The effect of a one for the road drink of hard liquor, beer or wine on peak breath alcohol concentration in a social drinking environment with food consumption M a rtin H. B r e e n, M.S., Q u i T. D a n g, M.S., J o se p h T. J a in g, B.S., G reta N. B o y d, O range C ounty Sheriff-C oroner s D epartm ent, C alifornia Forensic Science Services IN T R O D U C T IO N E ven though it is a traffic violation to drive a m otor vehicle w ith a blood alcohol concentration (BAC) o f 0.08% o r higher; there are over 20,000 individuals w ho are arrested every year fo r this violation in O range C ounty, C alifornia. T he m ajority o f these drivers consum e different types o f alcoholic beverages including hard liquor, beer, and w ine from a bar or a party over a period o f a few hours and w ith dinner o r a snack. Expert w itnesses testifying in driving under the influence o f alcohol cases are often asked in court to back-extrapolate the d riv er s B A C at the time o f the traffic stop by using the know n result o f a blood, breath o r urine test adm inistered one or tw o hours after the incident. Since B A C is a function o f tim e, the driver s B A C at the tim e o f driving could be low er than the BAC at the time o f the chem ical test. This rising B A C (Jones, 1990) is often seen in drivers w ho have a one for the road drink ju st before they are pulled over by a police officer on the suspicion o f driving under the influence o f alcohol. In order to properly calculate the d riv er s B A C at the time o f driving (M.J. L ew is, 1986; K.O. L ew is 1987; D ubow ski, 1985; Jo n e s, 1988), detailed inform ation such as the d riv er s drinking pattern, the type o f alcoholic beverage consum ed, and the presence o r absence o f food in the d riv er s stom ach (Jones, 1991; H olt, 1981; R ose, 1979; W ilkinson, 1977) m ust be taken into consideration. A lthough there are studies reporting that the m ajority o f alcohol is absorbed quickly (G ullberg, 1982) even w hen it is consum ed together w ith a large m eal (Jones and N eri, 1991), no previous study has reported the absorption and distribution of the one for the road drink. The purpose o f this series o f studies is to exam ine the m axim um increase in breath alcohol concentration and the tim e it takes to reach the peak after finishing the one for the road drink. T he sam e individuals consum ed hard liquor, beer or w ine on three separate occasions in a social - 7 3 9 -
environment with food. M E T H O D S u b je c ts an d c o n d itio n s Thirteen healthy volunteers, seven m en and six w om en, participated in these studies and were designated as subjects A through M. T hey described them selves as social drinkers w ho consum e alcohol only occasionally. The mean age o f the m ale and fem ale participants w as 32 and 28 years old respectively. The m ean body w eight o f the m ale and fem ale participants w as 164 and 134 pounds respectively. The subjects consum ed hard liquor for the first study, beer for the second study and w ine for the third study. N ine o f thirteen subjects participated in all three studies, w hile the rem aining subjects w ere able to participate in at least one or m ore o f the studies. A t the beginning o f each study, the drinking subjects w ere required to perform a breath test show ing that they w ere alcohol free. All subjects ate dinners w hich included com m on food such as hot dogs, ham burgers, sandw iches, burritos, m eatballs, rice, pasta, soup, salad, fruits and/or vegetables, immediately before or shortly before drinking started. Snacks w ere available throughout the study. The subjects w ere instructed to keep the same activities for Day 1 and D ay 2 o f each study. At the com pletion o f the study, the subjects w ere driven hom e by designated drivers. F o r each study, m onitors w ere assigned to each subject to record relevant inform ation such as the subjects activities during that day, the kind o f food they had fo r dinner, the time they had dinner, their age, sex and w eight. The m onitors also recorded the am ount o f drinks consum ed, the tim e it took to consum e the drinks, the time o f the breath tests and the duplicate breath test results. Each subject was assigned to the sam e breath alcohol instrum ent in D ay 1 and D ay 2 o f each study. E ach study consisted o f tw o consecutive days. D ay 1 served as a control in w hich the subjects consum ed a know n am ount o f alcohol at their ow n rate until their B ra C w as near the 0.08% level. C hips, dip, and other snacks w ere available; and the subjects talked, played cards, pool, etc... w ith m usic in the background. T he atm osphere w as sim ilar to that o f a bar o r a party. The subjects duplicate breath sam ples w ere taken fifteen m inute after finishing each drink. A fter the last drink, the subjects B ra C s w ere m easured at 15-20 m inute intervals fo r approxim ately four hours to establish their time to peak and their elim ination rates during the post-absorptive phase. D ay 2 w as a repeat o f D ay 1 w ith the addition o f the one for the road drink.. The subjects w ere given a one for the road drink w hen their B ra C started to decline. T he am ount o f alcohol for this drink was 30 to 60 m illiliters o f hard liquor for the first study, 355 m illiliters o f -7 4 0 -
beer fo r the second study and 177 m illiliters o f w ine for the third study. The subjects B ra C s w ere also recorded every 15-20 m inutes after the final drink until the com pletion o f the study, approxim ately two hours later. The m ain purpose o f D ay 1 w as to obtain a baseline curve fo r each subject that could later be com pared w ith the B ra C curve o f D ay 2. It was to ascertain that the B ra C increase o f the one for the road drink in D ay 2 w as attributed to this drink and w as not affected by other biological factors. It also helped to determ ine the dosage, the consum ption rate for each subject in D ay 2; and to determ ine w hether or not a subject could handle an alcoholic beverage other than his/her preference, so he/she could continue to D ay 2. In str u m e n ta tio n Intoxilyzer 5000 instrum ents, m anufactured by CM I Inc., w ere used to m easure the subjects B ra C. These instrum ents have been in use in all O range C ounty law enforcem ent agencies since 1987. B reath tests w ere taken in duplicate and the results m ust agree within 0.020%. If the tw o results did not agree, a third test w as taken. C alibration checks w ere perform ed on each instrum ent before, during and after its use each evening. They w ere w ithin 0.010% o f the know n values o f the sim ulator solution. A ir blanks betw een sam ples gave a reading o f 0.000%. A lc o h o lic b e v e r a g e s F or hard liquor, subjects consum ed S m irnoff V odka, R onrico R um, tequila, o r W illiam s B ourbon W hiskey. F o r beer, they consum ed M iller G enuine D raft, C orona or B udw eiser. F o r w ine, they consum ed M ondavi R iesling, B eringer W hite Z infandel, M ondavi Fumetf Blanc, R utherford C abernet, C olum bia C rest M erlot, or chardonnay. C a lc u la tio n s BrA Cs w ere plotted against time to obtain the B ra C curve fo r each subject. Each data point represents the average o f the duplicate BrACs. D ata collected from D ay 1 o f each study w ere used to calculate the tim e to peak after the last drink and the elim ination rate o f each subject. D ata collected from D ay 2 in each study w ere used to calculate the time to peak and the BrA C change after finishing the one for the road drink. Because o f a 15 m inute w aiting period for the dissipation o f m outh alcohol, the change in BrA C after the last drink is the difference between the highest BrA C and the last m easurem ent before -741 -
the last drink. Plateaus w ere observed fo r subjects w hose B ra C s rem ained w ithin 0.010% o f the highest B ra C over time w ith the beginning o f the plateau being the first data point w ithin 0.010% from the highest m easurem ent. R E S U L T S S h a p es o f B ra C cu rves: The shape o f the B ra C -tim e profile for m ost individuals follow ed the expected course o f a rapid rise during absorption, a clear peak, and a steady fall during elim ination. A typical profile is observed in F igure 1. The second peak representing the B ra C rise after finishing the one for the road drink is also seen in this figure. P lateau, w hich is the part o f the B ra C curve within 0.010% from the highest point w ithout a steady decline in B ra C over tim e is also observed and seem s to occur m ore often w ith hard liquor o r w ine and is not seen in beer drinkers. B ra C rise and tim e to peak after fin ish in g the one for the ro a d drink: Eleven subjects w ho had 30 to 60 m illiliters o f hard liquor gave an average B ra C rise o f 0.017% from the last m easurem ent w ith a range o f 0.005 to 0.034%. T he average time to peak or plateau after this one for the road drink w as 18 m inutes w ith a range o f 0 to 35 m inutes. T he average rise o f B ra C from 9 subjects w ho drank 355 m illiliters o f beer w as 0.016% from the last m easurem ent w ith a range o f 0.008 to 0.028%. The average tim e to peak or plateau after this one for the road beer drink w as 16 m inutes w ith a range o f 15 to 20 m inutes. T his is com parable to an average rise o f 0.016% (range o f 0.007 to 0.026% ) from the last m easurem ent in a 20 m inute average tim e (range o f 15 to 45 min.) to peak again fo r 10 subjects w ho had 177 m illiliters o f w ine for the road. T im e to peak or plateau after finish ing the last drink: T im e to peak or to the first point o f the plateau o f the last drink (not the one for the ro ad ) does not differ significantly for hard liquor, beer or w ine. The average tim e is 15 m inutes for hard liquor, 19 to 22 m inutes for beer and 23 to 24 minutes- for w ine. The time to peak is reproducible w ithin 5 m inutes for 9 o f 11 hard liquor drinkers, for 5 o f 10 beer drinkers and for 4 o f 10 w ine drinkers. T he range o f time to peak or plateau for the last drink in this study is from 0 to 35 min. for hard liquor, 15 to 40 m in. for beer and 5 to 60 m in. fo r wine. The tim e to peak o r plateau o f the one for the ro ad drink is very close to that o f the last drink. B ra C ch an ge after fin ish in g the last drink: The average B ra C rise from the m easurem ent before the last drink to the peak or plateau is from 0.022% to 0.028% for all three types o f alcoholic beverages. T hese values are higher than those o f the one for the road drink (0.016% to 0.017% ) because the last drink w as consum ed while -7 4 2 -
subjects w ere still in the absorptive phase o f the B ra C curve and the one fo r the road drink w as consum ed in the elim ination phase. F ig u re 1 : T y p ica l B ra C cu rv e o f o n e for th e road stu d y (su b je ct A, w in e). Time (min) D otted lines (day 1), last drink at 70 min. S olid lines (day 2), last drink at 85 m in., one for the road drink at 180 m in R E F E R E N C E S D ubow ski, K M. (1985) A bsorption, distribution and elim ination o f alcohol: highw ay safety aspects. J. Stud. Alcohol Suppl 10, 9 8-1 0 8. G ullberg, R.G. (1982) Variation in blood alcohol concentration follow ing the last drink. J. Police Sci. Adm. 10(3), 2 89-96. H olt, S. (1981) O bservation on the relation betw een alcohol absorption and the rate o f gastric em ptying. Can. M ed. Assoc. J. 124(3), 267-77. Jones, A.W. (1988) Problem s and pitfalls w ith backtracking B A C to the tim e o f driving. DW I J. Law and Sci. (3), 1-4. Jones, A.W. (M ay /Junel990) Status o f alcohol absorption am ong drinking drivers. J. Anal. - 7 4 3 -
Toxicol. 14. Jones, A.W.,Jonson, K.A., N eri, A. (1991) P eak blood ethanol concentration and the time o f its occurrence after rapid drinking on an em pty stom ach. J. Forensi. Sci. 36 (2), 376-385. Jones, A.W.and N eri, R. (1991) Evaluation o f blood ethanol profiles after consum ption o f alcohol together with a large m eal. Can. J. Forensic Sci. 24 (3), 165-173. Lew is, K.O. (1987) B ack calculation o f blood alcohol concentration. Br. M ed. J. 2 9 5, 800-801. L ew is, M.J. (1986) B lood alcohol: The concentration-tim e curve and retrospective estim ation o f level. J. Forensic Sci. Soc. 26, 95-113. R einhardt, G. and Z ink, P. (1985) The course o f the blood alcohol curve during and after consum ption o f alcohol in large quantities. Long term studies in hum an volunteers. Biom ed. and Social Aspects o f Alcohol, A m sterdam : E lsevier, pp 623-628. Rose, E.F. (1979) Factors Influencing gastric em ptying. J. Forensic Sci. 24, 200-206. W ilkinson, P.K.,S ed m an, J.A., S akm ar, E., L in, Y.J.and W agner, J.G. (1977) F asting and non fasting blood ethanol concentration follow ing repeated oral adm inistration o f ethanol to one adult m ale subject. J. Pharmacokinet. Biopharm. 5, 41-52. -744-