Stopped for a DUI? No problemo!

[Martin_Hyde]

@Jackmannii

Deliberate falsification doesn’t have to enter into it.

One would like to know the level of supervision of this subject (under constant surveillance for the entire testing period?) and whether there’s a possibility of a flawed lab result.

True, but without knowing specifics my hope would be a judge wouldn’t accept tests in which the defendant just self-reported, as that’d be subject to very obvious falsification. But maybe he/she did accept such a diagnostic, I don’t know.

Again (see the previously quoted article) this is not a given, seeing that reduced liver function in a chronic alcohol abuser/someone with a long-term high BAC generally means that they don’t hold their liquor as well as they used to, and possibly become impaired at a lesser exposure than someone who was never a heavy drinker.

Okay, but that tidbit has literally nothing to do with this woman or this case, for self-evident reasons.

The fact that she was registered at 0.33 when arrested and was cognizant suggests she wasn’t an end stage alcoholic at the point you’re talking about. For most of their “career” as a heavy daily alcohol user people like that will typically be able to remain functional at high BACs versus non-chronic alcohol abusers. While we don’t know all the details of the diagnostic, she registered a 0.36 during that and ostensibly wasn’t in the emergency room at the point of death. You’re talking the very end stage of the disease when they’ve irreversibly damaged their liver nearly to the point of it being fatal. The progression of liver disease from chronic alcohol abuse is not a uniform, predictable process. Some people can abuse alcohol for their entire lives and die of some unrelated other natural cause at old age, some people die as early as 35-40 from cirrhosis.

Most normal people who have not developed a high tolerance to alcohol, above about .15 are extremely intoxicated, and above .20 will experience severe degradation in motor skills, memory black outs, some people will start to slip out of consciousness in the .20-.25 range, many people will experience extreme nausea and vomiting.

Above .30 is a serious BAC for a non-tolerant drinker, with death being possible in that range (increasing in likelihood as BAC goes up, above .40 is deadly for a large portion of non-tolerant drinkers.) The levels above .30 are enough that many times, young college drinkers who engage in dangerous forms of binge drinking (bonging beers, taking a rapid series of shots etc–things that compress a lot of alcohol into a short time window) often are reported as having BACs in the .3+ range, sometimes when they die. Gordie Bailey, a University of Colorado undergrad, died of alcohol poisoning at .32 BAC, as an example.

This woman was moderately functional–meaning she was able to actually drive a car, stand up etc. She was reported as having the signs typical of drunkenness–bloodshot eyes, slurred speech, motor impairment. But at .32 BAC if she seriously had the sort of reduce liver function you’re talking about she’d likely be dead. The fact that she had signs of drunkenness suggests she probably wasn’t often that drunk, because I’ve heard of and seen alcoholics who have BACs in the .3+ range and do not have the obvious signs of drunkenness, which comes from a long time of extreme chronic alcohol abuse.

I think she had increased tolerance to alcohol, and certainly wasn’t at the “end stage alcoholic liver” point. Now, does she have auto-brewer syndrome, and that is how she built a tolerance? Or does she drink heavily and frequently, the most common and ordinary way of building alcohol tolerance? I don’t know–but I don’t see a reason to assume one way or the other without some further information made available.

[Jackmannii]

@Martin_Hyde

The fact that she was registered at 0.33 when arrested and was cognizant

Cite for “cognizant”?

For most of their “career” as a heavy daily alcohol user people like that will typically be able to remain functional at high BACs versus non-chronic alcohol abusers.

Depends on what you mean by “functional” (and I’d also like to see a study quantifying that, as opposed to I-know-people-who-are-functional-at-that level).
What I was questioning was whether someone self-generating a BAC at that high level would be unaware that something was seriously wrong (until getting stopped for a DUI after “three drinks”).

The progression of liver disease from chronic alcohol abuse is not a uniform, predictable process. Some people can abuse alcohol for their entire lives and die of some unrelated other natural cause at old age, some people die as early as 35-40 from cirrhosis.

I suggest variability likely also applies to “tolerance”.

I did manage to find a single case report on this purported syndrome which described it as extremely rare, with only a handful of case reports in recent decades (including the couple of children with abnormally short intestinal tracts). It described a case of a man who developed signs of intoxication out of proportion to his reported EtOH intake or without known intake. His physicians were said to have isolated him in his hospital room without visitors and that at the end of a 24-hour observation period his BAC level was 0.12 (which is a far cry from 0.36). Supposedly he had a positive culture for a Saccharomyces fungal species, though I didn’t see where they had a quantitative result, and his condition resolved after antifungal therapy and probiotic administration.

So in very rare instances a sort of “auto-brewery syndrome” may exist to some extent. I would still question the details of the story mentioned in the OP, and wonder how often alleged instances will be cited in the future to get drunk drivers off the hook (with the aid of quack practitioners and gullible juries).

[Andy_L]

Just ran across this article from the Canadian Medical Association Journal

Auto-brewery syndrome in a 50-year-old woman

[running_coach]

Auto-Brewery Syndrome: A Clinical Dilemma

[Jackmannii]

I had totally forgotten about this most intriguing thread.

If I’d been a peer reviewer for the Canadian Medical Association Journal I would’ve recommended against publication - not because of doubt that auto-brewery syndrome exists in very rare cases, but due to the fact that the authors failed to provide any culture or related evidence to show that fungal or bacterial overgrowth had occurred in this patient. While the clinical history including response to fluconazole was suggestive, the lack of documentation of etiology is a critical deficiency.

[Gatopescado]

Auto-Brewery Syndrome is a thing, and instead I get arthritis in my knee.

There is No God.

[Chisquirrel]

Or there is, and She just hates you. Could be ironic, or something.

[Gatopescado]

I hadn’t considered that. But that seems legit. I’ll ruminate on it after I sober up.

[Andy_L]

Thanks. That makes sense

[Chronos]

In the Discworld books, one of the minor premises is that most folks naturally generate a very small amount of alcohol in their bodies… but that Commander Vimes has a rare condition that he doesn’t. When he was drinking, he was attempting to self-medicate, and now that he doesn’t, he’s extra sober.

[Beckdawrek]

I can get high on sugar.

It’s not nearly as fun as it sounds.

[gnoitall]

@Chisquirrel

She just hates you. Could be ironic

Of course, because She is Alanis Morissette.

[Pleonast]

@Aji_de_Gallina

@John_Mace

Nit pick: No problema. This is one of those oddball Spanish nouns that, while masculine, ends in “a”. El problema. As is often true of such nouns, it derives from the Greek.

Nit-picking a nit-pick:
No problema is not grammatically correct Spanish.
No hay problema is the one

Of course, “no problemo” as an English phrase is perfectly cromulent.