I need a new doctor (to get me drunk)


the highlights:

Time to start sending letters to your HMO.

Dear god. Three drinks per hour for three days? And the patient somehow didn’t die? Wow.

The way I am picturing the hangover, death doesn’t sound so bad, really.

Make mine with a cranberry drip and a twist of lime. STAT!

There are several types of poisons that require ETOH. The alcohol and the poison use the same receptor sites. The ETOH fills the receptors until the poison is excreted.

Thanks, I thought of making a GQ of it, but I feared it would never go past the joke stage, so I figured I would kill that here first. How does alcohol poison people (from when people get drunk and die). How does that not happen when they are doing this?

I saw another article on it, from the BBC, that said he was in a medically induced coma at the time, and by the time he came out of it the doctors are pretty sure his hangover was gone.

But it still seems like a lot of alcohol to pour into someone!

Largely because the term alcohol actually refers to multiple different substances. You’ve got wood alcohol (methanol), ethanol, and isopropyl (rubbing) alcohol, for example. Methanol has fairly toxic metabolites after ingesting even small quantities in adults (and is quite deadly for kids). Fortunately, it gets metabolized at the same receptor site in the liver as ethanol, and large quantities of ethanol essentially makes it so that very little to none of the poison can be metabolized into its toxic form. Eventually, your body gets rid of the unchanged drug (through the lungs and kidneys, iirc), and you can be taken off the alcohol drip.

This competitive inhibition would be difficult during the Prohibition.

And where do we get this poison?

The particular poison this guy had ingested is commonly found in anti-freeze.

ok. But when people (frat boys) drink more than their share and are poisoned or even die, what is it that is poisoning them?

Wow. I was going to ask how booze could help him detoxify but that question has already been answered. I raise my glass (let’s make it a vodka martini, two olives) to the medical community!

My only question now is, how or why did this young man ingest anti-freeze?

Jeez, if you people would watch House, you would already know that ethanol is the cure for methanol poisoning. Watch more television people.[/sarcasm]

Must be ethylene glycol then. I’ve heard of people getting drunk off that. I’ve also heard of people dying from it.

“Medically induced coma.” Is that what the winos are calling it these days? :stuck_out_tongue:

Yup, that’s what the article says it was.

There are many substances that are poisonous in large doses but safe in smaller. As I understand it, the body can handle ethanol to a certain point by metabolizing it safely away. After that point, it starts messing with vital processes faster than it can be removed from the body.

Even water is “poisonous” in large enough amounts.

True, but this is what I was getting at. If (drinking) alcohol is poisonous at the levels one can achieve by drinking, how can 3 drinks an hour for 3 days not kill the patient? What else is at play here?

Also, I understand how water can be toxic. I don’t know the mechanism through which alcohol is toxic.

A couple of things are likely at play here. The first is the guy’s size. Most people can metabolize anywhere from 100-200 mg/kg/hour of alcohol. If he was a bigger guy, he can metabolize a larger quantity than a small guy would–Ie a 90kg guy would be able to metabolize 9 grams vs 7 grams for a 70kg guy (at the low end 100mg/kg/hr). Two, whether or not he was a chronic drinker plays a role. The secondary method by which the body metabolizes alcohol is an inducible process–ie, with chronic use, your body learns and kicks production of the metabolizing enzyme(s) into high gear–thus you can degrade more than if you aren’t a chronic drinker. Meaning the 90kg guy from above goes from 100mg/kg/hr to 200mg/kg/hr or 18 grams.

Assuming they used 50% alcohol (100-proof) vodka, for a 70kg guy administered an oral dose (since they did it through an NG tube), he’d be getting anywhere from 14 to 28ml per hour (equal to 7-14 grams ethanol)–at least if my calculations are right. :wink:

As for why it doesn’t kill the patient? The goal, as far as I can tell from some of my toxicology texts, is to hit a blood level which saturates the enzyme systems involved–which is well below the toxic blood levels needed for coma/death. They also treat the patient with vitamin replacements to replenish the cofactors alcohol uses up when its metabolized, as well as glucose to prevent the hypoglycemia that eventually leads to acidosis and the nasty complications of alcohol metabolism.

Oh, and standard disclaimer. I’m only a pharmacy student (for a few more months anyways), so everything I’ve said has to be taken with a grain of salt :smiley:

That’s my new term for it.

Friend: Oh man Tahssa you were so waisted last night. You passed out with your pants off in the bushes.

Tahssa: I did not pass out. I put myself into a medically induced coma for the sake of the bush. Who knows what I might have done to that poor bush.