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Context: Alcohol is a factor in many categories of injury. Alcohol intoxication is frequently associated with injuries from falls, fires, drowning, overdoses, physical and sexual abusements, occupational accidents, traffic accidents and domestic violence. In many instances, for forensic purpose, it may be necessary to establish whether the patients/subjects have consumed alcohol that would have been the reason for the injury/accidents. Combining rapidity and reliability, alcohol saliva strip test (AST) has been put forward for the detection of alcohol in saliva for blood alcohol concentration (BAC). In the present study, we have determined BAC by using AST. Aims and Objectives: The main objective of this study was to detect alcohol in saliva for BAC in alcoholics by using AST. Materials and Methods: Two socio-economic groups were selected for the present study where Group A consisted of 40 subjects from the local bar and Group B consisted of 40 subjects from an organized party. The subjects were selected randomly at the local bar and at the organized party who have consumed different forms of alcohol. ALCO-SCREEN 02 plastic strip with a reactive pad was used for the detection of presence of alcohol in saliva. Results: In the present study, 85% of subjects from Group A, i.e., at the local bar, demonstrated positive results of variable intensity with AST when compared to the subjects from Group B in the organized party which was only about 25%. Conclusion: The present study showed that AST, performed by using ALCO-SCREEN 02 plastic strip with a reactive pad, can detect the presence of 0.02% BAC or more that can be helpful for various purposes such as forensic, workplace, medical and research settings. The study also showed that amount, time period, concentration and quality of the alcohol intake can influence the BAC, which can be a contributory factor for many accidents, injuries and medical conditions.

Although the benefits of sauna bathing have been demonstrated in epidemiological studies, sauna deaths have been reported. The aim of this study was to determine the demographic and forensic characteristics associated with different blood alcohol concentrations (BACs) in sauna deaths in Korea. In this retrospective analysis, data were collected from a nationwide pool in Korea between January 2008 and December 2015 to determine the role of alcohol intoxication in sauna deaths based on the subjects’ BAC and to evaluate the demographic and forensic characteristics associated with different BACs. One hundred and three deaths were classified into 2 groups: the non-intoxication (NI) group (BAC,<0.08%; n = 27) and the intoxication (I) group (BAC,≥0.08%; n = 76). Demographic and forensic characteristics were compared between the groups using a multinomial logistic regression analysis. The proportions of decedents who were male (odds ratio: 17.4, 95.0% confidence interval: 3.8-79.8) and in a prone position at the scene of death (odds ratio: 11.3, 95.0% confidence interval: 2.1-60.1) were significantly higher (P < 0.001 and P < 0.05, retrospectively) in the I group than in the NI group. However, no significant differences were observed with respect to obesity, coronary artery narrowing, and liver pathology. Sauna deaths exhibited different characteristics according to BACs detected at autopsy. The differences in sauna deaths between the I and NI groups may have implications for the targeted prevention of sauna deaths associated with alcohol consumption. [ABSTRACT FROM AUTHOR]

Background: Although it has been purported that HIV‐positive individuals may experience a greater degree of intoxication than HIV‐negative individuals following acute alcohol consumption, no research to date has empirically tested this supposition. The present investigation entailed a randomized controlled experiment to identify whether the administration of a weight‐specified dose of alcohol would lead to differential blood alcohol concentrations (BACs) among HIV‐positive versus HIV‐negative men. Methods: In a specialized barroom laboratory, 143 men (n = 76 HIV‐positive and n = 67 HIV‐negative; mean age = 42.9) consumed beverages based on a formulation of 0.7 g alcohol/kg body weight over a 15‐minute time frame. BAC was assessed via breathalyzer at 2 set time points (10 and 13 minutes postconsumption) and then periodically until detoxification (BAC < 0.040%). Primary outcomes included (i) area under the curve (AUC), calculated based on all of one's BAC readings, (ii) “BAC‐EXP,” defined as one's BAC reading 13 minutes postconsumption, and (iii) BAC‐PEAK, defined as one's highest recorded BAC reading. Results: Contrary to predictions, AUC (t(141) = 2.23, p = 0.027), BAC‐EXP (t(141) = 2.68, p = 0.008), and BAC‐PEAK (t(141) = 2.29, p = 0.023) were significantly lower among HIV‐positive versus HIV‐negative participants. These effects were sustained in multivariable models controlling for age, race, and AUDIT‐based hazardous drinking classification. Among the HIV‐positive sample, outcomes did not significantly differ based on HIV viral load detectability, antiretroviral therapy (ART) status, or ART adherence. Conclusions: The administration of a controlled, weight‐specified dose of alcohol led to lower BACs among HIV‐positive versus HIV‐negative participants. These differences might derive from decreased body fat percentage and delayed gastric emptying associated with HIV seropositivity; however, additional research is necessary to verify these mechanisms. Unique alcohol dosing formulas based on HIV serostatus may be required in future alcohol administration experiments involving HIV‐positive samples. [ABSTRACT FROM AUTHOR]

Excessive drinking by college students is a major public health problem in Japan. However, data on heavy episodic drinking (HED) and nomihodai, a several-hour all-you-can-drink system, are scarce. We surveyed the drinking behavior of undergraduate and graduate students at 35 colleges, and examined the association between HED and use of nomihodai. The study used a cross-sectional design conducted by a selfadministered questionnaire. From December 2016 to March 2017, we sampled undergraduate and graduate students aged 20 or older at 35 colleges in the Kanto area, including Tokyo. The following items were measured: 1) frequency of drinking; 2) frequency of binge drinking in the past year; 3) nomihodai use; 4) the number of drinks consumed when using or not using nomihodai; and 5) sex and age for demographic data. Paired t-test was used to compare means between use and non-use state of nomihodai. The Fisher's exact test was used to evaluate the significance of the distribution difference between the two types of states. A total of 511 subjects completed the questionnaire, including 274 men and 237 women. The amount of drinking was increased 1.8-fold (85.9 ± 49.7 g vs. 48.2 ± 29.5 g) among men and 1.7-fold (63.7 ± 39.3 g vs. 36.5 ± 26.7 g) among women during nomihodai use, comapred with non-use states. Among them, 109 (39.8%) men and 71 (30.3%) women reported HED only at nomihodai states. These data suggest that the use of nomihodai system may lead to excessive drinking among college students. [ABSTRACT FROM AUTHOR]

Aim: We introduce a new remote real-time breathalyzer-based method for monitoring and early identification of lapse/relapse patterns for alcohol use disorder (AUD) patients using a composite measure of sobriety, the Addiction Monitoring Index (AMI). Methods: We constructed AMI from (a) obtained test results and (b) the pattern of ignored tests using data from the first 30 patients starting in the treatment arms of two on-going clinical trials. The patients performed 2-4 scheduled breath alcohol content (BrAC)-tests per day presented as blood alcohol content (BAC) data. In total, 10,973 tests were scheduled, 7743 were performed and 3230 were ignored during 3982 patient days. Results: AMI-time profiles could be used to monitor the daily trends of alcohol consumption and detect early signs of lapse and relapses. The pattern of ignored tests correlates with the onset of drinking. AMI correlated with phosphatidyl ethanol (n = 61, F-ratio = 34.6, P < 0.0001, R = -0.61). The recognition of secret drinking could further be improved using a low alcohol detection threshold (BrAC = 0.025 mg/l, BACSwe = 0.05‰ or US = 0.0053 g/dl), in addition to the legal Swedish traffic limit (BrAC = 0.1 mg/l, BACSwe = 0.2‰ or US = 0.021 g/dl). Nine out of 10 patients who dropped out from the study showed early risk signs as reflected in the level and pattern in AMI before the actual dropout. Conclusions: AMI-time profiles from an eHealth system are useful for monitoring the recovery process and for early identification of lapse/relapse patterns. High-resolution monitoring of sobriety enables new measurement-based treatment methods for proactive personalized long-term relapse prevention and treatment of AUD patients. Clinical Trial Registration: The data used for construction of AMI was from two clinical trials approved by the Regional Ethics Committee of Uppsala, Sweden and performed in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participating subjects. The study was registered at ClinicalTrials.gov (NCT03195894). [ABSTRACT FROM AUTHOR]

Background In recent years, there has been increasing attention to “lower BAC” drinking drivers, typically those whose blood alcohol content (BAC) is under the legal limits defined in criminal law. In 2009, legislation was enacted in Ontario, Canada that enabled police to issue roadside license suspensions to individuals caught driving with BAC between 0.05% and 0.08%, known as the “warn range”. Multiple warn range (MWR) offenders are required to attend the Back on Track (BOT) remedial measures program. This study aimed to provide: (1) a preliminary characterization of MWR drivers charged under warn range legislation; and (2) an initial assessment of outcomes associated with BOT participation among MWR offenders. Methods A subsample of 727 MWR offenders was drawn from program records, and compared to samples of 3597 first-time Criminal Code (CC) offenders (those caught driving with a BAC of 0.08% or higher) and 359 second-time CC offenders. To provide an initial assessment of outcomes associated with BOT participation, another subsample consisted of 394 MWR participants from whom pre- and post-workshop questionnaires were collected and successfully matched using probabilistic matching processes. Results Similarities in demographic profile and driving history between MWR and first-time CC participants were apparent. MWR offenders scored higher on risk of problem drinking and drink-driving recidivism than either of the CC offender groups. Second-time CC offenders scored higher on these measures than first-time CC offenders. Following BOT participation, MWR participants demonstrated positive change including improved knowledge of and intentions to avoid drink-driving. Conclusions MWR offenders share a similar demographic profile to that of first-time CC offenders and they report significantly higher risk of problem drinking and recidivism. MWR offenders may include high-functioning problem drinkers who are likely to continue drink-driving and who may escalate to a CC drink-driving offense. Like CC offenders, MWR offenders benefited from BOT participation. [ABSTRACT FROM AUTHOR]

Background: Producers of supersized alcopops have ignored requests from a number of state attorneys general to reduce the alcohol concentration in these products. To the contrary, new flavor options have since been released that contain even greater alcohol content so that some alcopop products now contain 5.5 standard alcoholic drinks in a single-serving can. Though alcohol content of supersized alcopops has risen, little attention has been paid to the blood alcohol concentration (BAC) level consumers can expect to achieve from drinking these products.Objectives: To estimate BAC levels expected from consuming one or two cans of supersized alcopop, relative to beer.Methods: Median weight data from the National Health and Nutrition Examination Survey were used in Matthews and Miller's (1979) BAC estimation formula.Results: Consuming a single supersized alcopop over the course of 2 hours can put youth and young adults well over the legal per se driving limit of 0.08 g/dL. Consuming two cans puts them at risk of alcohol poisoning.Conclusions: Estimates provided here show that supersized alcopop consumers obtain dangerously high BAC levels. Reductions in the alcohol content of supersized alcopops should be an urgent priority for public health policy and law. [ABSTRACT FROM AUTHOR]

Phosphatidylethanol (PEth) is increasingly used as a biomarker of heavy drinking. Many different forms of PEth can form in red blood cell membranes from the action of the enzyme phospholipase D. PEth has a very long duration in blood because, in contrast to other tissues, RBCs lack the enzymes that degrade PEth. Because this biomarker is relatively new, interpretations of the analytical measurements of PEth may be misinterpreted and the resulting predictions of actual alcohol consumption inaccurate. Hence, a simple pharmacokinetic model of PEth was developed to provide a means of contextualizing these analytical results. A number of alcohol consumption scenarios and current clinical screening levels were examined with the model. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Breathalyser estimate of blood alcohol concentration (BAC) is widely used as an objective intoxication measure, but is not always practical in nightlife contexts. This study uses in situ data collected in nightlife environments to explore how four measures of intoxication are related so as to inform the development of a more practical and reliable method of differentiating intoxication for people working in the night-time economy.Design and Methods: Nightlife patron interviews were conducted in five Australian cities. Participants completed demographic questions and were asked about current session (past 12 h) alcohol use, and four different measures of intoxication were assessed: BAC, participant's self-reported intoxication (0-10), interviewer rating of the participant's intoxication (0-10) and interviewer-rated number of the participants' of physical signs of intoxication.Results: A total of 7028 patrons were surveyed and n = 5273 included in analysis. Mean age was 23.9 years (SD = 6.36); 61.5% were male. There was a significant difference in occurrence of all observable intoxication symptoms across differing levels of BAC (P < 0.001). All visible symptoms became more common as intoxication increased, except for talking very quickly/talkative and giggly symptoms. As BAC levels increase, the extent of the disagreement between self-rated and interviewer-rated intoxication measures widens. Exhibiting four or more visible intoxication symptoms emerged as a reliable method for observers to identify intoxicated patrons.Discussion and Conclusions: As BAC increases, people become worse at estimating their own intoxication, but sober observers remain relatively accurate. Findings provide support for efforts to strengthen and enforce responsible service of alcohol. [ABSTRACT FROM AUTHOR]

Both chronic and acute (binge) alcohol drinking are important health and economic concerns worldwide and prominent risk factors for the development of alcoholic liver disease (ALD). There are no FDA-approved medications to prevent or to treat any stage of ALD. Therefore, discovery of novel therapeutic strategies remains a critical need for patients with ALD. Relevant experimental animal models that simulate human drinking patterns and mimic the spectrum and severity of alcohol-induced liver pathology in humans are critical to our ability to identify new mechanisms and therapeutic targets. There are several animal models currently in use, including the most widely utilized chronic ad libitum ethanol (EtOH) feeding (Lieber--DeCarli liquid diet model), chronic intragastric EtOH administration (Tsukamoto--French model), and chronic-plus-binge EtOH challenge (Bin Gao--National Institute on Alcohol Abuse and Alcoholism (NIAAA) model). This review provides an overview of recent advances in rodent models of binge EtOH administration which help to recapitulate different features and etiologies of progressive ALD. These models include EtOH binge alone, and EtOH binge coupled with chronic EtOH intake, a high fat diet, or endotoxin challenge. We analyze the strengths, limitations, and translational relevance of these models, as well as summarize the liver injury outcomes and mechanistic insights. We further discuss the application(s) of binge EtOH models in examining alcohol-induced multi-organ pathology, sex- and age-related differences, as well as circadian rhythm disruption. [ABSTRACT FROM AUTHOR]

Background: Drunk driving has been reported to increase the risk of road traffic accidents associated with death and severe injury. In South Africa, an increase in blood alcohol concentration of as little as 0.01 g per 100 ml above the legal limit may warrant criminal prosecution or the denial of an insurance claim for damages. However, multiple court cases have been withdrawn because of the incompetence of officials at various stages of the investigation. The scope of the mistakes range from poor scene handling to the incorrect handling of blood samples at the laboratory to eventual laboratory testing of blood samples. Using a group of community service doctors (CSDs) as a cohort study group, this study investigated the competency of medical graduates in relation to the medico-legal aspects of drunk driving.Methods: A self-administered questionnaire-based study was done with 150 CSDs. The questionnaire was administered in Afrikaans and English and was dispatched electronically via e-mail. All potential participants were contacted telephonically to obtain verbal consent. Results are displayed as percentages.Results: A response rate of 59.3% was achieved. The results obtained in this study confirm that some CSDs lack competency in handling medico-legal aspects relating to drunk driving, and are thus unable to serve the communities they have been assigned to adequately. Their lack of skills and knowledge suggests that the present undergraduate Clinical Forensic Medicine curriculum is inadequate.Conclusion: It would be beneficial to revise the curriculum for Clinical Forensic Medicine in undergraduate medical training to address the gap in knowledge and practice of various demands of forensic medicine required from new medical graduates and CSDs. [ABSTRACT FROM AUTHOR]

Alcohol operant self-administration paradigms are critical tools for studying the neural circuits implicated in both alcohol-seeking and consummatory behaviors and for understanding the neural basis underlying alcohol-use disorders. In this study, we investigate the predictive value of two operant models of oral alcohol self-administration in mice, one in which alcohol is delivered into a cup following nose-poke responses with no accurate measurement of consumed alcohol solution, and another paradigm that provides access to alcohol via a sipper tube following lever presses and where lick rate and consumed alcohol volume can be measured. The goal was to identify a paradigm where operant behaviors such as lever presses and nose pokes, as well as other tracked behavior such as licks and head entries, can be used to reliably predict blood alcohol concentration (BAC). All mice were first exposed to alcohol in the home cage using the "drinking in the dark" (DID) procedure for 3 weeks and then were trained in alcohol self-administration using either of the operant paradigms for several weeks. Even without sucrose fading or food pre-training, mice acquired alcohol self-administration with both paradigms. However, neither lever press nor nose-poke rates were good predictors of alcohol intake or BAC. Only the lick rate and consumed alcohol were consistently and significantly correlated with BAC. Using this paradigm that accurately measures alcohol intake, unsupervised cluster analysis revealed three groups of mice: high-drinking (43%), low-drinking (37%), and non-drinking mice (20%). High-drinking mice showed faster acquisition of operant responding and achieved higher BACs than low-drinking mice. Lick rate and volume consumed varied with the alcohol concentration made available only for high- and low-drinking mice, but not for non-drinking mice. In addition, high- and low-drinking mice showed similar patterns during extinction and significant cue-induced reinstatement of seeking. Only high-drinking mice showed insensitivity to quinine adulteration, indicating a willingness to drink alcohol despite pairing with aversive stimuli. Thus, this study shows that relying on active presses is not an accurate determination of drinking behavior in mice. Only paradigms that allow for accurate measurements of consumed alcohol and/or lick rate are valid models of operant alcohol self-administration, where compulsive-like drinking could be accurately determined based on changes in alcohol intake when paired with bitter-tasting stimuli. [ABSTRACT FROM AUTHOR]

Background: It is widely assumed that the amount of alcohol in the blood reflects the amount of alcohol consumed. However, several factors in addition to amount of alcohol consumed can influence blood alcohol concentration (BAC). This study examines the effect of alcohol dose, concentration, and volume on BAC in rats with a high‐alcohol‐drinking (HAD) phenotype. Methods: Study 1 examined the relationship between the amount of alcohol consumed and BAC. Alcohol‐naïve, male, HAD rats (N = 7) were given access to alcohol for 2 h/d for 9 consecutive days with food and water ad libitum. Alcohol intake and BAC were measured at 30, 60, and 90 minutes after onset of access. Study 2 examined the effects of altering alcohol dose, concentration, and volume on BAC (as measured by area under the curve). Alcohol‐naïve, male, HAD rats (N = 39) were infused, via an intragastric cannulus, with 1.16, 2.44, or 3.38 g alcohol/kg body weight (BW), produced by varying alcohol volume while holding concentration constant or by holding volume constant while varying concentration. Other rats were infused with 10, 15, or 20% v/v alcohol solutions while holding dose constant. Results: BAC was more strongly correlated with the ratio of alcohol intake (g/kg BW) to total fluid intake (mls) (R = 0.85 to 0.97, p < 0.05 to p < 0.001) than it was with the amount of alcohol consumed (g/kg BW) (R = 0.70 to 0.81, p < 0.05). No effect of alcohol dose was seen during the first hour following the onset of an alcohol infusion regardless of whether dose was achieved by altering alcohol volume or concentration. After 1 hour, higher alcohol doses were predictive of greater BACs. Conclusions: The fact that a 3‐fold difference in alcohol dose did not result in significant differences in BACs during the first 30 minutes after ingestion of alcohol has potentially important implications for interpretation of studies that measure alcohol‐sensitive end points during this time. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed whether college student (1) protective behavioral strategy (PBS) use differed between those who reached legal intoxication during their most recent drinking episode compared to those who did not reach the legal blood alcohol concentration (BAC) threshold, and (2) frequency of PBS use could explain the variance associated with BAC during the most recent drinking episode, above and beyond one's sex, age, and involvement in the Greek system.Design: Secondary data analysis of the American College of Health Association's National College Health Assessment.Setting: Forty-four distinct campuses were included.Participants: A total of 21479 college students were included.Measures: BAC and PBS were measured.Analysis: The data were analyzed by conducting both independent samples t-tests and a multiple regression model. Effect sizes are reported.Results: Participants who reached legal intoxication used PBS less frequently ( P < .001; d = 0.80). Frequency of PBS use had the strongest unique contribution to the regression model (β = -.315, P < .001), such that participants with higher BAC reported less frequent use of PBS.Conclusion: Interventions should seek to develop strategies that encourage college student use of PBS prior to, and during, drinking episodes. More frequent use of PBS can reduce intoxication as well as occurrence of alcohol-associated consequences. [ABSTRACT FROM AUTHOR]

Excessive alcohol consumption is a serious public health issue, because drunkenness affects critical judgment and self-control which could trigger violent and self-harm behavior, with thus a potential association between alcohol consumption and suicide deaths. The objective of the present study was to assess the association between alcohol consumption and suicide deaths in the city of Sao Paulo, Brazil, from 2011 to 2015, and its relationship with socio-demographic characteristics of the victims and the circumstances of the suicide. A cross-sectional retrospective study was conducted by collection of data from 1,700 suicide victims subjected to examination of blood alcohol concentration (BAC) from toxicology reports from the Institute of Legal Medicine of the State of Sao Paulo, Brazil. Alcohol was detected in blood samples of 30.2% of the victims and mean BAC levels were 1.73 ± 0.08 g/L. The mean age of the victims was 39.90 ± 0.75 years. The majority of the victims were male (74.6%) and the prevalence of positive BAC was higher amongst men (34.7%) than women (17.1%), p<0.05. The majority of the victims were white skinned (64.7%), but there was a higher proportion of victims with positive BAC among mulatto and black individuals, p<0.05. Hanging was the most prevalent suicide method in the sample (48.7%) and amongst men (55.4%), but amongst women it was jumping from a height (35%), p < 0.05. [ABSTRACT FROM AUTHOR]

Hangover due to alcohol consumption causes social and physical problems. There is a growing interest in edible insects worldwide. We have previously published a new technology to make hard mature silkworm, Bombyx mori , into edible form, steamed and freeze-dried mature silkworm larval powder (SMSP). In this study, AIN-76 or SMSP (0.1 and 1 g/kg rat body weight) containing diets in SD rats were pretreated for 2 weeks, and ethanol (3 g/kg rat body weight) was administered as an oral gavage and sacrificed after 3 hours. As a result, blood alcohol and aldehyde levels were significantly decreased in SMSP fed rats. In addition, liver injury markers, alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were significantly decreased in SMSP group compared to ethanol group. TNF-a, an inflammatory cytokine, and malondialdehyde (MDA), an oxidative stress marker, also showed a dosedependent decrease in the group receiving SMSP. Conclusively, consumption of SMSP not only reduced hangover induced by ethanol, but also decreased liver damage, oxidative stress, and inflammatory response. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to understand the social context and circumstances surrounding alcohol-impaired driving prior to fatal crash involvement for drivers with an illegal blood alcohol concentration (BAC ≥ 0.05 g/100 ml or 0.00 g/100 ml for restricted license holders).Methods: Coroners' case reports investigating fatal crashes in South Australia over a 3-year period (2008-2010) were examined. The personal and crash characteristics of drivers with an illegal BAC were compared with those who had a legal BAC. For each driver with an illegal BAC, information was recorded including characteristics of last trip, location and social context of alcohol consumption, quantity and type of alcohol consumed, BAC level, presence of drugs, perceived alcohol intoxication, and alcohol dependence. Official traffic offense records were also obtained.Results: Of the 284 fatal crashes included in the study, 34% (n = 95) involved a driver or rider with an illegal BAC. Prior to the crash, alcohol was most frequently consumed by drivers in rural areas, within private homes, and was part of normal social activities. Drivers recorded a high level of alcohol impairment, with a mean BAC of 0.173 g/100 ml and a level of alcohol dependence that was above the Australian national average (7.4 vs. 3.9%). In addition, 23% of drivers were known to be experiencing psychological stress at the time of the crash. The results also confirm that drink driving recidivism continues to be a significant problem, with 44% of drivers recording at least one prior alcohol driving offense.Conclusions: Alcohol-impaired driving continues to be a leading cause of fatal crashes. The popularity of drinking at home, particularly in rural areas, has implications for police enforcement strategies and suggests that drink driving interventions that focus on community values and looking after friends might be beneficial. Importantly, the study highlights the need for a broader holistic approach to reduce the high levels of alcohol consumption and alcohol dependence underlying drink driving behavior. [ABSTRACT FROM AUTHOR]

The binge drinking (BD) pattern of alcohol consumption is prevalent during adolescence, a period characterized by critical changes to the structural and functional development of brain areas related with memory and cognition. There is considerable evidence of the cognitive dysfunctions caused by the neurotoxic effects of BD in the not-yet-adult brain. Thus, the aim of the present study was to evaluate the effects of different blood alcohol concentrations (BAC) on memory during late adolescence (18–19 years old) in males and females with a history of BD. The sample consisted of 154 adolescents (67 males and 87 females) that were classified as refrainers if they had never previously drunk alcoholic drinks and as binge drinkers if they had drunk six or more standard drink units in a row for men or five or more for women at a minimum frequency of three occasions in a month, throughout the previous 12 months. After intake of a high acute dose of alcohol by binge drinkers or a control refreshment by refrainers and binge drinkers, subjects were distributed into four groups for each gender according to their BAC: BAC0-R (0 g/L, in refrainers), BAC0-BD (0 g/L, in binge drinkers), BAC1 (0.3 – 0.5 g/L, in binge drinkers) or BAC2 (0.54 – 1.1 g/L, in binge drinkers). The subjects’ immediate visual memory and working memory were then measured according to the Wechsler Memory Scale (WMS-III). The BAC1 group showed lower scores of immediate visual memory but not of working memory, while lower performance in both memories were found in the BAC2 group. Therefore, the brain of binge drinkers with moderate BAC could be employing compensatory mechanisms from additional brain areas to perform a working memory task adequately, but these resources would be undermined when BAC is higher (>0.5 g/L). No gender differences were found in BAC-related lower performance in immediate visual memory and working memory. In conclusion, immediate visual memory is more sensitive than working memory to the neurotoxic effects of alcohol in adolescent binge drinkers of both genders, being a BAC-related lower performance, and without obvious differences between males and females.

Driving under the influence of alcohol or drugs (DUI) is a crime or offence according to the laws of most countries. DUI increases the risk of traffic accidents as well as the severity and outcome of injuries that result from them. Some countries have a sophisticated control system to monitor DUI of alcohol in all traffic accidents. There is variation between different countries regarding the concept of driving under the influence of alcohol as well as the legal limits of Blood Alcohol Concentration (BAC) and the requirements to test the victims of accidents. This paper reviews the limit values for BAC in German traffic law (Administrative Offences Act), which stipulates a BAC value of 0.50 mg/g and a breath alcohol value of 0.25 mg/L as a marginal value for the application of punitive measures. German criminal law defines the minimum BAC values of relative unfitness to drive and absolute unfitness to drive as 0.3 mg/g and 1.10 mg/g, respectively (1.60 mg/g for cyclists).The minimum BAC values representing significant impairment and absolute impairment in criminal cases are 2.00 mg/g and 3.00 mg/g, respectively. Different penalties and legal consequences result according to the BAC level of an offender. In contrast, only eight out of twenty-two Arab countries recognise BAC limit values only in traffic laws. In Jordan, the BAC limit is 0.75 mg/g (0.08 g/dL).in the UAE, the BAC limit is 0.094 mg/g (0.01 g/dL), while Egyptian law does not recognise BAC values in the application of sanctions: the mere presence of alcohol in blood, regardless of its concentration and effect, is a sufficient and adequate condition for punishment. Accordingly, this study encourages lawmakers in Arab countries to define the limit values for BAC when investigating any crime in general and traffic offences in particular, in close cooperation with forensic doctors and toxicologists. It urges them to consider different BAC and their effects in relation to traffic offences. It also encourages them to take into account the principle of hierarchy in criminal liability when a crime is committed under the influence of alcohol.

Aims: The aim of this study was to characterize positive blood alcohol among patients injured at work, and to compare the severity of injury and outcome of blood alcohol concentration (BAC) positive and negative patients. Settings and Design: A retrospective cohort study was performed at a Level 1 academic trauma center. Patients injured at work between 01/01/07 and 01/01/12 and admitted with positive (BAC+) vs negative (BAC-) blood alcohol were compared using bivariate analysis. Results: Out of 823, 319 subjects were tested for BAC (38.8%), of whom 37 were BAC+ (mean 0.151 g/dL, range 0.015-0.371 g/dL). Age (41 years), sex (97.2% men), race, intensive care unit (ICU) and hospital length of stay (LOS), and mortality were similar between groups. Nearly half of BAC+ cases were farming injuries (18, 48.6%): Eight involved livestock, five involved all-terrain vehicles (ATVs), three involved heavy equipment, one fell, and one had a firearm injury. Eight (21.6%) were construction site injuries involving falls from a roof or scaffolding, five (13.5%) were semi-truck collisions, four (10.8%) involved falls from a vehicle in various settings, and two (5.4%) were crush injuries at an oilfield. BAC+ subjects were less likely to be injured in construction sites and oilfields, including vehicle-related falls (2.3 vs 33.9%, P < 0.0001). Over half of BAC+ (n = 20, 54%) subjects were alcohol dependent; three (8.1%) also tested positive for cocaine on admission. No BAC+ subjects were admitted to rehabilitation compared to 33 (11.7%) of BAC- subjects. Workers′ compensation covered a significantly smaller proportion of BAC+ patients (16.2 vs 61.0%, P < 0.0001). Conclusions: Alcohol use in the workplace is more prevalent than commonly suspected, especially in farming and other less regulated industries. BAC+ is associated with less insurance coverage, which probably affects resources available for post-discharge rehabilitation and hospital reimbursement.