationship between self-reported and behaviorally expressed emotion diverged significantly across beverage conditions: positive affect: b = -0.174, t = -2.36, p = .022; negative affect, b = 0.4319, t = 2.37, p = .021. Specifically, self-reports and behavioral displays converged among sober but not intoxicated participants. Further, alcohol's effects on positive facial displays remained significant in models controlling for self-reported positive and negative emotion, with alcohol enhancing Duchenne smiles 20% beyond effects captured via self-reports, pointing to unique effects of alcohol on behavioral indicators of positive emotion. Findings highlight effects of acute intoxication on the convergence and divergence of emotion measures, thus informing our understanding of measures for capturing emotions that are most proximal to drinking and thus most immediately reinforcing of alcohol consumption. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Measuring Alcohol-Induced Striatal Dopamine Release in Healthy Humans With [11C]-Raclopride: A Meta-Analysis.

Alcohol consumption is known to affect dopamine (DA) release in the brain, with significant implications for understanding addiction and its neurobiological underpinnings. This meta-analysis examined the effects of acute alcohol administration on striatal DA release in healthy humans as measured with [11C]-raclopride positron emission tomography (PET). Oral alcohol administration was associated with a significant reduction in [11C]-raclopride binding potential (BPND) in the ventral striatum (Cohen's d = -0.76), indicative of increased DA release, particularly at lower blood alcohol concentration (BAC) levels (0.08 gm%; Z = 2.34, p = 0.02). That oral alcohol may increase DA release in the ventral striatum at lower doses, and decrease DA release at higher doses, warrants further investigation but appears consistent with other known biphasic, hermetic dose-response effects of alcohol. Additionally, larger effect-sizes in the ventral striatum were observed among those studies which sampled more males than females (Z = -2.08, p = 0.04). While oral alcohol administration was associated with reduced [11C]-raclopride BPND in the caudate (Cohen's d = -0.39) and putamen (Cohen's d = -0.37), these findings in the dorsal striatum were more variable and less robust. Our analyses suggests that study design (i.e., counterbalanced versus fixed order) may moderate effect sizes observed in the putamen across studies (Z = -2.27, p = 0.02). By identifying gaps in the current literature and proposing directions for future research, this study hopes to inform the design of future PET studies aimed at quantifying alcohol-induced dopamine release in the striatum of humans.

Sea cucumber saponins reduce blood alcohol and acetaldehyde concentration by inhibiting alcohol absorption and regulating alcohol metabolism enzyme activity

Sea cucumber saponins reduce blood alcohol and acetaldehyde concentration by inhibiting alcohol absorption and regulating alcohol metabolism enzyme activity

Effects of diesel exhaust inhalation on cognitive performance in human volunteers: A randomized controlled crossover study.

Mounting evidence links exposure to traffic-related air pollution (TRAP) to impairment in cognitive functioning. To determine if short-term, controlled exposure to diesel exhaust (DE) adversely affects one or more cognitive function domains. We carried out a double-blinded crossover design with 28 healthy, adult volunteers. Volunteers were exposed to two conditions for 120min each, on separate order-randomized occasions: filtered air (FA) and DE (300µg/m3 PM2.5) at the Air Pollution Exposure Laboratory (APEL) at Vancouver General Hospital (VGH). Volunteers were blinded to the two exposure conditions. Volunteers completed five computerised neuropsychological tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) prior to (2-hr before) and at three timepoints following each exposure condition (0-hr, 3-h post-, and 24-h post-exposure). The selected CANTAB tests were related to five cognitive domains - attention, spatial working memory, strategy use, executive function, and processing speed. We hypothesized that short-term diesel exposure would adversely affect one or more cognitive function domains. Following screening, 15 volunteers were randomized to receive FA followed by DE and 14 volunteers were randomized to receive the exposures in the reverse sequence. A total of 28 volunteers contributed to the final analysis. Short-term exposure to DE was associated with slower reaction times in the Reaction Time Index task. DE was associated with a decrease of 18.2ms (p=0.05) in simple reaction time and 23.5ms (p=0.04) in five-choice reaction time. This first study to investigate the effects of TRAP on the cognitive performance of humans in a controlled environment shows slowed reaction times similar to those previously demonstrated with blood alcohol levels of 0.05%. Important implications exist for workers in occupations where attention and reaction time are connected to safety and performance.

Total Antioxidant and Oxidative Status as Potential Biomarkers of Alcohol Overdose.

Serious alcohol-associated hazards underscore the need to develop new biomarkers reflecting the biological changes caused by chronic alcohol use and predicting the risk of alcohol-related death. Oxidative stress is one mechanism of alcohol toxicity. The blood and urine redox status (total antioxidant capacity [TAC], total oxidative status [TOS], and oxidative stress index [OSI]) was assessed in 105 people who died a sudden death (controls), 47 people who died of alcohol overdose, and 102 people with alcohol dependency. TAC and TOS were determined utilizing the colorimetric method. Non-parametric tests were used for statistical analysis. Blood and urine TAC levels were significantly elevated in individuals both with alcohol dependency and alcohol poisoning compared with controls. TOS levels were elevated in the blood of both study groups compared with the control group, and significantly higher in patients with alcohol dependency compared with the group with alcohol poisoning. TAC in the blood highly correlated with blood alcohol content. Receiver operating characteristic (ROC) analysis showed that the blood TAC effectively discriminated between individuals with alcohol poisoning and alcohol dependency with high sensitivity and specificity. Our study confirmed impaired redox homeostasis in people with alcoholism and indicated the utility of TAC, TOS, and OSI as biomarkers of alcohol exposure.

An examination of autopsies in a 400 bedded government hospital in Jhelum. An insight into the sudden cause of death and costs associated with autopsy in young government personnel

Objective: To explore the different causes of sudden death among serving government employees. Method: The audit study was conducted at the Pathology Department of a tertiary care hospital Combined Military Hospital (CMH) Jhelum, Pakistan, and comprised data of all autopsies between January 2017 and June 2021. Sampling technique was non probability purposive sampling technique which requires no statistical method calculation. Data was recorded related to weight of specimens, lists of tissue specimens for histopathological, chemical, and forensic examination, and the tests performed on samples of blood, urine, and other body fluids. Ethical review approval was taken from ethical review committee of the hospital dated October 2017. Data was analysed using Microsoft excel. Results: All the 34 autopsies of male subjects were performed to explore the cause of sudden death. Coronary atherosclerosis was the most common cause of death 14(41.2%), followed by drowning 4(11.7%). Drug abuse, blood alcohol, narcotics, carbon monoxide and toxic elements were found in 5(14.7%) cases. Conclusion: Myocardial infarction was found to be the most common cause of death among serving government employees. Key Words: Autopsy, Coronary atherosclerosis.

Direct Estimation of Alcohol-Attributable Fractions for Suicide in the United States, 2021.

Objectives. To estimate the alcohol-attributable fraction (AAF) for suicide in the United States. Methods. Using restricted-access data from the National Violent Death Reporting System for 2021, we estimated the sex-specific AAF for suicide, among those 15 years of age and older, by sociodemographic characteristics and suicide means. An alcohol-attributable suicide was defined as that for which the decedent had a blood alcohol concentration of 0.10 grams per deciliter or higher. Results. In 2021, the AAF for suicide for males (20.2%) was significantly higher than that for females (17.8%; P < .001). The AAF for suicide was higher for both males and females who used a firearm as the means of suicide (23.4% and 22.8%, respectively) compared with their counterparts who used other means (16.5% and 15.9%, respectively). Conclusions. Despite some variation, AAFs for suicide were consistently high, with about 1 in 5 suicides being attributable to alcohol use. Therefore, suicide prevention initiatives in the United States should also target excessive alcohol use. (Am J Public Health. Published online ahead of print December 19, 2024:e1-e5. https://doi.org/10.2105/AJPH.2024.307910).

Efficacy of Hovenia dulcis Fruit Extract in Hangover Mitigation: Double-Blind Randomized Clinical Evaluation.

The fruit of Hovenia dulcis Thunb. (HD) is renowned for its medicinal properties and is rich in bioactive compounds, traditionally used in East Asian medicine as a natural antidote for alcohol intoxication. A randomized, double-blind, crossover, placebo (PLA)-controlled clinical trial was conducted to compare the effects of beverages containing 0.475% HD (HDB), HD combined with 0.1% Pueraria lobata extract (HDPB), and HD combined with 0.02% glutathione yeast extract (HDGB) with the PLA on the symptoms of a hangover. Subjects (n = 30) were randomized into six test groups consuming three beverages, including the PLA. After ingestion, blood alcohol and blood acetaldehyde concentrations were measured at 0, 0.25, 0.5, 1, 2, 4, 6, and 15 h post-alcohol consumption. No significant differences in hematology tests and vital signs were observed amongst the treatment groups; however, at 0.5 and 6 h, the blood alcohol concentrations of the HDB and HDPB groups were significantly lower compared to the PLA group (p < 0.05). Additionally, the blood acetaldehyde concentrations in the HDPB group showed significantly lower values than the PLA after 6 h (p < 0.05). These findings suggest that HD may aid in alcohol detoxification and limit acetaldehyde accumulation. This indicates the potential for HD as a functional food ingredient for alleviating hangover symptoms.

Understanding the effects of alcohol policies on treatment admissions and birth outcomes among young pregnant people.

This study examines whether state-level alcohol policy types in the United States relate to substance use disorder treatment admissions and birth outcomes among young pregnant and birthing people. We used data from the Treatment Episode Data Set: Admissions (TEDS-A) and Vital Statistics birth data for 1992-2019. We examined 16 state-level policies, grouped into three types: youth-specific, general population, and pregnancy-specific alcohol policies. Using Poisson and logistic regression, we assessed policy effects for those under 21 (aged 15-20) and considered whether effects differed for those just over 21 (aged 21-24). Youth-specific policies were not associated with treatment admissions or preterm birth. There were statistically significant associations between family exceptions to minimum legal drinking age (MLDA) policies and low birthweight, but findings were in opposite directions across possession-focused and consumption-focused (MLDA) policies and did not differentially apply to people 15-20 versus 21-24. Most pregnancy-specific policies were not associated with treatment admissions, and none were significantly associated with birth outcomes. A few general population policies were associated with improved birth outcomes and/or increased treatment admissions. Specifically, both government spirits monopolies and prohibitions of spirits and heavy beer sales in gas stations were associated with decreased low birthweight among people 15-20 and among people 21-24. Effects of Blood Alcohol Concentration (BAC) limits varied by age, with slight reductions in adverse birth outcomes among people 15-20, as BAC limits get stronger, but slight increases for those 21-24. Although treatment admissions rates across ages were similar when BAC limits were in place, treatment admissions were greater for pregnant people 21-24 than for 15-20 when there were no BAC limits. General population policies also appear effective for reducing the adverse effects of drinking during pregnancy for young people, including those under 21. Policies that target people based on age or pregnancy status appear less effective.

Effects of short-term exposure to moderate amounts of alcohol on brain volume.

Although numerous studies have reported that chronic alcohol consumption causes brain volume reduction and cerebrospinal fluid volume increase, few studies have examined the acute effects of alcohol on brain structure. This study aims to investigate the short-term brain volume changes following alcohol administration. Moderate doses of alcohol were administered intravenously to 18 healthy volunteers for a total of 90 min to achieve a blood alcohol concentration of 0.5 mg/mL. An alcohol clamp method combined with physiologically based pharmacokinetic modeling was used to achieve fine control over blood alcohol concentration. T1 images with 3T MRI were scanned at three time points: baseline, 0 min, and 90 min after the end of alcohol administration. Cortical, subcortical, and ventricular volumes were computed after segmentation with FreeSurfer. Repeated measures analysis of variance was used to evaluate longitudinal changes in brain volume at 96 regions. Acute alcohol administration increased bilateral lateral ventricular volumes, which lasted until 90 min after the end of alcohol injection. On the other hand, the volumes of total gray matter, left precentral cortex, left caudal middle frontal cortex, and left superior frontal cortex decreased after alcohol administration, but these changes disappeared 90 min after the end of alcohol administration. Acute injection of moderate doses of alcohol may enlarge ventricle volumes and reduce gray matter volumes. The transient volume changes caused by acute administration of alcohol may be related to changes in CSF flow and water content of brain tissue, which warrants further study.

Clinical Evaluation of Hovenia dulcis Extract Combinations for Effective Hangover Relief in Humans.

Alcohol consumption is associated with both short- and long-term adverse effects, including hangover symptoms. The objective of this study was to examine the potential benefits of traditional beverages containing a combination of Hovenia dulcis extract (HD) with either Pueraria lobata extract (HDPB) or glutathione yeast extract (HDGB) in abbreviating alcohol intoxication and mitigating hangover symptoms. A total of 25 participants between the ages of 19 and 40 who had previously experienced a hangover were evaluated in a randomized, double-blind, crossover, placebo (PLA)-controlled clinical trial. Results showed that lower blood alcohol concentrations in the HDPB and HDGB groups were significantly lower than in the PLA group at 0.25 and 0.5 h, suggesting that HD aids in early alcohol metabolism (0 h, p < 0.05). Analysis of the hourly Acute Hangover Scale (AHS) showed that all treatment groups had significantly reduced gastrointestinal disorder symptoms compared to the PLA group (p < 0.05). It can be confirmed that hangover symptoms can be significantly improved by consuming HD combination drinks, apart from the effect of reducing blood alcohol and acetaldehyde concentrations. Therefore, it is predicted that the consumption of natural phytochemicals added to HD is safe for humans and may help accelerate recovery from hangover symptoms.

Christmas article: A little booze to warm you up - true or false? A thermographic Christmas study

In December, it is common to enjoy mulled wine, often believed to warm the body. While alcohol can cause peripheral vasodilation, it remains unclear whether it truly increases body warmth or is merely a subjective sensation. This study aimed to evaluate the warming effect of mulled wine using thermography. This randomised, crossover study enrolled 15 participants. Participants consumed mulled wine with 12g alcohol or without alcohol on separate days. Facial temperatures were measured using thermography at baseline and every 10 minutes for 60 minutes after consumption. Participants wore Santa hats to standardise heat loss and maintained room temperature at 22°C. A questionnaire assessed subjective warmth and festive spirit. Blood alcohol concentration was evaluated throughout the study. Facial thermography showed a significant temperature increase in participants who consumed mulled wine with alcohol of mean (± SD) 33.6°C (± 1.3) vs 32.9 (± 1.0) °C on days with no alcohol, p = 0.039. Subjective warmth ratings were also higher on alcohol days, p = 0.002. However, participants reported an equally increased festive mood, regardless of alcohol content. Mulled wine with alcohol increases facial temperature and subjective feelings of warmth. However, non-alcoholic versions also elevate the festive spirit, suggesting they offer a seasonal atmosphere without the effects of alcohol. None. Not relevant.

Alcohol-related trauma and injuries: A review of presentation, evaluation, and management in the emergency department

The effects of alcohol are especially problematic in terms of trauma and injury that is encountered in the emergency departments (EDs) of hospitals globally. Such injuries occur due to different causes such as falls, assaults or motor vehicle accidents and management is often associated with alcohol and potential for other drug use. This review provides an up-to-date perspective on the diagnostic assessment and initial management of alcohol-related trauma in the ED. Alcohol-related injury is common, and a large proportion of trauma patients have blood alcohol concentrations (BACs). These patients are often young adults and males and the injuries can be in the head and neck regions mostly. Performing screening and identification of alcohol use among patients in the ED is essential to ensure appropriate feedback is given immediately. However, there are diagnostic difficulties due to the imitation or masking of injuries by alcohol influence. This means that the immediate agenda has a priority in establishing and responding to emergent situations and acute conditions and far-reaching plans include provisions of brief interventions and linkages to care. There are significant economic consequences of injuries due to alcohol, which can lead to escalation of health care costs. Potential issues for public health focus on the objectives towards campaigns and policies that are relevant to the risks that come along with the use of alcohol. This review also emphasizes the need for multifaceted continuation care approaches to minimize the reunion of alcohol-related injuries and their socioeconomic impacts.

Special Report from the CDC: Driving under the influence of alcohol, marijuana, or other illicit drugs among drivers aged ≥16 years — National Survey on Drug Use and Health, 2016–2019

Introduction: This study describes the prevalence of driving under the influence of alcohol (DUIA), marijuana (DUIM), or other illicit drugs (DUID) in the United States over time. Method: This study analyzed data from 2016–2019 National Survey on Drug Use and Health public-use files. The study sample was limited to drivers aged ≥16 years. Prevalence in 2019 and 2016–2019 trends were assessed overall, by sociodemographic characteristics, and by seatbelt use. Results: The 2019 overall prevalence of DUIA, DUIM, and DUID during the past year was 8.3%, 5.3%, and 0.9%, respectively. DUIA, DUIM, and DUID prevalence was highest for drivers who were male (10.6%, 7.0%, and 1.2%, respectively), not heterosexual (12.3%, 14.7%, and 3.5%, respectively), and did not always wear a seatbelt (12.1%, 11.5%, and 3.1%, respectively). DUIA and DUIM were highest among drivers aged 21–25 years; DUID was highest among drivers aged 21–25 or 26–34 years. From 2016 to 2019, overall DUIA decreased slightly, DUIM increased (4.5% to 5.3%), and DUID did not change; trends differed across sociodemographic groups. Conclusions: DUI is a pervasive public health issue. There are ≥10,000 DUIA crash deaths in the United States annually; proven interventions exist to prevent these deaths. Decision makers can save lives and make our roadways safer by implementing proven strategies to reduce DUIA, including lowering the legal blood alcohol concentration (BAC) for driving. Improved data and more research are needed to understand DUIM and DUID burden and determine effective prevention strategies, especially in the context of increasing DUIM. Practical Applications: There were groups for which changes in behavior patterns were found, which could guide prevention efforts. For drivers who did not always wear a seatbelt, DUIA decreased while DUIM increased. A similar pattern was noted for drivers aged 26–34 years; additionally, DUID increased in this group.

40. Utilization of lipidomics to evaluate the lipid profile of trauma patients with detectable blood alcohol levels on admission

40. Utilization of lipidomics to evaluate the lipid profile of trauma patients with detectable blood alcohol levels on admission

Post-mortem distribution of MDPHP in a fatal intoxication case.

The synthetic cathinone (SC) 3,4-methylenedioxy-α-pyrrolidinohexanophenone (MDPHP), is structurally correlated to the 3,4-methylenedioxypyrovalerone (MDPV). In recent years, the number of intoxication cases has increased even if little is known about the pharmacokinetics properties. The post-mortem (PM) distribution of MDPHP remains largely unexplored. In these reports, MDPHP levels were quantified in blood, gastric content and urine. This study aimed to describe the MDPHP PM distribution in several specimens, i.e. central and peripheral blood (CB and PB), right and left vitreous humor (rVH and lVH), gastric content (GCo), urine (U) and hair. The samples were collected from a cocaine-addicted 30-year-old man with a PM interval estimated in 3-4 h. Autopsy examination revealed unspecific findings, i.e. cerebral and pulmonary edema. No injection marks were observed. Toxicological analyses were performed using a multi-analytical approach: headspace gas chromatography for blood alcohol content (BAC); gas chromatography-mass spectrometry (GC-MS) for the main drugs of abuse; liquid chromatography-tandem mass spectrometry (LC-MS/MS) for benzodiazepines and new psychoactive substances (NPS). BAC was negative (0.02 g/L). MDPHP concentrations were: 1,639.99 ng/mL, CB; 1,601.90 ng/mL, PB; 12,954.13 ng/mL, U; 3,028.54 ng/mL, GCo; 1,846.45 ng/mL, rVH; 2,568.01 ng/mL, lVH; 152.38 (0.0-1.5 cm) and 451.33 (1.5-3.0 cm) ng/mg, hair. Moreover, hair segments were also positive for 3,4-dimethylmethcathinone (DMMC < limit of quantification: 0.01 ng/mg), α-PHP (0.59 ng/mg, 0.0-1.5 cm; 3.07 ng/mg, 1.5-3.0 cm), cocaine (6.58 ng/mg, 0.0-1.5 cm; 22.82 ng/mg, 1.5-3.0 cm), and benzoylecgonine (1.13 ng/mg, 0.0-1.5 cm; 4.30 ng/mg, 1.5-3.0 cm). MDPHP concentrations were significantly higher than those reported in the literature for fatal cases. For these reasons, the cause of death was probably the consumption of a lethal amount of MDPHP. Because CB and PB were similar, PM redistribution was not relevant.

The use of prescription medication and other drugs by New Zealand drivers with illegal blood alcohol levels

Objective This study examined the prevalence of the use of prescription medicines and other drugs by a selected subgroup of New Zealand drivers. The use of potentially impairing prescription drugs by the driving population is largely unknown. The population studied was drivers who were stopped by police, failed a breath alcohol test, elected to provide a blood sample for laboratory analysis, and had blood alcohol levels exceeding the legal limit. Method Blood samples taken from 3,050 drivers during the period 2011 to 2015 were analyzed for the presence of alcohol (ethanol) and a range of both prescription and illicit drugs using liquid chromatography with time-of-flight mass spectrometric detection (LC-TOFMS) and an immunoassay screen for cannabis use. Results One thousand two hundred thirty-five of these drivers had used alcohol in combination with potentially impairing drugs (41%) and alcohol only was detected in 1,815 of the samples (59%). Five hundred of the drivers had used prescription medication (16%), 816 had used cannabis (27%), and 81drivers had used other illicit recreational drugs (2.7%), all in combination with alcohol. The top 7 prescription medicines used in combination with alcohol were citalopram, fluoxetine, and venlafaxine (antidepressants); quetiapine (antipsychotic); diazepam (sedative); and tramadol (opioid). Conclusions Drug use did not correlate with the amount of alcohol consumed, and the use of multiple drugs in combination with alcohol was prevalent. Although this is a biased population sample, the results indicate the possible use of impairing prescription medication in the wider driving population and the need for more awareness of the potential impairment by all types of prescription medication.