Breath Alcohol Concentration Research Articles

Pre-Drinking and the Temporal Gradient of Intoxication in a New Zealand Nightlife Environment

We measured changes in the average level of intoxication over time in the nighttime economy and identified the factors associated with intoxication, including pre-drinking. A random intercept sample of 320 pedestrians (105 women; 215 men) was interviewed and received breath alcohol analysis in the nighttime economy of Hamilton, New Zealand. Data were collected over a five-night period, between 7 P.M. and 2:30 A.M. Data were analyzed by plotting the moving average breath alcohol concentration (BrAC) over time and using linear regression models to identify the factors associated with BrAC. Mean BrAC was 241.5 mcg/L for the full sample; 179.7 for women and 271.7 for men, which is a statistically significant difference. Mean BrAC was also significantly higher among those who engaged in pre-drinking than those who did not. In the regression models, time of night and pre-drinking were significantly associated with higher BrAC. The effect of pre-drinking on BrAC was larger for women than for men. The average level of intoxication increases throughout the night. However, this masks a potentially important gender difference, in that women's intoxication levels stop increasing after midnight, whereas men's increase continuously through the night. Similarly, intoxication of pre-drinkers stops increasing from 11 P.M., although remaining higher than non-pre-drinkers throughout the night. Analysis of BrAC provides a more nuanced understanding of intoxication levels in the nighttime economy.

A Rare Case of Drunk Driving in Japan: Alcohol-related Sleepwalking

Alcohol has been identified as a potential precipitating factor for parasomnia, particularly sleepwalking (SW), which categorized in a classic form of non-rapid eye movement sleep arousal disorder. The police consulted us regarding the association between alcohol consumed, blood alcohol concentration, and the behavior of a drunken driving suspect with complete memory loss. We report a rare case of a Japanese drunk driver who possibly experienced alcohol-related SW, based on the statements of the suspect, pharmacokinetic analyses of breath alcohol concentration, testimonies of the witnesses, driving recorder data, and medical records. We concluded that the suspect should be considered non-compos mentis when the drunken driving offense was committed because he might not have been able to control his behavior while in a SW state. However, if he again commits crimes during SW under the influence of alcohol, the crimes should not be excusable because he is now aware of his alcohol-related complicated characteristics.

“All the King’s horses and all the King’s men…”: What is broken should not always be put back together again

Miller, Chikritzha, Droste, Pennay & Tomsen (2017) raise multiple methodological questions regarding our recently published study into the night-time entertainment districts (NEDs) of Queensland, Australia (Devilly, Allen & Brown, 2017). They also raise wider ethical concerns regarding working with police and allowing research participants to enter their own data into questionnaires. As reported in an earlier issue of this journal (Devilly et al., 2017), we conducted a point of entry study into NEDs which found: a high prevalence of preloading (79%); little meaningful difference between the genders in this prevalence and breath alcohol concentration (BAC); a much higher preponderance of people reporting to pre-drink for reasons of socialisation (rather than just price) compared to earlier research; and a large number of people to have no meaningful understanding of the BAC system. Here I respond to concerns raised by Miller and colleagues. First, I provide a context and common ground for this debate in the specific domain of Queensland. Next, I look at the sample we acquired in comparison to Miller (2013), explain motivations for preloading, and why our results are different, as well as more reliable than those reported by Miller. I further point out why the lack of clarity around rejection rates is important and demonstrate that having police involved in such research is a good idea. I also address issues of misplaced concern in relation to the engagement of the energy drink industry and media, and the multiple charges of ethics violations implied in the commentary by Miller and colleagues. Taken together, I provide a corridor for future research, informed by the use of our scientifically reproducible methodology.

The Effect of Alcohol-Based Hand Sanitizer Vapors on Evidential Breath Alcohol Test Results.

This study was undertaken to determine if the application of alcohol-based hand sanitizers (ABHSs) to the hands of a breath test operator will affect the results obtained on evidential breath alcohol instruments (EBTs). This study obtained breath samples on three different EBTs immediately after application of either gel or foam ABHS to the operator's hands. A small, but significant, number of initial analyses (13 of 130, 10%) resulted in positive breath alcohol concentrations, while 41 samples (31.5%) resulted in a status code. These status codes were caused by ethanol vapors either in the room air or their inhalation by the subject, thereby causing a mouth alcohol effect. Replicate subject samples did not yield any consecutive positive numeric results. As ABHS application can cause a transitory mouth alcohol effect via inhalation of ABHS vapors, EBT operators should forego the use of ABHS in the 15min preceding subject testing.

Exogenous ghrelin administration increases alcohol self-administration and modulates brain functional activity in heavy-drinking alcohol-dependent individuals.

Preclinical evidence suggests that ghrelin, a peptide synthesized by endocrine cells of the stomach and a key component of the gut-brain axis, is involved in alcohol seeking as it modulates both central reward and stress pathways. However, whether and how ghrelin administration may impact alcohol intake in humans is not clear. For, we believe, the first time, this was investigated in the present randomized, crossover, double-blind, placebo-controlled, human laboratory study. Participants were non-treatment-seeking alcohol-dependent heavy-drinking individuals. A 10-min loading dose of intravenous ghrelin/placebo (3 mcg kg-1) followed by a continuous ghrelin/placebo infusion (16.9 ng/kg/min) was administered. During a progressive-ratio alcohol self-administration experiment, participants could press a button to receive intravenous alcohol using the Computerized Alcohol Infusion System. In another experiment, brain functional magnetic resonance imaging was conducted while participants performed a task to gain points for alcohol, food or no reward. Results showed that intravenous ghrelin, compared to placebo, significantly increased the number of alcohol infusions self-administered (percent change: 24.97±10.65, P=0.04, Cohen's d=0.74). Participants were also significantly faster to initiate alcohol self-administration when they received ghrelin, compared to placebo (P=0.03). The relationships between breath alcohol concentration and subjective effects of alcohol were also moderated by ghrelin administration. Neuroimaging data showed that ghrelin increased the alcohol-related signal in the amygdala (P=0.01) and modulated the food-related signal in the medial orbitofrontal cortex (P=0.01) and nucleus accumbens (P=0.08). These data indicate that ghrelin signaling affects alcohol seeking in humans and should be further investigated as a promising target for developing novel medications for alcohol use disorder.

Cardiovascular and Cutaneous Responses to the Combination of Alcohol and Soft Drinks: The Way to Orthostatic Intolerance?

Aim: Acute ingestion of alcohol is often accompanied by cardiovascular dysregulation, malaise and even syncope. The full hemodynamic and cutaneous responses to the combination of alcohol and sugar (i.e., alcopops), a common combination in young people, and the mechanisms for the propensity to orthostatic intolerance are not well established. Thus, the purpose of this study was to evaluate the cardiovascular and cutaneous responses to alcopops in young subjects.Methods: Cardiovascular and cutaneous responses were assessed in 24 healthy young subjects (12 men, 12 women) sitting comfortably and during prolonged active standing with a 30-min baseline and 130 min following ingestion of 400 mL of either: water, water + 48 g sugar, water + vodka (1.28 mL.kg−1 of body weight, providing 0.4 g alcohol.kg−1), water + sugar + vodka, according to a randomized cross-over design.Results: Compared to alcohol alone, vodka + sugar induced a lower breath alcohol concentration (BrAC), blood pressure and total peripheral resistance (p < 0.05), a higher cardiac output and heart rate (p < 0.05) both in sitting position and during active standing. In sitting position vodka + sugar consumption also led to a greater increase in skin blood flow and hand temperature (p < 0.05) and a decrease in baroreflex sensitivity (p < 0.05). We observed similar results between men and women both in sitting position and during active standing.Conclusion: Despite lower BrAC, ingestion of alcopops induced acute vasodilation and hypotension in sitting position and an encroach of the hemodynamic reserve during active standing. Even if subjects did not feel any signs of syncope these results could be of clinical importance with higher doses of alcohol or if combined to other hypotensive challenges.

Alcohol increases inattentional blindness when cognitive resources are not consumed by ongoing task demands

RationaleInattentional blindness (IB) is the inability to detect a salient yet unexpected task irrelevant stimulus in one’s visual field when attention is engaged in an ongoing primary task. The present study is the first to examine the impact of both task difficulty and alcohol consumption on IB and primary task performance.ObjectivesOn the basis of alcohol myopia theory, the combined effects of increased task difficulty and alcohol intoxication were predicted to impair task performance and restrict the focus of attention on to task-relevant stimuli. We therefore expected increases in breath alcohol concentration to be associated with poorer primary task performance and higher rates of IB, with these relationships being stronger under hard than easy task conditions.MethodsThis hypothesis was tested in a field study where alcohol drinkers in a local bar were randomly assigned to perform a dynamic IB task with an easy or hard visual tracking and counting task at its core (Simons and Chabris in Perception 28:1059–1074, 1999).ResultsIncreasing the difficulty of the primary task reduced task accuracy but, surprisingly, had no impact on the rate of IB. Higher levels of alcohol intoxication were, however, associated with poorer task performance and an increased rate of IB, but only under easy primary task conditions.ConclusionsResults are consistent with alcohol myopia theory. Alcohol intoxication depletes attentional resources, thus reducing the drinker’s awareness of salient stimuli that are irrelevant to some ongoing primary task. We conclude that this effect was not observed for our hard task because it is more resource intensive, so leaves no spare attentional capacity for alcohol to deplete.

507P - Breath alcohol concentrations in patients undergoing taxane chemotherapy: An observational pilot study (BrACT study)

507P - Breath alcohol concentrations in patients undergoing taxane chemotherapy: An observational pilot study (BrACT study)

Sonochemically Synthesized Zinc Oxide Nanoflakes Based Electrochemical Immunosensor for Ethyl Glucuronide (EtG) Detection

Continuous monitoring of alcohol detection is imperative for the prevention of accidents, point of care monitoring, and personal safety. The cutting-edge technologies are mostly focused to detect alcohol from the breath (e.g. breathalyzer), which is not compatible for the real-time monitoring. The relationship between the blood and breath alcohol concentrations and the improvement of the detection techniques of alcohol biomarkers from the sweat render an opportunity for point of care monitoring. Due to its prolonged existence in sweat, Ethylglucuronide (EtG) is considered as one of the most promising biomarkers for alcohol detection. We report on label-free highly sensitive electrochemical immunosensor for the detection and the quantification of EtG based on sonochemically synthesized two-dimensional (2D) zinc oxide (ZnO) nanoflakes (NFs) on flexible Au-coated polyethylene terephthalate (PET) substrate. Highly sensitive detection of EtG using cyclic voltammetry (CV) is achieved by immobilizing EtG antibody on the as-synthesized sensing electrodes of ZnO NFs.

Alcohol Intoxication and Metamemory: Little Evidence that Moderate Intoxication Impairs Metacognitive Monitoring Processes

SummaryThere is minimal research on metacognition in alcohol‐intoxicated participants. Study 1 examined metacognition across sober, intoxicated, and placebo groups, with the intoxicated group's breath alcohol concentration reaching 0.074 g/210 L on average immediately prior to the metacognition task. Participants answered cued recall general knowledge questions and provided confidence ratings and feeling‐of‐knowing judgments. They then completed a recognition (i.e., multiple choice) version of the same task, indicating an answer and a confidence rating for each question. Findings suggest that metacognitive accuracy generally did not vary across intoxication levels, although the control group's retrospective confidence judgments better discriminated between accurate and inaccurate responses than the alcohol groups in the recognition task. Study 2 surveyed academic psychologists about their expectations regarding the relation between alcohol and metacognition. Study 1's results were counter to their expectations, as respondents generally predicted a relation would be present. We discuss the implications for alcohol and memory.Copyright © 2017 John Wiley &amp; Sons, Ltd.

Sexual vs. Nonsexual Currently Most Upsetting Trauma: A Fresh Look at Attenuation of Sexual Response, Alcohol Intoxication, and Post-Traumatic Stress

This study examined the dependence of sexual response (vaginal pulse amplitude [VPA] and subjective sexual arousal) on alcohol intoxication (.10% breath alcohol concentration [BrAC] versus no alcohol) and the nature of a woman’s currently most upsetting traumatic event (C-MUTE), whether it was sexual (e.g., rape) or nonsexual (e.g., combat). Self-reported sexual outcomes were also compared by C-MUTE type. A total of 117 women completed background measures and either drank alcoholic or nonalcoholic beverages. They were shown erotic films and their VPA was assessed. A two (sexual versus nonsexual C-MUTE) by two (.10% BrAC versus no alcohol) analysis of variance (ANOVA) showed that, controlling for post-traumatic stress (PTS) symptoms, women with a sexual C-MUTE showed lower percent VPA change than women with a nonsexual C-MUTE. No significant effects were found for subjective sexual arousal. A multivariate analysis of variance (MANOVA) showed that women with a sexual C-MUTE reported more frequent anxiety and inhibition during partnered sex and more frequent lack of vaginal lubrication versus women with a nonsexual C-MUTE. There was no significant interaction between C-MUTE and alcohol intoxication. Whether a woman is currently upset by past sexual victimization may influence current sexual difficulties. Attenuated VPA may be attributable to the sexual nature of a C-MUTE as opposed to general trauma exposure.

Alcohol improves cerebellar learning deficit in myoclonus-dystonia: A clinical and electrophysiological investigation.

To characterize neurophysiological subcortical abnormalities in myoclonus-dystonia and their modulation by alcohol administration. Cerebellar associative learning and basal ganglia-brainstem interaction were investigated in 17 myoclonus-dystonia patients with epsilon-sarcoglycan (SGCE) gene mutation and 21 age- and sex-matched healthy controls by means of classical eyeblink conditioning and blink reflex recovery cycle before and after alcohol intake resulting in a breath alcohol concentration of 0.08% (0.8g/l). The alcohol responsiveness of clinical symptoms was evaluated by 3 blinded raters with a standardized video protocol and clinical rating scales including the Unified Myoclonus Rating Scale and the Burke-Fahn-Marsden Dystonia Rating Scale. Patients showed a significantly reduced number of conditioned eyeblink responses before alcohol administration compared to controls. Whereas the conditioning response rate decreased under alcohol intake in controls, it increased in patients (analysis of variance: alcohol state × group, p = 0.004). Blink reflex recovery cycle before and after alcohol intake did not differ between groups. Myoclonus improved significantly after alcohol intake (p = 0.016). The severity of action myoclonus at baseline correlated negatively with the conditioning response in classical eyeblink conditioning in patients. The combination of findings of reduced baseline acquisition of conditioned eyeblink responses and normal blink reflex recovery cycle in patients who improved significantly with alcohol intake suggests a crucial role of cerebellar networks in the generation of symptoms in these patients. Ann Neurol 2017;82:543-553.

Preliminary evaluation of a human laboratory model of impaired control over alcohol using intravenous alcohol self-administration.

Impaired control over alcohol is central to alcohol use disorder, but most research on impaired control is limited to self-report methods. This study applied intravenous alcohol self-administration to conduct a preliminary investigation of a novel human laboratory model of impaired control. Heavy episodic drinkers (ages 19-22 years) completed a two-hour intravenous alcohol self-administration session that involved an incentive to maintain breath alcohol concentration below 80 mg%. Impaired control was operationalized based on whether participants exceeded (impaired control positive; IC+) or adhered to (impaired control negative; IC-) the breath alcohol concentration limit, as well as the discrepancy between intended and actual peak breath alcohol concentration. Analyses of subjective processes revealed that IC+ participants tended to underestimate their peak breath alcohol concentration relative to IC- participants. Further, IC+ reported greater craving after an initial priming phase, and craving mediated the relationship between self-report impaired control and discrepancies between intended and actual breath alcohol concentration. IC+ participants also showed stronger within-person associations between state changes in stimulation and momentary alcohol self-administration throughout the session. Laboratory impaired control indices demonstrated convergent validity with an established self-report measure of impaired control. These findings provide preliminary validation of a novel human laboratory model of impaired control in a sample of young heavy episodic drinkers, and offer insight into the role of subjective responses (craving, stimulation) in impaired control.

Baseline breath alcohol concentration in Nigerian commercial drivers and motorcyclists

ABSTRACTObjective: We sought to determine breath alcohol concentration (BrAC) in a sample of consenting Nigerian commercial drivers and motorcyclists and relate values obtained to some social parameters and practices.Method: A cross-sectional study of randomly selected, consenting commercial drivers, and motorcyclists in two Nigerian cities was undertaken. We obtained data on subjects’ sociodemographics, driving/riding related experiences and practices with the aid of a pretested structured questionnaire. We determined their BrAC and analyzed data using SPSS version 17.0. Statistical significance was inferred at p ≤ 0.05.Result: One hundred ninety respondents aged 20–65 years mean (SD) 40 (11.28) were studied. They were 112 (58.9%) drivers, 78 (41.1%) motorcyclists, and predominantly males (98.9%). A significant proportion of motorcyclists were aged <40 years and most drivers >40 years (p < 0.001). Respondents’ educational attainment did not differ significantly with age groups and status; however, 6.8% had no formal education.Alcohol use decreased significantly with increasing years of experience (p < 0.001). Note that 68.9% of respondents tested positive with the breathalyzer with blood alcohol concentration (BAC) levels 0.01–1.8 mg/ml with mean (SD) at 0.16 (0.32) mg/ml. In total, 51.1% of respondents had BAC values ≥0.1% while 7.9% had BAC ≥0.5 mg/ml. A total of 92.6% admitted use of various measures to enhance their performances and overcome fatigue.Conclusion: The drink driving/riding law in Nigeria needs to be revised to suit prevailing circumstance and enforced.

Nature versus intensity of intoxication: Co-ingestion of alcohol and energy drinks and the effect on objective and subjective intoxication

BackgroundWe report a series of studies examining the effect of alcohol mixed with energy drinks (AmEDs) versus alcohol on objective intoxication (breath alcohol concentration; BrAC), intensity, and nature of intoxication. We also aimed to disentangle the role of energy drink (ED) ingredients in any effects. MethodThree within-subject double-blind placebo-controlled studies measured BrAC, subjective intoxication and impairment (‘intensity of intoxication’), stimulation and sedation (‘nature of intoxication’) following administration of ED, Cola, Caffeine+Sugar, and Placebo with alcohol (Study 1, n=18); ED, Caffeine-only, Sugar-only and Placebo with alcohol (Study 2, n=20); and ED and Placebo with alcohol (Study 3, n=27). ResultsSignificant moderate-to-large magnitude BrAC decrements and delayed time to peak BrAC were observed after ED administration versus Placebo. However, no meaningful BrAC differences between ED and other active conditions were observed in Study 1 and 2. After BrAC adjustment, moderate-to-large magnitude reductions in intoxication and impairment ratings were observed after ED versus Placebo on the ascending limb in all studies and at peak in Study 2 and 3. No meaningful differences were observed in intoxication and impairment ratings between ED and Caffeine+Sugar and Cola conditions (Study 1); ratings were lower after ED versus Sugar-only (Study 2). Stimulation and sedation ratings did not differ between ED and Placebo. ConclusionReductions in objective intoxication and perceived intensity of intoxication, but not nature of intoxication, were observed after AmED consumption. However, effects may be common to alcohol mixers containing sugars (objective intoxication) and caffeine (intensity of intoxication) and specific to a laboratory setting.

Proximal predictors of breath alcohol level at venues primarily serving sexual minority patrons

PurposeThe purpose of this paper is to assess the proximal predictors of breath alcohol content (BrAC) at exit of a venue that primarily served sexual minority patrons. Contrary to prior research that relies on self-report of alcohol consumption, participants’ BrAC level was measured prior to entering the venue and again at exit.Design/methodology/approachA portal method was used to assess individuals before and after attending a sexual minority bar. Participants (n=96) were randomly selected for participation on weekends from four bars.FindingsA multivariate path model was conducted to predict BrAC at exit from the bar. Individuals who drank before coming to the bar had a mean BrAC of 0.093 (SD=0.065) at exit from the bar and those who did not drink before attending the bar had a mean BrAC 0.030 (SD=0.050) at exit (t=5.47 (99), p<0.001). Drinking before bar attendance, BrAC at entrance, planning to drive, and drinking intentions were significant predictors of BrAC at exit from the bar. There were no significant variations in BrAC by sexual identity.Research limitations/implicationsBrAC levels at exit were mainly influenced by the BrAC levels at entrance and were not significantly changed while at the venue.Originality/valueWhile previous research has demonstrated a higher incidence of problematic drinking behaviors in nonheterosexual populations, the current study suggests that bars and clubs who serve sexual minority patrons might not be adding to these problematic behaviors, and instead serve as a place of community for LGB individuals.

Sonochemically Synthesized Zinc Oxide Nanoflakes Based Electrochemical Immunosensor for Ethyl Glucuronide (EtG) Detection

We report on label free highly sensitive electrochemical immunosensor for monitoring alcohol consumption through the detection and quantification of ethyl glucuronide (EtG) -a metabolite of ethanol-based on two-dimensional (2D) zinc oxide (ZnO) nanoflakes (NFs), which were synthesized on flexible Au-coated polyethylene terephthalate (PET) substrate using simple one step sonochemical approach. Highly sensitive detection of EtG using cyclic voltammetry (CV) is achieved by immobilizing EtG antibody on the as-synthesized sensing electrodes of ZnO NFs. Continuous monitoring of alcohol detection is imperative for the prevention of accidents, point of care monitoring, and personal safety. The cutting-edge technologies are mostly focused to detect alcohol from the breath (e.g. breathalyzer), which is not compatible for the real-time monitoring. The relationship between the blood and breath alcohol concentrations and the improvement of the detection techniques of alcohol biomarkers from the sweat render an opportunity for point of care monitoring. Among different biomarkers, Ethylglucuronide (EtG) has been found as a promising indicator of alcohol due toit’s prolonged existence in sweat (24 hours for one or two “drinks” or 2-4 days for binge drinking), which prevents relapsing. PET has gained popularity as substrate for wearables because of its intrinsic elasticity, thermal stability, hydrophobicity, excellent dielectric properties, low coefficient of thermal expansion, structural resiliency against repeated bending forces and compatibility with roll-to-roll fabrication processes for low cost and scalable manufacturing. ZnO, a semiconducting material with piezoelectricity,high catalytic efficiency, biocompatibility, chemical stability in physiological environments, low toxicity and a high isoelectric point (IEP) of about 9.5, has been proposed for biosensing applications. ZnO nanostructures (NSs) with different morphologies such as nanorods, nanowalls, nanobelts and quantum dots have been used as immobilizing matrix in fabrication of biosensors for the detection of physiologically relevant biomarkers such as cholesterol, galactose, glucose. Considering their promising properties and potential applications, many techniques have been developed to synthesize various ZnO NSs. In comparison to the more conventional approaches such as hydrothermal method, sonochemical synthesis method is not only significantly faster, inexpensive and performed at ambient conditions but also highly stable and reproducible with the advantages of more uniform size distribution, faster reaction time and a higher surface area, which are essential to design sensing platform withimproved performance. Compared to bulk materials, the 2D ZnO NFs provide unique sensing advantages with polarized (0001) plane orientation and high surface charge density, which could enhance EtG antibody loading and thus improve sensing performance. High isoelectric point allows immobilization of most biomolecules without any additional biding layer. This provides a direct, stable pathway for rapid electron transport when an analyte is immobilized on NFs and improves electron transfer rate greater than 1D ZnO nanorods, high isoelectric point,that results in change of the resistance.Taking advantage of these unique properties, we immobilizedEtG antibody on the synthesized ZnO NFs. When an analyte binds the antibody, there is a change in the current due to increase in the charge transfer resistance. The cyclic voltammetry (CV) measurements were taken in the potential range of -0.1V-0.8V at a scan rate of 50mVs-1. For the EtGconcentrationsof1ng/mL-100µg/mLusing PET/Au/ZnO NFs as the working electrode. The minimum detection limit was found to be much lower than 1ng/mL which covers the physiological range. The sensitivity of the sensor was found to be 18.48 mA/ng/mL/cm-2.

Drunk-Driver Detection and Alert System (DDDAS) for Smart Vehicles

One of the major causes of road accidents, crashes, mishaps and fatalities globally all over the world is drunk driving. Though driving under intoxication is illegal, even then people restore to such hard-core habits often. In order to combat such risky situation on road, technological innovation needs to be implemented in a cost-effective, efficient and legal manner. This paper discusses design, development and live-performance test of the prototype of drink and drive situation detection and alert cum vehicle control system to minimize road mishaps and enhance public safety on road. It also analyses the response of breath –alcohol semiconductor sensor with respect to variation in distance from source which is critical part of system design. Based upon the recent smart gas sensing and integration of satellite and cellular wireless communication technologies, the proposed device quickly senses the drunken state of the driver during start-up/driving by estimating the equivalent breath alcohol concentration level corresponding to the legally permissible state’s threshold blood alcohol concentration level. On detection of such situation, on-vehicle siren/audio alarm is activated to warn the persons on road and vehicle control system is triggered to lock ignition or stop the fuel inflow to the vehicle. Additionally, ‘alert SMS’ indicating drunk driver location, tracked by onboard GPS receiver, along with vehicle number is communicated remotely to authorized (family members, traffic police) mobile user using GSM cellular network to take appropriate action thereafter. The live experiment results highlighted the successful working performance of the device in-housed at the steering wheel of the vehicle with the drunk driver.

Unsuspected Critical Illness Among Emergency Department Patients Presenting for Acute Alcohol Intoxication

Emergency department (ED) visits for acute alcohol intoxication are common, but this population is at risk for decompensation and occult critical illness. The purpose of this study is to describe the incidence and predictors of unsuspected critical illness among patients with acute alcohol intoxication. This was a retrospective observational study of ED patients from 2011 to 2016 with acute alcohol intoxication. The study cohort included patients presenting for alcohol intoxication, whose initial assessment was uncomplicated alcohol intoxication without any other active acute medical or traumatic complaints. The primary outcome was defined as the unanticipated subsequent use of critical care resources during the encounter or admission to an ICU. We investigated potential predictors for this outcome with generalized estimating equations. We identified 31,364 eligible patient encounters (median age 38 years; 71% men; median breath alcohol concentration 234 mg/dL); 325 encounters (1%) used critical care resources. The most common diagnoses per 1,000 ED encounters were acute hypoxic respiratory failure (3.1), alcohol withdrawal (1.7), sepsis or infection (1.1), and intracranial hemorrhage (1.0). Three patients sustained a cardiac arrest. Presence of the following had an increased adjusted odds ratio (aOR) of developing critical illness: hypoglycemia (aOR 9.2), hypotension (aOR 3.8), tachycardia (aOR 1.8), fever (aOR 7.6), hypoxia (aOR 3.8), hypothermia (aOR 4.2), and parenteral sedation (aOR 2.4). The initial blood alcohol concentration aOR was 1.0. Critical care resources were used for 1% of ED patients with alcohol intoxication who were initially assessed by physicians to have low risk. Abnormal vital signs, hypoglycemia, and chemical sedation were associated with increased odds of critical illness.

Ethanol-induced autonomic responses and risk taking increase in young adults with a positive family history of alcohol problems

The mechanisms that underlie the greater prevalence of alcohol use disorders in individuals with a positive family history (FH+) of alcohol abuse are still under investigation. These subjects may exhibit differential sensitivity to alcohol's effects on psychomotor stimulation and impulsivity. Alcohol-induced psychomotor stimulation, measured as the heart rate (HR) response, is a proxy for the positive rewarding effects of the drug. We analyzed alcohol-induced effects on time perception (Time Production Task), risk taking (Balloon Analogue Risk Task [BART]), and HR in FH+ and FH− participants. In the FH+ and FH− groups, women and men received 0.6 and 0.7g/kg alcohol, respectively. The alcohol dose yielded a breath alcohol concentration of 0.08% throughout the experiment. The control groups received placebo, and the subjective perception of alcohol intoxication was assessed. Alcohol intoxication significantly increased HR and the adjusted average number of pumps on the BART (a measure of risk taking) in FH+ men and women but not in FH− participants. Behavioral impulsivity was unaffected by alcohol or a FH of alcohol abuse. FH− but not FH+ participants who received alcohol reported significantly greater subjective perception of alcohol's effects than their placebo counterparts. These results indicate that FH+ individuals presented heightened sensitivity to alcohol-induced HR stimulation and alcohol-induced risk taking compared with their FH− counterparts. FH+ subjects, however, were insensitive to the subjective effects of alcohol. This idiosyncratic response pattern may be a likely pathway by which a FH of alcohol problems promotes alcohol drinking.