Perry Paul J, Doroudgar Shadi, Van Dyke Priscilla
Dr. Perry is a Emeritus Professor and Dr. Doroudgar is an Assistant Professor, Clinical Sciences Department, Touro University California College of Pharmacy, Vallejo, CA. Dr. Van Dyke is an Ambulatory Care Clinical Pharmacist, Kaiser Permanente, Walnut Creek, CA.
J Am Acad Psychiatry Law. 2017 Dec;45(4):429-438.
Ethanol abuse can lead to negative consequences that oftentimes result in criminal charges and civil lawsuits. When an individual is suspected of driving under the influence, law enforcement agents can determine the extent of intoxication by measuring the blood alcohol concentration (BAC) and performing a standardized field sobriety test. The BAC is dependent on rates of absorption, distribution, and elimination, which are influenced mostly by the dose of ethanol ingested and rate of consumption. Other factors contributing to BAC are gender, body mass and composition, food effects, type of alcohol, and chronic alcohol exposure. Because of individual variability in ethanol pharmacology and toxicology, careful extrapolation and interpretation of the BAC is needed, to justify an arrest and assignment of criminal liability. This review provides a summary of the pharmacokinetic properties of ethanol and the clinical effects of acute intoxication as they relate to common forensic questions. Concerns regarding the extrapolation of BAC and the implications of impaired memory caused by alcohol-induced blackouts are discussed.
乙醇滥用会导致负面后果，这些后果常常会引发刑事指控和民事诉讼。当怀疑某人酒后驾车时，执法人员可以通过测量血液酒精浓度（BAC）并进行标准化的现场清醒度测试来确定其醉酒程度。BAC取决于吸收、分布和消除的速率，这些主要受摄入乙醇的剂量和消费速率影响。其他影响BAC的因素包括性别、体重和身体组成、食物影响、酒精类型以及长期酒精暴露。由于乙醇药理学和毒理学存在个体差异，需要对BAC进行仔细的推断和解释，以证明逮捕和刑事责任的判定是合理的。本综述总结了乙醇的药代动力学特性以及急性中毒的临床效应，因为它们与常见的法医问题相关。讨论了有关BAC推断以及酒精性遗忘导致记忆受损的影响的问题。
