Alternative Sources of Alcohol found on the Breath but not found in the BAC

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Brand Name

(All items TM)

Manufacturer

Percent Alcohol

(%)

Listerine Mouthwash

Warner-Lambert

26.9

Scope Mouthwash

Procter & Gamble

16.6

Nyquil

Richardson-Vicks

25.0

Benadryl Elixir antihistamine

Parke-Davis

5.3

Cepacol

Marion Merrell Dow

14.0

Triaminic Expectorant

Sandoz

5.0

Sudafed Cough Syrup

Burroughs-Wellcome

2.4

Geritol Liquid

Smith Kline Beecham

12.0

Plax Mouthwash

Pfizer

7.5

ACT Mouthwash

Johns & Johnson

7.0

Viadent Mouthwash

Viadent, Inc.

10.0

Hy-Top

Federated Foods, Inc.

18.9

Alcoholic Beverages- Sources of alcohol in blood, breath, or urine:

Different beverages contain different amounts of alcohol. For example, wine generally is 12% alcohol, beer is about 4%. Usually, the amount of alcohol in a beverage is listed as "proof" or percentage. Alcohol proof is twice the percentage. Thus, a 100 proof beverage contains 50% alcohol, and pure (100%) ethanol is 200 proof. The origin of the term "proof" comes from the anecdotal tale of early California miners testing the beverage to ensure that the beverage was not watered down. Since gun powder soaked in whiskey will burn if it is at least 50%, miners would test the whiskey to determine if they had "100% proof" that the beverage was not watered down.

Many scientists work with "drink equivalents." Since wine is approximately 12%, and beer is approximately 4%, it is logical to state that 4 ounces ("one glass") of wine is equivalent in alcohol content to 12 ounces of beer. An additional equivalent is that 1.25 ounces of 80 proof liquor is equivalent to 1.0 ounces of 100 proof liquor. In court, an attorney will often ask how many drinks the defendant would have to consume to be a particular blood alcohol level. Using the drink equivalent method, an estimate can be provided in layman's terms. For example, stating that a 180 pound man will consume 4 beers, or 4 glasses of wine, to reach a 0.08% is an easy concept to comprehend.

Bottles and measurements in a drink can vary. For example, a drink may have either one shot of 80 proof liquor, or one ounce of 100 proof. The amount of ethanol is the same (80 x 1.25 = 1 x 100). Other conversion factors are beneficial to consider: a shot is approximately 1.25 ounces, a pint is 16 ounces, a fifth is 25.6 shots, and a quart is 32 shots.

Alcohol Percentages in Different Beverages

Type of Beverage

General/Specific Beverage

Percentage alcohol

Beer (Lagers)

 

3.2-5%

 

Coors

5%

 

Budweiser

4.9%

 

Heineken

5%

 

Michelob

5%

 

St. Pauli Girl

4.9%

 

Tecate

4.1%

Beer (Ales and Stouts)

  
 

Bass Ale

5.1%

 

Pete's Wicked Ale

5.3%

 

Guinness Extra Stout

4.1%

 

Anchor Steam Ale

4.9%

Beer (Light)

  
 

Amstel Light

3.6%

 

Coors Light

4.2%

 

Bud Light

4.2%

 

Miller Lite

4.5%

Wine (fortified)

  
 

Madeira

18%

 

Sherry

17-20%

 

Vermouth

16-18%

 

Aperitifs

16-19%

 

Sake

15-16%

Distilled Spirits

  
 

Rum

40-80%

 

Vodka

35-50%

 

Tequila

40%

 

Brandy

35-45%

 

Gin

40-47%

 

Schnapps

20-50%

 

Whiskey (Scotch)

40-46%

   

Alcohol concentration in the blood can be expressed in a variety of ways. The most common is weight per volume, or grams/volume of blood. In the United States, this is commonly designated as grams/100 milliliters of blood, gram %, %, or percent (W/V). However, the conversion factors need to be applied when reviewing international studies or clinical tests.

Blood Alcohol Conversions

BAC Concentration

0.08% Equivalents

0.10% Equivalents

Percent (%)

0.08

0.10

Grams per 100 milliliter g/100 mL

0.08

0.10

Milligrams per gram (mg/g)

0.76

0.95

Millimoles per liter (mmol/L)

17.3

21.7

Milligrams/deciliter (mg/dL)

80

100

Grams/Liter (g/L)

.80

1.0

When converting volume to weight, the specific gravity of ethanol must be considered. The specific gravity (weight/volume) of ethanol is 1.05. Thus, when concentrations are expressed in terms of grams, the conversion factor of 1.05 must be used to express the concentration in volume. For example, converting 0.08% to mg/g requires that 0.08% be divided by 1.05. When working with millimoles, the molecular weight of ethanol, 46 moles, needs to be considered. Converting .80 g/L to mmol/L requires the multiplication of .80 by 46 and 1000 (for millimoles).

Blood alcohol tests performed in clinical settings usually use mg/dL as the units of measure. When medical records are being reviewed, special care must be exercised to determine the units designated by the hospital, and to convert the concentration to the legal units of measure.

Alcohol's Affects on Various Bodily Organs/Functions:

Blood Constituents

Alcohol affects the production of red and white blood cells. Lowered red blood cell counts leads to anemia, and a lower production of white blood cells can lead to an increased incidence of infections.

Alcohol can elevate uric acid, free fatty acids and corpuscular volume in the blood.

Effects on the blood affect any and all organs that receive blood supply. Of special concern is the lowered levels of thiamine that can occur when dietary needs are not met. Thiamine is necessary to form new blood vessels and keep old vessels from leaking. When capillaries in the brain leak blood into the brain tissue, the resulting encephalopathy can lead to irreparable brain damage.

The Brain

Brain functions rely on the communication of one nerve cell to another and the transmission of signals from one part of the brain to another. The human nervous system is made up of over 100 billion nerve cells. Nerve cells transmit messages from one to another by relaying the nerve impulse down the axon to the nerve terminal. At the nerve terminal, several vesicles of chemical substances are released out of the end of the nerve "button" across a narrow space called the synaptic gap, and slot into receptor sites at the next nerve cell. When enough receptor sites are filled, the message is transmitted. Most active compounds modify chemical synaptic transmission. Some affect the storage, release and metabolism of the transmitter in the "button." Other drugs influence the movement in the synaptic cleft or block the action on the receiving neuron. Alcohol is thought to produce some of its effects by interfering with this signal transduction. In addition, alcohol's effects on genes may also alter proteins involved in signal transduction, and play an important role in intoxication and alcohol dependence.

Many alcoholics may show signs of intellectual impairment and decreased functioning. Individuals with pre-existing brain damage may show confusion lasting weeks. [Graff-Radford, N. R., Heaton, R. K., Earnest, M.P. et al., Brain atrophy and neuropsychological impairment in young alcoholics, Journal of Studies on Alcohol, 43:859-868, 1982.]

Some brain conditions are more serious. The Wernicke-Korsakoff syndrome, which can occur from alcohol-induced dietary deficiencies, can manifest as dizziness, disorientation, and confusion. When these conditions are not treated the subject develops Korsakoff psychosis, which destroys short term memory. Marchiafava-Bignami syndrome also results in reduced intelligence and confusion, hallucination, and tremors. [http://alcoholresearch.lsuhsc.edu/Wernicke-Korsakoff.asp.]

The Heart

Low and moderate levels of alcohol have been shown to reduce some risk from coronary artery disease. Red wines decrease the clotting of the blood, which can reduce strokes. Small amounts of alcohol, such as one drink a day, have also been shown to increase NDL level, the "good" cholesterol.

However, higher doses can cause high blood pressure and heart enlargement. The heart muscle cells can become weakened and be unable to effectively pump the blood. When this happens, other organs are affected.

Gall Bladder

Alcohol lowers gall bladder contractile response and suppresses bile flow and bile acid secretion rate.

However, alcohol may play a key role in inhibiting the formation of gall stones by inhibiting the precipitation of calcium salts in the bile.

Kidneys

Alcohol changes the structure and function of the kidneys, and can interfere with the make up of fluid and salts in the body.

The proper chemical levels of water, sodium, potassium, calcium, and phosphate are vital in a well-functioning body. The kidneys regulate the amounts and concentrations of these substances.

Alcohol is also a diuretic and increases urine volume. Frequent urination changes the electrolyte balance in the body.

Liver

Alcohol abuse may cause cirrhosis, the formation of scar tissue and fiber deposition around the central veins, which interferes with functioning.

Fatty Liver Disease, the increase of lipids inside the liver cell, is also prevalent among people who use alcohol regularly.

In addition, alcoholic hepatitis can cause significant inflammation of the liver and irreparable damage. Cirrhosis occurs in about one in five alcoholics. [Lieber, C.S., Liver Adaptation and Injury in Alcoholism, New England Journal of Medicine, 2:88; 356-362, 1973.]

Lungs

Alcohol plays a part in the body's natural response to lung infection. The human body normally produces cytokine production when an infection is detected. Alcohol inhibits this chemical response to infection, thus increasing the lung's susceptibility to infections.

Alcohol increases the chance for adult respiratory distress syndrome, makes the lung liable to injury and infection, and lowers glutathione (an antioxidant) in the alveolar epithelial levels.

Pancreas

Alcohol lowers the amount of digestive enzymes released from the pancreas. Binge alcohol drinking is a common cause of pancreatitis, leading to the pancreas becoming inflamed. Once inflamed, the pancreas is more susceptible to pancreatitis, which further results in a lack of insulin production.

Stomach

Stomach lining inflammation, bleeding stomach ulcers, and acid secretion ability are only a few of the stomach problems associated with alcohol abuse.

Because the stomach acid secretion is lower, the drinker may become more susceptible to infection in the upper small intestine due to the stomach's inability to kill the bacteria in food products. Stomach contraction is also affected by alcohol; high concentrations slow down contractions and thus stomach emptying time. Increased rates of cancer of the esophagus and stomach all correlate to alcohol abuse. [Haukulinen, T., Lehtenamk, L., Lentonene, M., et al., Cancer Morbidity Among Two Male Cohorts, Journal of the National Cancer Institute 52:1711-1082, 1974.]

Repeated vomiting and esophageal reflux can result in a tear in the stomach lining or the esophagus. Stomach acids and fluids wear away at the esophageal lining, leading to tears and Mallory-Weiss syndrome or Boerhaave syndrome.

Procreation and Childbirth

Consumption of alcohol during pregnancy has a profound affect on the development of the unborn child, especially during the fourth to eighth weeks of gestation. There are many effects that can occur, including Fetal Alcohol Syndrome (FAS). Children born with FAS exhibit low birth weight, retarded growth, central nervous system damage, and physical deformities (generally to the face/head).