Intoxicated Subjects Research Articles

Leveraging Dissolution by Autoinjector Designs.

Chemical warfare or terrorism attacks with organophosphates may place intoxicated subjects under immediate life-threatening and psychologically demanding conditions. Antidotes, such as the oxime HI-6, which must be formulated as a powder for reconstitution reflecting the molecule's light sensitivity and instability in aqueous solutions, dramatically improve recovery-but only if used soon after exposure. Muscle tremors, anxiety, and loss of consciousness after exposure jeopardize proper administration, translating into demanding specifications for the dissolution of HI-6. Reflecting the patients' catastrophic situation and anticipated desire to react immediately to chemical weapon exposure, the dissolution should be completed within ten seconds. We are developing multi-dose and single-dose autoinjectors to reliably meet these dissolution requirements. The temporal and spatial course of dissolution within the various autoinjector designs was profiled colorimetrically. Based on these colorimetric insights with model dyes, we developed experimental setups integrating online conductometry to push experiments toward the relevant molecule, HI-6. The resulting blueprints for autoinjector designs integrated small-scale rotor systems, boosting dissolution across a wide range of viscosities, and meeting the required dissolution specifications driven by the use of these drug products in extreme situations.

Induction of hemolysis and eryptosis by occupational pollutant nickel chloride is mediated through calcium influx and p38 MAP kinase signaling.

Nickel (Ni) is an abundant environmental hazard and an occupational pollutant. Exposure to Ni compounds is prevalent in electroplating workers and in the printing industry, among others. The toxicity of Ni manifests as dermatological, gastrointestinal, respiratory, allergic, and cardiovascular symptoms. In particular, hyperbilirubinemia and reticulocytosis have been detected in intoxicated subjects; an observation possibly implicating selective red blood cell (RBC) toxicity. Herein, the interaction of nickel chloride (NiCl2) with human RBCs and associated molecular mechanisms are described. Cells from healthy donors were incubated for 24 h at 37°C in the presence or absence of 0.5‒10 mM of NiCl2, and cytotoxicity was determined through hemoglobin leakage by colorimetry under different experimental conditions. Eryptotic markers were also identified by flow cytofluorometry using Annexin-V-FITC tagging for phosphatidylserine (PS) exposure, light scatter properties for cellular dimensions, Fluo4/AM labeling for intracellular calcium, and H2DCFDA staining for reactive oxygen species (ROS). Additionally, small molecule inhibitors were used to probe the signaling pathways involved. It was found that NiCl2 at 10 mM caused profound intracellular calcium overload and significant calcium-dependent hemolysis. Also, NiCl2 reduced forward scatter and increased side scatter, Annexin- positive cells, and ROS levels. Importantly, NiCl2-induced hemolysis was significantly attenuated by the exclusion of extracellular calcium, and in the presence of p38 MAP kinase (MAPK) inhibitor SB203580. It is concluded that NiCl2 induces p38 MAPK-dependent hemolysis, and stimulates the canonical features of premature eryptosis. This report presents the first description of the molecular mechanisms underlying the hemolytic and eryptotic potential of NiCl2 and, thus, may explain changes in hematological parameters observed in poisoning victims. Int J Occup Med Environ Health. 2022;35(1):1-11.

The prevalence of illegal and alcoholic substances among motor vehicle crash survivors: results from a Level-I Trauma Center in Saudi Arabia

Background: Drug abuse is a public health problem in any country and road safety in particular as it poses serious consequences while driving, affecting the safety of all road users. This study aimed to investigate the drug prevalence and alcohol abuse among motor vehicle crash (MVC) survivors. Methods: This descriptive study was based on a review of the retrospective chart involving patients that were admitted to the Emergency Department (ED) of a level-I trauma center in Riyadh following an MVC. Injured patients in 2018 were identified from the electronic medical record system, and substance investigation was documented. After the hospital discharge, the research team contacted patients via phone to obtain further details about the nature of the crash and illegal substance use. Results: During the study, 209 patients were admitted to the ED following MVCs. The population was primarily males (84.7%) with an average age of 30 years. Forty subjects (19.14%) were screened for illegal substances by blood, urine, or both, 35 of which had confirmed intoxication. Alcohol was used in almost two-thirds of the 35 lab-confirmed intoxicated subjects (n = 23, 65.71%) either alone or in combination with other types of drugs. Conclusion: The widespread use of alcohol and other drug abuse among those involved in MVC is alarming and endangers road safety. There is a need to implement well-defined guidelines to screen, detect, and impose a penalty on driving under the influence to reduce MVC and improve population health.

Acute drug effects on habitual and non-habitual responding in crossed high alcohol preferring mice.

Drug reward plays a central role in acquiring drug-seeking behavior. However, subjects may continue using drugs despite negative consequences because self-administration becomes habitual, and divorced from outcome values. Although a history of drug and alcohol use expedite habit acquisition, and in spite of the fact that self-administration leads to intoxication, the acute effects of drugs on habitual responding are not well understood. We sought to observe how acute ethanol and amphetamine affect the balance between habitual and goal-directed behavior, as measured by a fluid-reinforced operant conditioning task. Selectively bred crossed high-alcohol-preferring (cHAP) mice were trained on an operant conditioning task reinforced on a variable interval schedule with 1% banana solution, which was subsequently devalued via LiCl pairing in half the animals. Ethanol (1.0g/kg), amphetamine (2.0mg/kg), or saline was administered prior to a post-devaluation test. Overall, mice showed habitual behavior, but when divided into high- or low-responding groups based on training response rates, saline-treated, low-responding animals devalued, while saline-treated high-responding animals did not. Furthermore, amphetamine elicited devaluation even in high-responding animals, while ethanol prevented devaluation even in low-responding animals. These data show that ethanol shifts animals toward behaving habitually. This may illuminate why alcohol-intoxicated individuals display impaired judgment about the relative merits of drinking, and potentially serve as a mechanism by which intoxicated subjects resume previously devalued behaviors, such as comorbid drug use. These findings also show that high variable interval response rates facilitate a shift from goal-directed to habitual behavior.

Alcohol consumption decreases lactate clearance in acutely injured patients

IntroductionAlcohol, a common risk factor for injury, has direct toxic effects on the liver. The use of lactate clearance has been well described as an indicator of the adequacy of resuscitation in injured patients. We investigated whether acutely injured patients with positive blood alcohol content (+BAC) had less lactate clearance than sober patients. MethodsWe conducted a retrospective cohort study of acutely injured patients treated at an urban Level 1 trauma centre between January 2010 and December 2012. Blood alcohol and venous lactate levels were measured on all patients at the time of arrival. Study subjects were patients transported directly from the scene of injury, who had an elevated lactate concentration on arrival (≥3.0mmol/L) and at least one subsequent lactate measurement within 24h after admission. Lactate clearance ([Lactate1−Lactate2]/Lactate1) was calculated for all patients. Chi-squared tests were used to compare values from sober and intoxicated subjects. Lactate clearance was plotted against alcohol levels and stratified by age and Injury Severity Score (ISS). ResultsSerial lactate concentration measurements were obtained in 3910 patients; 1674 of them had +BAC. Patients with +BAC were younger (mean age: 36.6 [SD 14.7] vs 41.0 [SD 19.9] years [p=0.0001]), were more often male (83.4% vs 75.9% [p=0.0001]), had more minor injuries (ISS<9) (33.8% vs 27.1% [p=0.0001]), had a lower in-hospital mortality rate (1.4% vs 3.9% [p=0.0001]), but also had lower average lactate clearance (37.8% vs 47.6% [p=0.0001]). The lactate clearance of the sober patients (47.6 [SD 33.5]) was twice that of those with +BAC >400 (23.5 [SD 6.5]). Lactate clearance decreased with increasing BAC irrespective of age and ISS. ConclusionsIn a large group of acutely injured patients, a dose-dependent decrease in lactate clearance was seen in those with elevated BAC. This relationship will cause a falsely elevated lactate reading or prolong lactate clearance and should be taken into account when evaluating patients with +BAC.

The effects of acute alcohol intoxication on the cognitive mechanisms underlying false facial recognition.

RationaleFalse face recognition rates are sometimes higher when faces are learned while under the influence of alcohol. Alcohol myopia theory (AMT) proposes that acute alcohol intoxication during face learning causes people to attend to only the most salient features of a face, impairing the encoding of less salient facial features. Yet, there is currently no direct evidence to support this claim.ObjectivesOur objective was to test whether acute alcohol intoxication impairs face learning by causing subjects to attend to a salient (i.e., distinctive) facial feature over other facial features, as per AMT.MethodsWe employed a balanced placebo design (N = 100). Subjects in the alcohol group were dosed to achieve a blood alcohol concentration (BAC) of 0.06 %, whereas the no alcohol group consumed tonic water. Alcohol expectancy was controlled. Subjects studied faces with or without a distinctive feature (e.g., scar, piercing). An old-new recognition test followed. Some of the test faces were “old” (i.e., previously studied), and some were “new” (i.e., not previously studied). We varied whether the new test faces had a previously studied distinctive feature versus other familiar characteristics.ResultsIntoxicated and sober recognition accuracy was comparable, but subjects in the alcohol group made more positive identifications overall compared to the no alcohol group.ConclusionsThe results are not in keeping with AMT. Rather, a more general cognitive mechanism appears to underlie false face recognition in intoxicated subjects. Specifically, acute alcohol intoxication during face learning results in more liberal choosing, perhaps because of an increased reliance on familiarity.

Impairment of the autophagic flux in astrocytes intoxicated by trimethyltin

Autophagy is a lysosomal catabolic route for protein aggregates and damaged organelles which in different stress conditions, such as starvation, generally improves cell survival. An impairment of this degradation pathway has been reported to occur in many neurodegenerative processes. Trimethyltin (TMT) is a potent neurotoxin present as an environmental contaminant causing tremors, seizures and learning impairment in intoxicated subjects. The present data show that in rat primary astrocytes autophagic vesicles (AVs) appeared after few hours of TMT treatment. The analysis of the autophagic flux in TMT-treated astrocytes was consistent with a block of the late stages of autophagy and was accompanied by a progressive accumulation of the microtubule associated protein light chain 3 (LC3) and of p62/SQSTM1. Interestingly, an increased immunoreactivity for p62/SQSTM1 was also observed in hippocampal astrocytes detected in brain slices of TMT-intoxicated rats. The time-lapse recordings of AVs in EGFP-mCherry-LC3B transfected astrocytes demonstrated a reduced mobility of autophagosomes after TMT exposure respect to control cells. The observed block of the autophagic flux cannot be overcome by known autophagy inducers such as rapamycin or 0.5mM lithium. Although ineffective when used at 0.5mM, lithium at higher concentrations (2mM) was able to protect astrocyte cultures from TMT toxicity. This effect correlated well with its ability to determine the phosphorylation/inactivation of glycogen kinase synthase-3β (GSK-3β).

Czech mass methanol outbreak 2012: Epidemiology, challenges and clinical features

Objectives. Methanol poisonings occur frequently globally, but reports of larger outbreaks where complete clinical and laboratory data are reported remain scarce. The objective of the present study was to report the data from the mass methanol poisoning in the Czech Republic in 2012 addressing the general epidemiology, treatment, and outcomes, and to present a protocol for the use of fomepizole ensuring that the antidote was provided to the most severely poisoned patients in the critical phase. Methods. A combined prospective and retrospective case series study of 121 patients with confirmed methanol poisoning. Results. From a total of 121 intoxicated subjects, 20 died outside the hospital and 101 were hospitalized. Among them, 60 survived without, and 20 with visual/CNS sequelae, whereas 21 patients died. The total and hospital mortality rates were 34% and 21%, respectively. Multivariate regression analysis found pH < 7.0 (OR 0.04 (0.01–0.16), p < 0.001), negative serum ethanol (OR 0.08 (0.02–0.37), p < 0.001), and coma on admission (OR 29.4 (10.2–84.6), p < 0.001) to be the only independent parameters predicting death. Continuous hemodialysis was used more often than intermittent hemodialysis, but there was no significant difference in mortality rate between the two [29% (n = 45) vs 17% (n = 30), p = 0.23]. Due to limited stockpiles of fomepizole, ethanol was administered more often; no difference in mortality rate was found between the two [16% (n = 70) vs. 24% (n = 21), p = 0.39]. The effect of folate administration both on the mortality rate and on the probability of visual sequelae was not significant (both p > 0.05). Conclusions. Severity of metabolic acidosis, state of consciousness, and serum ethanol on admission were the only significant parameters associated with mortality. The type of dialysis or antidote did not appear to affect mortality. Recommendations that were issued for hospital triage of fomepizole administration allowed conservation of valuable antidote in this massive poisoning outbreak for those patients most in need.

O38: Determination of GHB concentrations in postmortem samples: A case series and comparison between matrices

Introduction The interpretation Gamma-HydroxyButyric acid (GHB) concentrations in postmortem samples is a difficult task. Not only is GHB an endogenous substance, but it can also be produced in tissues after death and in vitro in stored samples. Collection of data from forensic cases is important in order to determine a possible threshold value enabling to differentiate between endogenous production and exogenous intake. As multiple analysis on different matrices are also helpful for the interpretation, we compiled a series of forensic cases where peripheral blood, cardiac blood and vitreous humor were analyzed. Methods 31 cases were selected, and analysis were carried out on all available matrices. Delay between death and sampling was unknown for most of the cases and the samples were kept at – 20°C before analysis. One case was a documented user of GHB. In the other cases no GHB intake was evoked in the circumstances of the death. The three matrices (vitreous humor, peripheral blood and cardiac blood) were present for 21 cases and for 10 other cases only two matrices were available (vitreous humor and peripheral blood). GHB was analyzed by gas chromatography- mass spectrometry (GC-MS) after derivation with BSTFA according to a previously published technique (Villain et al., 2003). The limit of quantification was 1 mg/L for all the matrices. Results 82 samples were analyzed, the results are presented in the table below: In peripheral blood, if only the matching pairs of blood samples were considered, mean concentration of GHB was 18,8 mg/L and median was 13,1 mg/L (N = 20). The ratios of the concentrations between the different matrices were evaluated and found as follows: [Cardiac blood]/[Peripheral blood] = 1.9 ; [Vitreous humor]/ [Peripheral Blood] = 0.4. Among the data presented, the alleged user of GHB had the highest concentration in vitreous humor (69 mg/L) and in peripheral blood (246 mg/L). Cardiac blood was not sampled in this case. The ratio between vitreous humor and peripheral blood for this documented abuse of GHB was 0.3. N Mean (mg/L) Median (mg/L) Range (mg/L) Peripheral blood 31 25.1 15.4 Cardiac blood 20 31.2 17.8 Vitreous humor 31 8.1 3.1 1.0 − 69.0 Conclusion Establishing a threshold value for differentiating endogenous production and exogenous intake of GHB is a complex goal. Numerous publications have given concentrations in various matrices. Most of the time the concentrations of GHB between cases with proven intake and cases where no GHB intoxication was suspected are overlapping. Delay between death and sampling, storage conditions and preservatives are some of the multiple factors that could influence the evolution of GHB concentrations over time. With our case series we have shown that the ratio between vitreous humor and peripheral blood is not different for subjects with no history of GHB abuse and intoxicated subjects. This finding needs to be confirmed on larger series of both positive and control cases.

Investigating the Association between Angiogenic Cytokines and Corneal Neovascularization in Sulfur Mustard Intoxicated Subjects 26 Years after Exposure.

Objectives:This study aimed to evaluate the associations between the concentrations of three major angiogenic cytokines–vascular endothelial growth factor-A165 (VEGF-A165), basic fibroblast growth factor (bFGF), and platelet-derived growth factor-BB (PDGF-BB)–in the tear of sulfur mustard (SM)-exposed subjects and corneal neovascularization (CNV) 26 years after exposure.Materials and Methods:The concentrations of VEGF-A, bFGF, and PDGF-BB were measured by enzyme-linked immunosorbent assay (ELISA) in reflex tears of (i) SM-injured patients with CNV (positive case group including 18 individuals) and (ii) SM-injured patients without CNV (negative case group including 22 individuals). Then results were compared to corresponding values obtained from tears of 40 healthy control subjects.Results:The mean concentrations of all investigated growth factors, VEGF-A165, bFGF, and PDGF-BB, were significantly higher in positive cases than controls (P ≤ 0.001, P = 0.028, and P = 0.041, respectively). Whereas, VEGF-A165 was the only growth factor which displayed significantly elevated concentrations in negative case group compared to the healthy individuals (P = 0.030). Additionally, the mean level of VEGF-A165 was also higher in positive patient group than negative patients (P = 0.022). Subjects with increased concentrations of tear VEGF-A165 were more than 10 times more likely to suffer from CNV than normal individuals (odds ratio (OR) = 10.43, confidence interval (CI): 2.14–38.46, P = 0.001), while elevated levels of bFGF and PDGF-BB increased the risk of CNV by about twofold.Conclusion:Although all investigated cytokines had increased in tears of positive patients, VEGF-A was the only one which showed a significant correlation with the severity of CNV, and thus played a crucial role in corneal angiogenesis.

HPLC analysis in drug level monitoring of K027

Summary HPLC monitoring of pharmacokinetics was done in two body compartments of rats following intramuscular treatments with three different doses of K027, a bispyridinium mono-aldoxime type of antidotes to organoposphate intoxicated subjects. Reversed-phase HPLC separation with electrochemical detections was done to monitor the onset, the maximum level, and offset in K027 concentration. Serum level of K027 showed a fast onset, independently from the doses of K027. Drug level in brain was showing an essentially delayed kinetics.

Are serum levels of immunoglobulin classes and IgG subclasses involved in delayed pulmonary complications induced by sulfur mustard? Sardasht-Iran Cohort Study

Respiratory complications are the foremost long term debilitating effects after sulfur mustard toxicity. The underlying immunological mechanisms of sulfur mustard induced lung damage are still poorly understood. The question of the involvement of immunoglobulin classes and subclasses in delayed pulmonary complications induced by SM was addressed in this study as a part of Sardasht-Iran Cohort Study (SICS).In SICS, 372 male participants who were exposed to SM 20 years earlier were compared with 128 unexposed age-matched controls. At the time of study (2007), the clinical evaluations and spirometry was performed for all subjects according to the American Thoracic Society Criteria, and at the same time, the sera were isolated, labeled and aliquots were kept frozen in -80°C. Serum immunoglobulin (Ig) levels including IgM, IgA, IgE, IgG, and IgG subclasses (IgG1, IgG2, IgG3 and IgG4) were measured using quantitative Elisa method. It was found that among immunoglobulin classes and IgG subclasses only IgM and IgG4 were significantly decreased in the peripheral blood of exposed cases. IgM level also positively correlated with FEV1 only in the SM exposed group. These results indicated a weak but significant role for IgA in control of the delayed pulmonary complications. There were no strong correlations between other immunoglobulin classes or IgG subclasses with pulmonary disease severity in sulfur mustard intoxicated subjects. The authors proposed that systemic levels of immunoglobulins do not exert essential roles in severity of delayed pulmonary complications following SM toxicity. However, more studies on local and systemic levels of immunoglobulins in more severe groups are suggested.

Compression of the acoustic space in intoxicated speech.

Researchers at the phonetics-phonology interface frequently invoke “articulatory effort” to explain the behavior of various speech sounds: less effortful sounds are preferred. However, there is scant empirical basis for most claims about which sounds are the effortful ones. This experiment attempts to observe effort reduction in the laboratory by comparing the speech of sober and intoxicated subjects; there is reason to believe that subjects produce more “easy” sounds when intoxicated than when sober. Subjects produced 264 target words containing intervocalic stops, nasal-stop sequences, and stressed vowels. Acoustic analysis of these productions reveals that subjects’ acoustic space was somewhat smaller in the intoxicated condition than in the sober condition for several measures including stop voicing and intensity; however, no such contraction occurred for vowels. These results have two implications. First, compression of the acoustic space suggests that speech in the intoxicated condition may indeed have been less effortful. Second, the results call into question traditional hypotheses about effort reduction: intervocalic stops moved toward the middle of the VOT continuum, rather than becoming more voiced; vowels, contrary to expectation, did not become more centralized. This study highlights the need for further experimental work on the role of articulatory effort in sound patterns.

Dynamics of a Stroop matching task: Effect of alcohol and reversal with training.

Using a Stroop matching task, we evaluated how alcohol affects the time needed to overcome Stroop conflict and whether practice might reverse the effect of alcohol. Participants (n = 16) performed two sessions in which they had to compare the color of a color-word with the meaning of a color-word in neutral color. The two task stimuli were presented simultaneously or with a Stimulus Onset Asynchrony (SOA) of 200, 500, or 800 ms. For half of the subjects, alcohol was administered in the first session, and for the other half, alcohol was administered in the second session. The results showed that the Stroop effect was significant at the 0 and 200 ms intervals in the sober subjects. Moreover, in untrained intoxicated individuals, interference endured until the 500 ms interval, a result that was abolished in trained intoxicated subjects. In conclusion, alcohol increased the time needed for Stroop matching task conflict resolution. However, this deleterious effect was minimized by a previous practice session.

A randomised controlled feasibility trial of alcohol consumption and the ability to appropriately use a firearm

Objective:To show the feasibility of using a controlled trial to investigate the effect of alcohol on firearm use.Methods:Randomised, blinded, placebo-controlled trial in the Firearm Usage and Safety Experiments (FUSE) Lab....

Monitoring the Pharmacokinetics of Pyridinium Aldoximes in the Body

A huge number of organophosphate poisonings occurring in agriculture, and a constant threat of misapplication of organophosphates as warfare agents require antidotes that efficiently improve the health-condition of intoxicated subjects. Pyridinium aldoximes are medically used to reactivate the cholinesterase enzymes inhibited by organophosphates. This paper outlines pharmacokinetics, metabolic disposition and blood-brain-barrier penetration of pyridinium aldoximes into the human and animal body, and the methods of their pharmacological analysis.

Rapid and sensitive headspace gas chromatographic method for cyanide determination in whole blood

We reported a simple and rapid headspace (HS) gas chromatographic (GC) assay for the determination of cyanide in human whole blood obtained from both cadaveric and intoxicated subjects. The poison was extracted from whole blood samples by HS technique after 10 min incubation at 80°C with a HCl (1N) acidic solution supplemented with 30 g L−1 of sodium chloride and 10 mg L−1 of isopropanol as internal standard. A SGE WAX capillary column (30 m × 0.32 mm ID × 0.5 µm df) was used. The Flame Ionization Detector (FID) was set at 250°C. The detection and the quantification limits were 0.02 and 0.2 mg L−1, respectively. In the within-day study, the coefficients of variation for three different whole blood cyanide concentrations varied between 3.2 and 6.5%, whereas those in the day-to-day study varied between 4.8 and 6.3%. The assay was performed in less than 20 min per sample, which appears to be suitable for emergency toxicological tasks involved in diagnosis of cyanide poisoning.

T12-O-08 Alcohol and sexual risk taking in young heterosexual men: an empirical test of Alcohol Myopia Theory

Objective Sexual risk taking by heterosexual men is important to the high levels of sexually transmitted infections (STIs) and unplanned pregnancies. Alcohol Myopia Theory suggests that behaviour is influenced by an interaction between alcohol-induced cognitive impairment and environmental cues, thus reducing one's ability to process inhibitory cues. The present study addressed the intentions and justifications to engage in risky sexual behaviour according to level of intoxication and in conditions of both explicit and implicit inibitory conflict. Design and method 48 men were recruited in nightclubs for an interview. We employed a vignette methodology in order to create explicit or implicit inibitory conflict condition. Levels of blood alcohol concentration were measured and. Results When inibitory cues are not explicit, intoxicated subjects report greater intention to have an unprotected sexual intercourse, while there are no significant differences between sober and intoxicated subjects in justifications for risky behaviour. Conclusions These results therefore confirm the assumptions of alcohol myopia theory, showing that stronger environmental cues have much more influence on behaviour when cognitive and perceptive processes are impaired.

Alcohol Intoxication Reduces Detection of Asymmetry: An Explanation for Increased Perceptions of Facial Attractiveness after Alcohol Consumption?

Ratings of physical attractiveness are related to degree of facial symmetry. Acute alcohol consumption affects ratings of physical attractiveness and also attenuates aspects of visual perception. We tested the hypothesis that increases in ratings of attractiveness associated with alcohol intoxication can be attributed at least in part to a reduced ability to discern facial asymmetry due to reductions in levels of visual perception. We examined whether alcohol intoxication reduces ability to detect asymmetry in approximately symmetrical images. Sober and intoxicated subjects were shown a series of simple geometric images to which they responded on whether they perceived each one to be symmetrical or asymmetrical. Intoxicated subjects were significantly less able to detect asymmetry than were sober subjects, providing support for the hypothesis.

Alcohol and Aggression

This article presents the first systematic test of the attention-allocation model for alcohol-related aggression. According to this model, alcohol has a "myopic" effect on attentional capacity that presumably facilitates aggression by focusing attention on more salient provocative, rather than less salient inhibitory, cues in hostile situations. Aggression was assessed using a laboratory task in which mild electric shocks were received from, and administered to, a fictitious opponent. Study 1 demonstrated that a moderate-load cognitive distractor suppressed aggression in intoxicated subjects (to levels even lower than those exhibited by a placebo control group). Study 2 assessed how varying the magnitude of a distracting cognitive load affected aggression in the alcohol and placebo conditions. Results indicated that the moderate-load distraction used in Study 1 (i.e., holding four elements in sequential order in working memory) suppressed aggression best. Cognitive loads of larger and smaller magnitudes were not successful in attenuating aggression.