Fast Five Quiz: Alcohol Use Facts vs Fiction

Richard H. Sinert, DO

Disclosures

January 21, 2021

Ethanol is rapidly absorbed across both the gastric mucosa and the small intestine, reaching a peak concentration 20-60 minutes after ingestion. As a general rule, serum ethanol levels less than 25 mg/dL are associated with a sense of warmth and well-being. Euphoria and decreased judgment occur at levels between 25 and 50 mg/dL. Incoordination, decreased reaction time/reflexes, and ataxia occur at levels of 50-100 mg/dL. Cerebellar dysfunction (eg, ataxia, slurred speech, nystagmus) is common at levels of 100-250 mg/dL. Coma can occur at levels greater than 250 mg/dL, whereas respiratory depression, loss of protective reflexes, and death occur at levels greater than 400 mg/dL.

The table below indicates the most common effects seen at different blood alcohol concentration levels, although a wide variation exists among individuals, and symptoms overlap among different blood alcohol concentration levels.

  • 0.01%-0.05%: No loss of coordination, slight euphoria, loss of shyness

  • 0.04%-0.06%: Well-being feeling, relaxation, lower inhibitions, minor impairment of reasoning and memory, euphoria

  • 0.07%-0.09%: Slight impairment of balance, speech, vision, reaction time, and hearing; euphoria; judgment and self-control reduced; caution, reasoning, and memory impaired

  • 0.10%-0.125%: Significant impairment of motor coordination and loss of good judgment; slurred speech; balance, vision, reaction time, and hearing impaired; euphoria

  • 0.13%-0.15%: Gross motor impairment and lack of physical control, blurred vision and major loss of balance, euphoria reduced, dysphoria beginning

  • 0.16%-0.20%: Dysphoria (anxiety, restlessness) predominate, nausea, appearance of a "sloppy drunk"

  • 0.25%: Needs assistance in walking, total mental confusion, dysphoria with nausea and some vomiting

  • 0.30%: Loss of consciousness

  • 0.40% and up: Onset of coma, possible death due to respiratory depression/arrest

Gastric decontamination is rarely necessary for any alcohol poisoning. An exception to this may be a patient who presents immediately after ingestion of a toxic alcohol if one might reasonably expect to be able to recover a significant amount of the toxin via aspiration through a nasogastric tube.

Read more about alcohol toxicity.

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