Intoxication is a defense available to criminal defendants on the basis that, A common example is the crime of assault, which requires an intent to cause harm. so intoxicated that he was unable to form an “intent to commit a crime therein. 4) a defense in a criminal case in which the claim is made by the defendant that he/she was too intoxicated to form an intent to commit the crime or to know what. Alcohol intoxication, also known as drunkenness or alcohol poisoning, is the negative behavior Alcohol is then broken down at a rate of about mmol/L ( 15 mg/dL) per . Administer the vitamin thiamine to prevent Wernicke-Korsakoff syndrome, which can cause a seizure (more usually a treatment for chronic alcoholism.
intoxication? of form Can any create it
When a person indulges in alcohol, the effects take time to become apparent. Depending on the amount consumed, how quickly it is consumed, and whether or not the person has eaten before drinking, there are predictable stages of alcohol intoxication through which the individual will progress as drinking continues.
Do You Want to Stop Drinking? From the legal limit to drive and feeling buzzed to the extremes of alcohol poisoning and death. According to the website Drinking and Driving , this will be the BAC level of an average man after consuming no more than 1 drink over one hour; for women, this is also generally true, except for particularly small individuals pounds or under.
Nevertheless, at concentrations in this range, there are tests that can still determine whether or not alcohol has been consumed. In addition, depending on the individual, judgment and reaction time may be very slightly impaired.
The second stage of intoxication, referred to as euphoria , occurs between 0. In this stage, the individual gets animated, talkative, and self-confident. Inhibitions also begin to decline. Based on information from the National Highway Traffic Safety Administration , attention and judgment decline further, short-term memory and perception are affected, and the person may have a trouble maintaining physical control.
As a note, a BAC of 0. Legally intoxicated, the man in this stage has probably had drinks within one hour, or drinks for a woman.
The person begins to experience emotional instability, and loss of coordination is profound. Other symptoms at this stage include:. A BAC level of 0. The confusion in this stage results in emotional upheaval and extremes. Those in this stage of intoxication are highly likely to forget things that happen to or around them.
In addition, a person may not be able to feel pain. This makes the individual more susceptible to severe injury during this stage of intoxication. Stupor can indicate that alcohol poisoning has occurred.
Results of alcohol poisoning include:. If a person has reached this stage, medical assistance is necessary. The individual could potentially choke on vomit or have breathing problems at this stage, because the gag reflex and respiration are impaired as well. Blood Alcohol Concentrations and Blackouts. Drinking large quantities of alcohol often precedes blackouts, but several other factors also appear to play important roles in causing such episodes of memory loss.
Among the factors that preceded blackouts were gulping drinks and drinking on an empty stomach, each of which leads to a rapid rise in BAC. Subsequent research provided additional evidence suggesting a link between blackouts and rapidly rising BACs.
Goodwin and colleagues examined the impact of acute alcohol exposure on memory formation in a laboratory setting. The author recruited 10 male subjects for the project, all but one through the unemployment office in St. Most subjects met diagnostic criteria for alcoholism and half had a history of frequent blackouts. The men were asked to consume roughly 16 to 18 ounces of 86—proof bourbon in approximately 4 hours. Subjects were asked to recall details regarding these stimuli 2 minutes, 30 minutes, and 24 hours after the stimuli were shown.
Half of the subjects reported no recall for the stimuli or their presentation 30 minutes and 24 hours after the events, though most seemed to recall the stimuli 2 minutes after presentation.
Lack of recall for the events 24 hours later, while sober, represents clear experimental evidence for the occurrence of blackouts. The fact that subjects could remember aspects of the events 2 minutes after they occurred but not 30 minutes or 24 hours afterward provides compelling evidence that the blackouts stemmed from an inability to transfer information from short—term to long—term storage.
For all but one subject in the blackout group, memory impairments began during the first few hours of drinking, when BAC levels were still rising. The average peak BAC in this group, which was roughly 0. In a similar study, Ryback examined the impact of alcohol on memory in seven hospitalized alcoholics given access to alcohol over the course of several days. All subjects were White males between the ages of 31 and Blackouts occurred in five of the seven subjects, as evidenced by an inability to recall salient events that occurred while drinking the day before e.
Estimates of BAC levels during blackout periods suggested that they often began at levels around 0. The duration of blackouts ranged from 9 hours to 3 days. Based on his observations, Ryback concluded that a key predictor of blackouts was the rate at which subjects consumed their drinks.
The two subjects who did not black out, despite becoming extremely intoxicated, experienced slow increases in blood alcohol levels. Blackouts Among Social Drinkers. Most of the research conducted on blackouts during the past 50 years has involved surveys, interviews, and direct observation of middle—aged, primarily male alcoholics, many of whom were hospitalized.
Researchers have largely ignored the occurrence of blackouts among young social drinkers, so the idea that blackouts are an unlikely consequence of heavy drinking in nonalcoholics has remained deeply entrenched in both the scientific and popular cultures. Yet there is clear evidence that blackouts do occur among social drinkers. Knight and colleagues observed that 35 percent of trainees in a large pediatric residency program had experienced at least one blackout. Similarly, Goodwin reported that 33 percent of the first—year medical students he interviewed acknowledged having had at least one blackout.
In a study of 2, Finnish males, Poikolainen found that 35 percent of all males surveyed had had at least one blackout in the year before the survey. As might be expected given the excessive drinking habits of many college students Wechsler et al. White and colleagues c recently surveyed undergraduates regarding their experiences with blackouts. Fifty—one percent of the students who had ever consumed alcohol reported blacking out at some point in their lives, and 40 percent reported experiencing a blackout in the year before the survey.
Of those who had consumed alcohol during the 2 weeks before the survey, 9. Students in the study reported that they later learned that they had participated in a wide range of events they did not remember, including such significant activities as vandalism, unprotected intercourse, driving an automobile, and spending money.
During the 2 weeks preceding the survey, an equal percentage of males and females experienced blackouts, despite the fact that males drank significantly more often and more heavily than females. This outcome suggests that at any given level of alcohol consumption, females—a group infrequently studied in the literature on blackouts—are at greater risk than males for experiencing blackouts. The greater tendency of females to black out likely arises, in part, from well—known gender differences in physiological factors that affect alcohol distribution and metabolism, such as body weight, proportion of body fat, and levels of key enzymes.
There also is some evidence that females are more susceptible than males to milder forms of alcohol—induced memory impairments, even when given comparable doses of alcohol Mumenthaler et al. In a subsequent study, White and colleagues interviewed 50 undergraduate students, all of whom had experienced at least one blackout, to gather more information about the factors related to blackouts.
As in the previous study, students reported engaging in a range of risky behaviors during blackouts, including sexual activity with both acquaintances and strangers, vandalism, getting into arguments and fights, and others. During the night of their most recent blackout, most students drank either liquor alone or in combination with beer.
Only 1 student out of 50 reported that the most recent blackout occurred after drinking beer alone. On average, students estimated that they consumed roughly Males reported drinking significantly more than females, but they did so over a significantly longer period of time.
As a result, estimated peak BACs during the night of the last blackout were similar for males 0. As Goodwin observed in his work with alcoholics b , fragmentary blackouts occurred far more often than en bloc blackouts, with four out of five students indicating that they eventually recalled bits and pieces of the events. Roughly half of all students 52 percent indicated that their first full memory after the onset of the blackout was of waking up in the morning, often in an unfamiliar location.
Many students, more females 59 percent than males 25 percent , were frightened by their last blackout and changed their drinking habits as a result. Use of Other Drugs During Blackouts. Alcohol interacts with several other drugs, many of which are capable of producing amnesia on their own. Alcohol enhances the effects of benzodiazepines for a review, see Silvers et al.
Thus, combining these compounds with alcohol could dramatically increase the likelihood of experiencing memory impairments. Similarly, the combination of alcohol and THC, the primary psychoactive compound in marijuana, produces greater memory impairments than when either drug is given alone Ciccocioppo et al.
Indeed, based on interviews with heavy—drinking young adults mean age 22 , Hartzler and Fromme b concluded that en bloc blackouts often arise from the combined use of alcohol and other drugs. White and colleagues observed that, among 50 undergraduate students with a history of blackouts, only 3 students reported using other drugs during the night of their most recent blackout, and marijuana was the drug in each case.
In classic studies of hospitalized alcoholics by Goodwin and colleagues a,b , 36 out of the patients interviewed indicated that they had never experienced a blackout. In some ways, the patients who did not experience blackouts are as interesting as the patients who did.
What was it about these 36 patients that kept them from blacking out, despite the fact that their alcoholism was so severe that it required hospitalization?
Although they may actually have experienced blackouts but simply were unaware of them, there may have been something fundamentally different about these patients that diminished their likelihood of experiencing memory impairments while drinking.
In support of this possibility, a recent study by Hartzler and Fromme a suggests that people with a history of blackouts are more vulnerable to the effects of alcohol on memory than those without a history of blackouts. These authors recruited college students, half of whom had experienced at least one fragmentary blackout in the previous year. While sober, members of the two groups performed comparably in memory tasks.
However, when they were mildly intoxicated 0. There are two possible interpretations for these data, both of which support the hypothesis that some people are more susceptible to blackouts than others.
One plausible interpretation is that subjects in the fragmentary blackout group always have been more vulnerable to alcohol—induced memory impairments, which is why they performed poorly during testing under alcohol, and why they are members of the blackout group in the first place.
A second interpretation is that subjects in the blackout group performed poorly during testing as a result of drinking enough in the past to experience alcohol—induced memory impairments. In other words, perhaps their prior exposure to alcohol damaged the brain in a way that predisposed them to experiencing future memory impairments.
This latter possibility is made more likely by recent evidence that students who engage in repeated episodes of heavy, or binge, drinking are more likely than other students to exhibit memory impairments when they are intoxicated Weissenborn and Duka Similar results have been observed in animal studies White et al.
The argument for an inherent vulnerability to alcohol—induced memory impairments, including blackouts, is strengthened by two recent studies. In an impressive longitudinal study, Baer and colleagues examined the drinking habits of pregnant women in and , and then studied alcohol use and related problems in their offspring at seven different time points during the following 21 years. In addition, a recent report by Nelson and colleagues suggests that there might actually be a genetic contribution to the susceptibility to blackouts, indicating that some people simply are built in a way that makes them more vulnerable to alcohol—induced amnesia.
As discussed in the section below on the potential brain mechanisms underlying alcohol—induced amnesia, it is easy to imagine that the impact of alcohol on brain circuitry could vary from person to person, rendering some people more sensitive than others to the memory—impairing effects of the drug. During the first half of the 20th century, two theoretical hurdles hampered progress toward an understanding of the mechanisms underlying the effects of alcohol on memory. More recent research has cleared away these hurdles, allowing for tremendous gains in the area during the past 50 years.
In the s, following observations of an amnesic patient known as H. In , large portions of H. Although the frequency and severity of H. He still was able to learn basic motor skills, keep information active in short—term memory for a few seconds or more if left undistracted, and remember episodes of his life from long ago, but he was unable to form new long—term memories for facts and events. The pattern of H. This strongly suggests that the transfer of information into long—term storage actually takes place over several years, with the hippocampus being necessary for its retrieval for the first year or so.
Subsequent research with other patients confirmed that the hippocampus, an irregularly shaped structure deep in the forebrain, is critically involved in the formation of memories for events see figure 2 for a depiction of the brain, with the hippocampus and other relevant structures highlighted.
He survived but showed memory impairments similar to those exhibited by H. Upon his death, histology revealed that the loss of blood to R. Hippocampal CA1 pyramidal cells assist the hippocampus in communicating with other areas of the brain. The hippocampus receives information from a wide variety of brain regions, many of them located in the tissue, called the neocortex, that blankets the brain and surrounds other brain structures.
The hippocampus somehow ties information from other brain regions together to form new autobiographical memories, and CA1 pyramidal cells send the results of this processing back out to the neocortex. As is clear from patient R. Figure 2 The human brain, showing the location of the hippocampus, the frontal lobes, and the medial septum.
Until recently, alcohol was assumed to affect the brain in a general way, simply shutting down the activity of all cells with which it came in contact.
The pervasiveness of this assumption is reflected in numerous writings during the early 20th century. During the s, researchers hypothesized that alcohol depressed neural activity by altering the movement of key molecules in particular, lipids in nerve cell membranes. This change then led to alterations in the activity of proteins, including those that influence communication between neurons by controlling the passage of positively or negatively charged atoms i.
Substantial evidence now indicates that alcohol selectively alters the activity of specific complexes of proteins embedded in the membranes of cells i. In some cases, only a few amino acids appear to distinguish receptors that are sensitive to alcohol from those that are not Peoples and Stewart It remains unclear exactly how alcohol interacts with receptors to alter their activity.
Alcohol, Memory, and the Hippocampus. More than 30 years ago, both Ryback and Goodwin and colleagues a speculated that alcohol might impair memory formation by disrupting activity in the hippocampus.
This speculation was based on the observation that acute alcohol exposure in humans produces a syndrome of memory impairments similar in many ways to the impairments produced by hippocampal damage. Specifically, both acute alcohol exposure and hippocampal damage impair the ability to form new long—term, explicit memories but do not affect short—term memory storage or, in general, the recall of information from long—term storage.
Research conducted in the past few decades using animal models supports the hypothesis that alcohol impairs memory formation, at least in part, by disrupting activity in the hippocampus for a review, see White et al. Such research has included behavioral observation; examination of slices of and brain tissue, neurons in cell culture, and brain activity in anesthetized or freely behaving animals; and a variety of pharmacological techniques.
As mentioned above, damage limited to the CA1 region of the hippocampus dramatically disrupts the ability to form new explicit memories Zola—Morgan et al. In rodents, the actions of CA1 pyramidal cells have striking behavioral correlates. Some cells tend to discharge electrical signals that result in one cell communicating with other cells i. The location differs for each cell. For instance, while a rat searches for food on a plus—shaped maze, one pyramidal cell might generate action potentials primarily when the rat is at the far end of the north arm, while another might generate action potentials primarily when the rat is in the middle of the south arm, and so on.
Collectively, the cells that are active in that particular environment create a spatial, or contextual map that serves as a framework for event memories created in that environment. Given that CA1 pyramidal cells are critically important to the formation of memories for facts and events, and the clear behavioral correlates of their activity in rodents, it is possible to assess the impact of alcohol on hippocampal output in an intact, fully functional brain by studying these cells.
In recent work with awake, freely behaving rats, White and Best showed that alcohol profoundly suppresses the activity of pyramidal cells in region CA1.
Figure 3 displays the activity of an individual CA1 pyramidal cell. The activity—which corresponds to the middle portion of the lower left arm of the maze—is shown before alcohol administration A , 45 to 60 minutes after alcohol administration B , and 7 hours after alcohol administration C.
The dose of alcohol used in the testing session was 1. A corresponding BAC in humans would be twice the legal driving limit in most States. Neural activity returned to near—normal levels within about 7 hours of alcohol administration.
Figure 3 Alcohol suppresses hippocampal pyramidal cell activity in an awake, freely behaving rat. The figure shows the activity of an individual pyramidal cell before alcohol administration baseline , 45 to 60 minutes after alcohol administration, and 7 hours after alcohol administration 1. Each frame in the figure shows the firing rate and firing location of the cell across a 15—minute block of time during which the rat was foraging for food on a symmetric, Y—shaped maze.
White pixels are pixels in which the cell fired at very low rates, and darker colors represent higher firing rates see key to the right of figure. As is clear from a comparison of activity during baseline and 45 to 60 minutes after alcohol administration, the activity of the cell was essentially shut off by alcohol.
Neural activity returned to near normal levels within roughly 7 hours after alcohol administration. White and Best administered several doses of alcohol in this study, ranging from 0. Only one of the experiments is represented in figure 3. They found that the dose affected the degree of pyramidal cell suppression. The dose—dependent suppression of CA1 pyramidal cells is consistent with the dose—dependent effects of alcohol on episodic memory formation.
Alcohol and Hippocampal Long—Term Potentiation. In addition to suppressing the output from pyramidal cells, alcohol has several other effects on hippocampal function. For instance, alcohol severely disrupts the ability of neurons to establish long—lasting, heightened responsiveness to signals from other cells Bliss and Collinridge This heightened responsiveness is known as long—term potentiation LTP.
Because researchers have theorized that something like LTP occurs naturally in the brain during learning for a review, see Martin and Morris , many investigators have used LTP as a model for studying the neurobiology underlying the effects of drugs, including alcohol, on memory.
In a typical LTP experiment, two electrodes A and B are lowered into a slice of hippocampal tissue kept alive by bathing it in oxygenated artificial cerebral spinal fluid ACSF. A small amount of current is passed through electrode A, causing the neurons in this area to send signals to cells located near electrode B. Electrode B then is used to record how the cells in the area respond to the incoming signals. This response is the baseline response.
Next, a specific pattern of stimulation intended to model the pattern of activity that might occur during an actual learning event is delivered through electrode A. When the original stimulus that elicited the baseline response is delivered again through electrode A, the response recorded at electrode B is larger i. In other words, as a result of the patterned input, cells at position B now are more responsive to signals sent from cells at position A.
The potentiated response often lasts for an extended period of time, hence the term long—term potentiation. If sufficient alcohol is present in the ACSF bathing the slice of hippocampal tissue when the patterned stimulation is given, the response recorded later at position B will not be larger than it was at baseline that is, it will not be potentiated.
And, just as alcohol tends not to impair recall of memories established before alcohol exposure, alcohol does not disrupt the expression of LTP established before alcohol exposure. One of the key requirements for the establishment of LTP in the hippocampus is that a type of signal receptor known as the NMDA 2 receptor becomes activated.
Alcohol interferes with the activation of the NMDA receptor, thereby preventing the influx of calcium and the changes that follow Swartzwelder et al. This is believed to be the primary mechanism underlying the effects of alcohol on LTP, though other transmitter systems probably are also involved Schummers and Browning Indirect Effects of Alcohol on Hippocampal Function.
Like other brain regions, the hippocampus does not operate in isolation. Information processing in the hippocampus depends on coordinated input from a variety of other structures, which gives alcohol and other drugs additional opportunities to disrupt hippocampal functioning.
One brain region that is central to hippocampal functioning is a small structure in the fore brain known as the medial septum Givens et al. The medial septum sends rhythmic excitatory and inhibitory signals to the hippocampus, causing rhythmic changes in the activity of hippocampal pyramidal cells.
In electroencephalograph recordings, this rhythmic activity, referred to as the theta rhythm, occurs within a frequency of roughly 6 to 9 cycles per second hertz in actively behaving rats. The theta rhythm is thought to act as a gatekeeper, increasing or decreasing the likelihood that information entering the hippocampus from cortical structures will be processed Orr et al.
For more information on the role of electrophysiology in diagnosing alcohol problems, see the article in this issue by Porjesz and Begleiter. Information entering the hippocampus when pyramidal cells are slightly excited i. Manipulations that disrupt the theta rhythm also disrupt the ability to perform tasks that depend on the hippocampus Givens et al. Alcohol disrupts the theta rhythm in large part by suppressing the output of signals from medial septal neurons to the hippocampus Steffensen et al.
Given the powerful influence that the medial septum has on information processing in the hippocampus, the impact of alcohol on cellular activity in the medial septum is likely to play an important role in the effects of alcohol on memory. Indeed, in rats, putting alcohol directly into the medial septum alone produces memory impairments Givens and McMahon The hippocampus is not the only structure involved in memory formation. A host of other brain structures also are involved in memory formation, storage, and retrieval Eichenbaum Recent research with humans has yielded compelling evidence that key areas of the frontal lobes play important roles in short—term memory and the formation and retrieval of long—term explicit memories e.
Damage to the frontal lobes leads to profound cognitive impairments, one of which is a difficulty forming new memories. Recent evidence suggests that memory processes in the frontal lobes and the hippocampus are coordinated via reciprocal connections Wall and Messier ; Shastri , raising the possibility that dysfunction in one structure could have deleterious effects on the functioning of the other.
Considerable evidence suggests that chronic alcohol use damages the frontal lobes and leads to impaired performance of tasks that rely on frontal lobe functioning Kril and Halliday ; Moselhy et al. Although much is known about the effects of chronic i. Compelling evidence indicates that acute alcohol use impairs the performance of a variety of frontal lobe—mediated tasks, like those that require planning, decisionmaking, and impulse control Weissenborn and Duka ; Burian et al.
Research also suggests that baseline blood flow to the frontal lobes increases during acute intoxication Volkow et al. Although the exact meaning of these changes remains unclear, the evidence suggests that acute intoxication alters the normal functioning of the frontal lobes.
Future research is needed to shed more light on this important question. In particular, research in animals will be an important supplement to studies in humans, affording a better understanding of the underlying prefrontal circuitry involved in alcohol—induced memory impairment. As detailed in this brief review, alcohol can have a dramatic impact on memory.
Alcohol primarily disrupts the ability to form new long—term memories; it causes less disruption of recall of previously established long—term memories or of the ability to keep new information active in short—term memory for a few seconds or more.
At low doses, the impairments produced by alcohol are often subtle, though they are detectable in controlled conditions. Large quantities of alcohol, particularly if consumed rapidly, can produce a blackout, an interval of time for which the intoxicated person cannot recall key details of events, or even entire events. En bloc blackouts are stretches of time for which the person has no memory whatsoever. Blackouts are much more common among social drinkers than previously assumed and should be viewed as a potential consequence of acute intoxication regardless of age or whether one is clinically dependent upon alcohol.
Tremendous progress has been made toward an understanding of the mechanisms underlying alcohol—induced memory impairments. Alcohol disrupts activity in the hippocampus via several routes—directly, through effects on hippocampal circuitry, and indirectly, by interfering with interactions between the hippocampus and other brain regions.
The impact of alcohol on the frontal lobes remains poorly understood, but probably plays an important role in alcohol—induced memory impairments. Modern neuroimaging techniques, such as positron emission tomography PET and functional magnetic resonance imaging fMRI , provide incredible opportunities for investigating the impact of drugs like alcohol on brain function during the performance of cognitive tasks.
The use of these techniques will no doubt yield important information regarding the mechanisms underlying alcohol—induced memory impairments in the coming years. Memory formation and retrieval are highly influenced by factors such as attention and motivation e.
With the aid of neuroimaging techniques, researchers may be able to examine the impact of alcohol on brain activity related to these factors, and then determine how alcohol contributes to memory impairments. Despite advances in human neuroimaging techniques, animal models remain absolutely essential in the study of mechanisms underlying alcohol—induced memory impairments.
Hopefully, future work will reveal more regarding the ways in which the effects of alcohol on multiple transmitter systems interact to disrupt memory formation. Similarly, recent advances in electrophysiological recording techniques, which allow for recordings from hundreds of individual cells in several brain regions simultaneously Kralik et al. Impairment of semantic and figural memory by acute ethanol: Clinical and Experimental Research A proposed system and its control processes.
The Psychology of Learning and Motivation: Advances in Research and Theory. A 21—year longitudinal analysis of the effects of prenatal alcohol exposure on young adult drinking. Archives of General Psychiatry
What Are the Stages of Alcohol Intoxication
Driving under the influence (DUI), driving while impaired/driving while intoxicated (DWI), drunk In relation to motor vehicles, the Road Traffic Act creates a narrower offense of driving (or being in charge of) a With alcohol consumption, a drunk driver's level of intoxication is typically determined by a measurement of. What you take isn't the active form, but is transformed in the liver into the active agent. Drinking alcohol while taking painkillers creates a “bottleneck” in the liver. Serving alcohol to a visibly intoxicated person (VIP) is against the law. If you can tell on sight that a person has been drinking or using other drugs, the person is visibly intoxicated. Servers Bravado, boasting. Making irrational statements.