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Impairments in gait occur after alcohol consumption, and, if detected in real-time, could guide the delivery of “just-in-time” injury prevention interventions. We aimed to identify the salient features of gait that could be used for estimating blood alcohol content (BAC) level in a typical drinking environment. We recruited 10 young adults with a history of heavy drinking to test our research app. During four consecutive Fridays and Saturdays, every hour from 8 p.m. to 12 a.m., they were prompted to use the app to report alcohol consumption and complete a 5-step straight-line walking task, during which 3-axis acceleration and angular velocity data was sampled at a frequency of 100 Hz. BAC for each subject was calculated. From sensor signals, 24 features were calculated using a sliding window technique, including energy, mean, and standard deviation. Using an artificial neural network (ANN), we performed regression analysis to define a model determining association between gait features and BACs. Part (70%) of the data was then used as a training dataset, and the results tested and validated using the rest of the samples. We evaluated different training algorithms for the neural network and the result showed that a Bayesian regularization neural network (BRNN) was the most efficient and accurate. Analyses support the use of the tandem gait task paired with our approach to reliably estimate BAC based on gait features. Results from this work could be useful in designing effective prevention interventions to reduce risky behaviors during periods of alcohol consumption.

In most studies, the alcohol marker phosphatidylethanol (PEth) was used to differentiate social drinking from alcohol abuse. This study investigates PEth’s potential in abstinence monitoring by performing a drinking study to assess the detection window of PEth after ingesting a defined amount of alcohol. After 2 weeks of abstinence, 16 volunteers ingested a single dose of alcohol, leading to an estimated blood alcohol concentration (BAC) of 1 g/kg. In the week after drinking, blood and urine samples were taken daily; in the second week, samples were taken every other day. PEth 16:0/18:1 and 16:0/18:2 were analyzed in blood by online-SPE-LC-MS/MS. Ethyl glucuronide and ethyl sulfate were determined in urine for abstinence monitoring. Prior to start of drinking, PEth 16:0/18:1 exceeded 30 ng/mL in blood samples of five volunteers despite the requested abstinence period. Positive PEth values resulted from drinking events prior to this abstinence period. After the start of drinking, maximum BACs were reached after 2 h with a mean of 0.80 ± 0.13 g/kg (range: 0.61–1.11 g/kg). PEth 16:0/18:1 increased within 8 h to maximum concentrations (mean: 88.8 ± 47.0 ng/mL, range: 37.2–208 ng/mL). After this event, PEth was detectable for 3 to 12 days with a mean half-life time of approximately 3 days. PEth has a potential in abstinence monitoring, since PEth could be detected for up to 12 days after a single drinking event. Further investigations are necessary, to establish cut-off levels for PEth as diagnostic marker for the determination of drinking habits like abstinence, social drinking, or risky alcohol consumption.

There are a range of wearable transdermal alcohol sensors that are available and are being developed. These devices have the potential to monitor alcohol consumption continuously over extended periods in an objective manner, overcoming some of the limitations of other alcohol measurement methods (blood, breath, and urine). The objective of our systematic review was to assess wearable transdermal alcohol sensor accuracy. A systematic search of the CINAHL, Embase, Google Scholar, MEDLINE, PsycINFO, PubMed, and Scopus bibliographic databases was conducted in February 2021. In total, 2 team members (EB and SH) independently screened studies for inclusion, extracted data, and assessed the risk of bias. The methodological quality of each study was appraised using the Mixed Methods Appraisal Tool. The primary outcome was transdermal alcohol sensor accuracy. The data were presented as a narrative synthesis. We identified and analyzed 32 studies. Study designs included laboratory, ambulatory, and mixed designs, as well as randomized controlled trials; the length of time for which the device was worn ranged from days to weeks; and the analyzed sample sizes ranged from 1 to 250. The results for transdermal alcohol concentration data from various transdermal alcohol sensors were generally found to positively correlate with breath alcohol concentration, blood alcohol concentration, and self-report (moderate to large correlations). However, there were some discrepancies between study reports; for example, WrisTAS sensitivity ranged from 24% to 85.6%, and specificity ranged from 67.5% to 92.94%. Higher malfunctions were reported with the BACtrack prototype (16%-38%) and WrisTAS (8%) than with SCRAM (2%); however, the former devices also reported a reduced time lag for peak transdermal alcohol concentration values when compared with SCRAM. It was also found that many companies were developing new models of wearable transdermal alcohol sensors. As shown, there is a lack of consistency in the studies on wearable transdermal alcohol sensor accuracy regarding study procedures and analyses of findings, thus making it difficult to draw direct comparisons between them. This needs to be considered in future research, and there needs to be an increase in studies directly comparing different transdermal alcohol sensors. There is also a lack of research investigating the accuracy of transdermal alcohol sensors as a tool for monitoring alcohol consumption in clinical populations and use over extended periods. Although there is some preliminary evidence suggesting the accuracy of these devices, this needs to be further investigated in clinical populations. PROSPERO CRD42021231027; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=231027.

Ethanol metabolism in vivo is primarily mediated by CYP2E1 and alcohol dehydrogenase, with CYP2E1 playing the predominant role at high ethanol concentrations. However, it is a difficult problem to evaluate CYP2E1 activity with ethanol as a probe, especially in rats. Currently, high-performance liquid chromatography (HPLC)-based detection of chlorzoxazone is the standard method for evaluating CYP2E1 activity. Nevertheless, this method is labor-intensive, time-consuming, costly, and unsuitable for real-time on-site or multipoint noninvasive monitoring. This study aimed to develop and optimize a noninvasive and rapid method for blood alcohol concentration BAC detection in rats. The optimized approach was subsequently applied to preliminarily assess hepatic CYP2E1 activity. Male Sprague-Dawley rats were randomly divided into two groups: the immune-mediated liver injury (hepatitis) group and the control group. Hepatitis rats was induced by tail vein injection of Bacillus Calmette-Guerin and lipopolysaccharide, whereas the control rats received an equivalent volume of normal saline. On day 14 of the experiment, following intragastric administration of 56% (v/v) alcohol (5 mL·kg ⁻ ¹), BAC in both groups was measured using a breath alcohol meter. The BAC-time curve was segmented at 46 mg·dL ⁻ ¹: the upper portion was used to assess CYP2E1 activity, while the lower portion reflected alcohol dehydrogenase activity. Liver tissues were collected from rats and observed for histopathological changes using hematoxylin and eosin staining. To validate the accuracy of breath alcoholmeter, headspace gas chromatography was employed. Additionally, HPLC was used to determine plasma chlorzoxazone metabolism, serving as an independent measure of CYP2E1 activity. Based on these findings, we further investigated the potential of ethanol as a probe substrate for assessing the activity of CYP2E1. The pathological findings demonstrated that BCG successfully induced immune liver injury in rats. Comparative analysis using both breath alcohol meter and gas chromatography revealed significantly reduced alcohol metabolism in the immune-mediated liver injury rats relative to the control. The gas chromatographic measurements of BAC confirmed the accuracy and reproducibility of the breath alcohol detection method. Furthermore, HPLC analysis demonstrated a marked reduction in CYP2E1 activity in the liver injury rats compared to control. The breath alcohol detection method offers a simple, non-invasive approach that can serve as a viable alternative for assessing hepatic CYP2E1 metabolic activity.

Objectives. To assess cannabis and alcohol involvement among motor vehicle crash (MVC) fatalities in the United States. Methods. In this repeated cross-sectional analysis, we used data from the Fatality Analysis Reporting System from 2000 to 2018. Fatalities were cannabis-involved if an involved driver tested positive for a cannabinoid and alcohol-involved based on the highest blood alcohol concentration (BAC) of an involved driver. Multinomial mixed-effects logistic regression models assessed cannabis as a risk factor for alcohol by BAC level. Results. While trends in fatalities involving alcohol have remained stable, the percentage of fatalities involving cannabis and cannabis and alcohol increased from 9.0% in 2000 to 21.5% in 2018, and 4.8% in 2000 to 10.3% in 2018, respectively. In adjusted analyses, fatalities involving cannabis had 1.56 (95% confidence interval [CI] = 1.48, 1.65), 1.62 (95% CI = 1.52, 1.72), and 1.46 (95% CI = 1.42, 1.50) times the odds of involving BACs of 0.01% to 0.049%, 0.05% to 0.079%, and 0.08% or higher, respectively. Conclusions. The percentage of fatalities involving cannabis and coinvolving cannabis and alcohol doubled from 2000 to 2018, and cannabis was associated with alcohol coinvolvement. Further research is warranted to understand cannabis- and alcohol-involved MVC fatalities. (Am J Public Health. 2021;111(11):1976–1985. https://doi.org/10.2105/AJPH.2021.306466 )

The current meta-analytic review examined the experimental literature to quantify the causal effect of acute alcohol consumption on self-reported and observed indicators of male-to-female general, sexual, and intimate partner aggression. Database and reference list searches yielded 22 studies conducted between 1981 and 2014 that met all criteria for inclusion and that were subjected to full text coding for analysis. Results detected a significant overall effect (d = .36), indicating that male participants who consumed alcohol evidenced greater aggressive behavior toward females while completing a subsequent laboratory aggression paradigm than male participants who received no alcohol. We found homogeneity across all categories of potential moderator variables. Results further indicated that alcohol resulted in comparable increases of male-to-female sexual (d = .32) and intimate partner (d = .45) aggression. Further research is required to draw meaningful conclusions about individual and situational factors that may interact with acute alcohol consumption to produce the highest levels of risk.

Drink driving is an important risk factor for road traffic accidents (RTAs), which cause high levels of morbidity and mortality globally. Lowering the permitted blood alcohol concentration (BAC) for drivers is a common public health intervention that is enacted in countries and jurisdictions across the world. In Scotland, on Dec 5, 2014, the BAC limit for drivers was reduced from 0·08 g/dL to 0·05 g/dL. We therefore aimed to evaluate the effects of this change on RTAs and alcohol consumption. In this natural experiment, we used an observational, comparative interrupted time-series design by use of data on RTAs and alcohol consumption in Scotland (the interventional group) and England and Wales (the control group). We obtained weekly counts of RTAs from police accident records and we estimated weekly off-trade (eg, in supermarkets and convenience stores) and 4-weekly on-trade (eg, in bars and restaurants) alcohol consumption from market research data. We also used data from automated traffic counters as denominators to calculate RTA rates. We estimated the effect of the intervention on RTAs by use of negative binomial panel regression and on alcohol consumption outcomes by use of seasonal autoregressive integrated moving average models. Our primary outcome was weekly rates of RTAs in Scotland, England, and Wales. This study is registered with ISRCTN, number ISRCTN38602189. We assessed the weekly rate of RTAs and alcohol consumption between Jan 1, 2013, and Dec 31, 2016, before and after the BAC limit came into effect on Dec 5, 2014. After the reduction in BAC limits for drivers in Scotland, we found no significant change in weekly RTA rates after adjustment for seasonality and underlying temporal trend (rate ratio 1·01, 95% CI 0·94–1·08; p=0.77) or after adjustment for seasonality, the underlying temporal trend, and the driver characteristics of age, sex, and socioeconomic deprivation (1·00, 0·96–1·06; p=0·73). Relative to RTAs in England and Wales, where the reduction in BAC limit for drivers did not occur, we found a 7% increase in weekly RTA rates in Scotland after this reduction in BAC limit for drivers (1·07, 1·02–1·13; p=0·007 in the fully-adjusted model). Similar findings were observed for serious or fatal RTAs and single-vehicle night-time RTAs. The change in legislation in Scotland was associated with no change in alcohol consumption, measured by per-capita off-trade sales (−0·3%, −1·7 to 1·1; p=0·71), but a 0·7% decrease in alcohol consumption measured by per-capita on-trade sales (−0·7%, −0·8 to −0·5; p<0·0001). Lowering the driving BAC limit to 0·05 g/dL from 0·08 g/dL in Scotland was not associated with a reduction in RTAs, but this change was associated with a small reduction in per-capita alcohol consumption from on-trade alcohol sales. One plausible explanation is that the legislative change was not suitably enforced—for example with random breath testing measures. Our findings suggest that changing the legal BAC limit for drivers in isolation does not improve RTA outcomes. These findings have significant policy implications internationally as several countries and jurisdictions consider a similar reduction in the BAC limit for drivers. National Institute for Health Research Public Health Research Programme.

Objectives. To estimate the alcohol-attributable fraction (AAF) for suicide in the United States. Methods. Using restricted-access data from the National Violent Death Reporting System for 2021, we estimated the sex-specific AAF for suicide, among those 15 years of age and older, by sociodemographic characteristics and suicide means. An alcohol-attributable suicide was defined as that for which the decedent had a blood alcohol concentration of 0.10 grams per deciliter or higher. Results. In 2021, the AAF for suicide for males (20.2%) was significantly higher than that for females (17.8%; P < .001). The AAF for suicide was higher for both males and females who used a firearm as the means of suicide (23.4% and 22.8%, respectively) compared with their counterparts who used other means (16.5% and 15.9%, respectively). Conclusions. Despite some variation, AAFs for suicide were consistently high, with about 1 in 5 suicides being attributable to alcohol use. Therefore, suicide prevention initiatives in the United States should also target excessive alcohol use. ( Am J Public Health. Published online ahead of print December 19, 2024:e1–e5. https://doi.org/10.2105/AJPH.2024.307910 )

The alcohol hangover is a combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero. A popular theory suggests that dehydration is the primary cause of alcohol hangover and that the consumption of water could alleviate hangover symptoms. Here, the current evidence on the relationship between hangover severity, thirst, and water consumption is summarized. The positive correlations of the amount of water consumed with both hangover severity and thirst suggest that both dehydration and the hangover are co-occurring after-effects of alcohol consumption. While hangovers were typically relatively enduring, dehydration effects were usually mild and short-lasting. Survey data revealed that water consumption during or directly after alcohol consumption had only a modest effect in preventing next-day hangover. Also, the amount of water consumed during hangover was not related to changes of hangover severity and thirst. Thus, water consumption was not effective to alleviate the alcohol hangover. Taken together, these data suggests that alcohol hangover and dehydration are two co-occurring but independent consequences of alcohol consumption. •A popular theory suggests that dehydration is the primary cause of alcohol hangover. ∗ If correct, the consumption of water could alleviate hangover symptoms.•This review concludes that hangover and dehydration are two co-occurring but independent consequences of alcohol consumption.

Alcohol use is associated with injury. Although ACS guidelines require screening injured patients for alcohol misuse, outcome data remains inconclusive. This single-center, 10-year (2013–2023) retrospective study examined patients with ISS >15 ​at a Level I trauma center. Patients from an institutional registry were grouped by blood alcohol content (BAC): positive (>80 ​mg/dL, BAC-P) or negative (BAC-N). Of 517 patients, 401 were BAC-N and 116 BAC-P. BAC-P patients were younger, mostly male, with lower GCS, higher ISS, and higher Shock Indexes (p ​< ​0.001). They required emergency surgery more often (p ​= ​0.023), ICU care (p ​< ​0.001), and had longer hospital stays (12.1 vs. 8.9 days, p ​= ​0.003). Mortality rates were similar between groups. BAC-P patients received more aggressive interventions, possibly mitigating alcohol-related harm. Though BAC-P trauma patients had more severe injuries and required more aggressive care, the lack of difference in mortality suggests that targeted, evidence-based management strategies may benefit intoxicated trauma patients. •Alcohol-intoxicated trauma patients present with higher injury severity and shock index.•Intoxicated patients receive more prehospital and emergent resuscitative interventions.•No difference in mortality despite greater acuity in alcohol-intoxicated patients.•Alcohol use linked to longer hospital stays and increased rehab after discharge.•Study supports reevaluation of early care practices in intoxicated trauma patients.