Intoxication, in its usual context, relates to a high blood alcohol content (BAC), expressed as a percentage of ethanol in the blood. However it can also be related to illegal and prescription drugs such as amphetamines, cannabis, cocaine and opiates.

The BAC is used as a metric of alcohol intoxication for medical and legal purposes. As Australia occupies a top 10 place in international rankings of highest alcohol consumption per capita, blood alcohol toxicology is a particularly relevant field.

Consuming alcohol faster than the body can metabolise it results in alcohol intoxication, which causes progressive impairments to coordination and decision making. Symptoms can include confusion, blurred vision, slower reaction times, loss of balance, nausea and memory loss. An extremely high BAC, for example from binge drinking, can even result in coma or death. Chronically high BAC can lead to many health problems including cirrhosis of the liver, dementia, high blood pressure and jaundice.

Being under the influence of alcohol places individuals at a greater risk of being either a perpetrator or victim of crime. Intoxication increases the likelihood of engaging in risky and reckless behaviours as drinkers lose the ability to make rational decisions. A high number of violent and sexual assaults involve at least one party under the influence, and roughly half of traffic injuries involve alcohol.

Many industries have restrictions on the BAC of their workers. For workers operating machinery or driving heavy vehicles, they must have a BAC of near zero. Pilots and others operating in the aviation industry such as air traffic controllers must not have consumed alcohol for eight hours before the commencement of work, as well as refrain from consuming amphetamines, cannabis, cocaine and opiates. Some workplaces implement alcohol and drug testing as a protocol, engaging in pre-employment screening or random tests.

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The consumption of alcohol, while a legal substance for adults, always carries some degree of risk. These risks increase as more alcohol is consumed and motor skills become increasingly uncoordinated. As well as risks at the time of drinking, consumers of alcohol also expose themselves to more long-term risks and medical researchers are constantly discovering new links between casual, binge or chronic alcohol consumption and adverse health effects. For newer drugs such as ecstasy and its variants, the long term effects are yet to be fully understood by medical researchers, especially when mixed with other illegal and prescription drugs.

While most people are able to process one standard drink of alcohol per hour, experts are needed to properly consider the numerous variables that render this inexact. Factors dictating the alcohol absorption rate for different consumers include their size, genes and health, whether they are a regular drinker, and whether they have consumed other drugs.

Claims related to blood alcohol toxicology usually result from alleged driving under the influence, or in alleged unfair dismissals from workplaces with a zero BAC limit. The influence of alcohol also plays a unique and critical role in many sexual assault cases. In many Australian states individuals are considered incapable of consenting if they are extremely intoxicated.

Toxicologists serving as expert witnesses in cases with blood alcohol as a factor are frequently faced with questions involving estimation of BAC from given consumption or estimating the consumption required to reach a measured BAC. Consulting toxicologists can use retrograde extrapolation techniques to obtain a BAC some time after the event, and can also conduct post-mortem forensic evaluations with regards to BAC. The opinions they provide can be useful to plaintiffs and defendants alike.

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Alcohol related dementia is, as the name suggests, a form of dementia related to the excessive drinking of alcohol. This affects memory, learning and other mental functions. Korsakoff’s syndrome and Wernicke/Korsakoff syndrome are particular forms of alcohol related brain injury which may be related to alcohol related dementia.

Alcohol and Human Performance from an Aviation Perspective: A Review

Alcohol is a widely used drug, and its abuse is a serious public health problem. It has widespread effects on the body, and impairs almost all forms of cognitive function, such as information processing, decision-making, social inhibitions, attention, and reasoning. Visual and vestibular functions are also adversely affected. The performance of any demanding task, such as flying an aircraft is thus impaired by alcohol. Many studies have shown a significant proportion of aircraft accidents associated with alcohol use.

Relevant Cases Wood v State of New South Wales [2018] NSWSC 1247

The lack of presence of alcohol in a suspected homicide victim’s blood (Caroline Byrne) was a matter of contention in several appeals in the conviction of murder and the subsequent overturning of this conviction.

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A sample of our experts in Medical - Intoxication

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