Alcoholism is a disease caused by both psychological and physical dependence of a person on alcoholic beverages. Often, a person is pushed onto the path of addiction by reasons such as social insecurity, the negative example of relatives and friends, the inability to relieve stress in healthy ways, or simple lack of self-confidence. Depending on the characteristics of the drinker’s body and the amount of drink, a person may show various signs of intoxication.
However, in any case, excessive libation will lead the drinker to the state of an unconscious animal, when only medical assistance in the form of life-saving infusions (droppers) can save the patient.
Important: alcoholism, also depending on the strength of the patient’s nervous system, can occur both with subsequent psychoses and disorders of consciousness, and without them. But in any case, uncontrolled and prolonged use of ethanol in large quantities will lead the patient to degradation and dementia. And the reason for this is the worn-out and incapacitated liver under the influence of alcohol.
Alcohol intoxication: definition and severity depending on the characteristics of the body
Alcohol intoxication is a disorder of the nervous system under the influence of ethanol. It can manifest itself both mentally and somatically, neurologically. That is, ethanol affects either all body systems at once, or weaker ones. At the same time, the severity of the manifestations of an alcoholic “high” depends on the quantity, quality and type of drink. In addition, the severity of intoxication at the same doses and quality of alcohol may depend on a person’s sensitivity to ethanol, and on the physical component of the drinker’s body.
The absorption of ethanol into the blood begins immediately after alcohol enters the stomach. At the same time, absorption can be slightly delayed if you eat high-quality and fatty foods. If you drink on an empty stomach, which alcoholics do at stages 2-3 of the disease, then the absorption of alcohol will be higher and faster.
Important: it is worth knowing that sensitivity to ethanol increases significantly if a person is physically tired, prone to chronic lack of sleep, or is on the verge of nervous exhaustion. In addition, sensitivity to ethanol increases during periods of fasting, dieting, or exhaustion. Prolonged overheating or hypothermia can also provoke sudden intoxication of the drinker.
Note that women, older people, children and adolescents are more sensitive to alcoholic beverages than the adult male population. At the same time, the body’s resistance to alcoholic beverages is due to the presence of a large number of enzymes that can break down alcohol in the blood and neutralize it.
Important: people of the Far North have a genetically low level of such enzymes, which means that the slightest dose of alcohol can put them in a coma. That is, such people have complete intolerance to alcohol. Similar cases occur among residents of other regions of Russia, but they are rare.
Stages of alcohol intoxication and their signs
Signs of alcohol intoxication may appear depending on its stage. Thus, professional narcologists distinguish three stages of alcohol intoxication with symptoms and signs inherent in each of them.
Mild degree of intoxication
The amount of ethanol in the blood in this case ranges from 20 to 100 mmol/l. A drunk person is slightly more excitable. The eyes shine, movements become more impetuous and slightly blurred. The person experiences some euphoria, relaxation and elation. Communication among friends and acquaintances becomes more lively and witty. It seems to a person that he is capable of moving mountains, and strives to prove it to everyone. With a slight degree of intoxication, attention becomes distracted, which is where blunders in work occur. And if a person notices his mistakes, it causes laughter. In addition, a mild degree of intoxication is characterized by rapid heartbeat and redness of the facial skin as a result of a rush of blood. There is increased appetite and libido. It is noteworthy that a decline in excitement (talkativeness, euphoria and relaxation) occurs after 2-5 hours, if you do not take more alcohol. In this case, the person falls into a drowsy state and goes to sleep. As a rule, there are no memory loss after such intoxication. And the person does not suffer from headaches or hangover.
Average degree of intoxication
Here, a person already has pronounced neurological disorders of the central nervous system (CNS), since the amount of ethanol in the blood is from 100 to 250 mmol/l. In this case, the person experiences an unsteady gait and impaired coordination of movements. Speech becomes incoherent, and if you want to perform a finger test, as a rule, an unclear hit occurs. Also, with an average degree of intoxication, a physically weak person may experience vomiting or nausea, which indicates that the body is rejecting alcohol. With moderate intoxication, the mood can change from good-natured to aggressive or embittered. It is worth noting that it is becoming increasingly difficult to attract the attention of such a person in a company, but at the same time the drinker is still oriented in space. As a rule, after waking up, a person who has brought himself to a moderate degree of alcohol intoxication will experience all the delights of toxic poisoning - headache, nausea, chills, dizziness. Occasional memory loss is also possible.
Severe stage of alcohol intoxication
When the concentration of alcohol in the blood is from 250 to 400 mmol/l and above, a severe stage of intoxication occurs. A person who has drunk a large amount of alcoholic beverages experiences ataxia (the inability to stand on their own). In addition, the drinker experiences depression of consciousness. That is, the person is as if stunned and is not present in the environment. This condition may be characterized by unintelligible muttering or sharp shouting. In addition, a person in a severe stage of intoxication may exhibit the following signs:
- Severe vomiting;
- Urinary and possibly fecal incontinence;
- Decreased body temperature, especially in the extremities;
- It is impossible to bring a sick (drunk) patient back to consciousness even with the help of ammonia. After awakening, a person does not remember more of what happened to him.
Important: in this condition, it is possible to fall into a coma due to excessive toxic effects on the liver. Especially if the drunk person drank such a dose of alcohol for the first time. They (such people), as a rule, need to be sent to a medical facility for emergency care.
Pathologies of intoxication
Doctors also distinguish between certain types of pathological intoxication that are characteristic of persons with various forms of psychosis (schizophrenia, etc.). In pathological intoxication, a person may only need a small enough dose of alcohol for his body to fall into transient psychosis. At the same time, the person outwardly remains almost similar to the sober people around. Such a drinker is betrayed by ridiculous, inappropriately thrown phrases, a state of prostration in relation to himself and those around him. At the same time, you can notice a person who is in a twilight state under the influence of pathological alcoholic intoxication only if he commits some unusual act that shocks society. People in this state are characterized by fears and a state of passion. Often it is in this state that all crimes are committed.
Epileptoid intoxication
If pathological intoxication transforms in a person into the so-called epileptoid form, then the state of detachment is replaced by severe excitability. Here the external signs of alcohol intoxication will look different. Their main manifestations will be aggression, anger, actions that are not justified by anything and are incomprehensible to others. At the same time, a person’s speech can be sharp, but at the same time completely meager. It is noteworthy that at this stage of intoxication a person does not have hallucinations. He is fully conscious.
Paranoid intoxication
In this case, the pathology is expressed by the fact that the drinker is in a state of paranoia. He sees danger and threat everywhere. Often such a person can be recognized by his state of uncontrollable horror. At the same time, the drinker may falsely recognize the person around him as the person who threatens him. As a rule, with the paranoid pathology of intoxication, anxious sleep occurs, followed by amnesia.
Important: in Russia there are on average about 10 million alcohol dependent people who put their lives and health at enormous risk. This figure is 7% of the total population of the country. Every year their number is growing compared to 1999.
Signs of alcohol intoxication appear in various forms. Depending on the amount drunk, internal or external pathologies may appear. Alcohol can have different effects on the entire body as a whole, or on some systems more strongly if they are more vulnerable. The degree of intoxication differs not only from the dose taken and the type of alcohol, but also from the drinker’s individual tolerance to ethanol, as well as from his physical condition.
Three main degrees of alcohol intoxication have been identified, and their characteristic features:
Lightweight
Is the initial stage. Clinical signs of this degree of intoxication are a feeling of pleasure and lightness. Excessive sociability appears, and boundaries are erased during a conversation. A person’s facial expressions change and become more animated. The movements change, they become more free, but not precise. In this state, the person himself cannot notice the manifested changes in his behavior; they are visible only to others. In addition, the pulse quickens and the skin of the face turns red. In a state of intoxication, uncontrollable thirst manifests itself and there is sexual desire. After five hours you feel tired and want to sleep.
Average
For this degree, the determining factor is the presence of neurological stigmas. The middle stage can be determined by the appearance of incoherent speech. The gait of a drunk person changes, it becomes more uncertain, the legs become tangled, and there is staggering. This degree also includes partial or complete loss of balance and loss of coordination. A clear sign is vomiting and nausea. And with the euphoria inherent in mild intoxication comes aggression and uncontrollable anger. Significant experiences are revealed: jealousy, resentment. Excitability is not characteristic of this stage, because it is replaced by sound sleep. However, awakening is accompanied by lethargy, apathy and headache. In some cases, memories of the previous evening are erased.
Heavy
This stage can be identified by a depressed state. Other clinical symptoms of alcohol intoxication are the inability to stand on one's feet without assistance. There is also no opportunity to show and express one’s emotions and thoughts through facial expressions. A severe degree is accompanied by profuse vomiting; there are cases when fecal and urine incontinence occurs during alcohol intoxication. Body temperature drops, skin becomes cold. Speech is incoherent and incomprehensible to others. This is followed by deep sleep, from which it is impossible to awaken a person, even with the help of ammonia. From a state of sleep he goes into a coma, the pupils do not react to light, breathing becomes difficult, the pulse is barely palpable. The consequences of an alcoholic coma are the absence of pain and the disappearance of tendon reflexes. A person develops amnesia; he cannot remember the events that happened to him. Appetite disappears during this period, and a feeling of weakness appears throughout the body, which lasts about one day.
Forms of intoxication
In medicine, there is another classification of alcohol disorder based on human behavior. It includes the following types:
- Depressive – characterized by an obsession with committing suicide. Only a specialist can cope with this condition.
- Hysterical – more common in women. Behavior in this form becomes defiant, accompanied by hysteria and an attempt to conflict.
- Hebephrenic - this type is characterized by behavior that is not typical for an adult, closer to that of a child. However, if you point this out to a drunk person, he becomes aggressive.
- Dysphoric – accompanied by inexplicable panic and fear, as well as unreasonable melancholy.
Intoxication in teenagers
No specific symptoms of intoxication were identified in adolescents, but they are more pronounced in them. In this state, all the problems that young people face in society are revealed. Due to the fact that the body is not sufficiently adapted to ethanol, severe autonomic disturbances are detected and movements become more diffuse and imprecise.
The most dangerous consequence of alcohol intoxication for teenagers is death. In other cases, liver failure, hepatitis, acute pancreatitis, hallucinations, central nervous system damage, and mental disorders may develop.
Pathologies of intoxication
In medicine, there are also some types of pathological intoxication related to persons with diseases such as schizophrenia and other mental disorders. For people with these syndromes, a small amount of alcohol will be enough to trigger a transient psychosis. It is almost impossible to distinguish a person in this state from a sober one. All that can be seen is inappropriate phrases said during a conversation, as well as a loss of interest in others and in oneself. Since appearance does not in any way indicate a person is in a state of pathological intoxication, it is worth paying attention to actions. Most often they are shocking, because... done in a state of passion. It is under such conditions that crimes are most often committed.
Pathological intoxication is divided into two forms:
- Epileptoid, when a person moves from a state of prostration to excitement. The main signs will be: aggression, anger, inappropriate and incomprehensible actions. Speech becomes noticeably sharper, but poorer. The patient is fully conscious and does not suffer from hallucinations.
- Paranoid, this intoxication is characterized by paranoia. A person in this state begins to feel as if he is in danger. This form is distinguished by the fact that patients experience uncontrollable horror. Hallucinations appear, for example, a person sees a threat in strangers.
Then comes restless sleep, upon awakening amnesia is discovered.
Reasons for punishment for drunkenness, drawing up an act
People who are drunk often drive a vehicle or go to work. In the fight against violators, a document is drawn up - an act of alcohol intoxication.
If an official arrives at his workplace drunk, he may be subject to disciplinary action or dismissal. The law also regulates being under the influence of alcohol while driving a car. For an offense, the driver may lose his driver's license or pay a large fine. It happens that a drunkard can be punished with administrative arrest. This is due to the fact that after drinking strong drinks, the motorist loses the ability to concentrate on driving and poses a danger to others and himself.
While performing official duties, the employee also cannot fully perform the functions assigned to him and bear responsibility for the actions taken.
Employee drunkenness as a reason for dismissal
A report of intoxication is drawn up if an employee is caught drinking alcoholic beverages:
- At work;
- On the territory related to the organization;
- On other sites owned by the company.
An official should know that if he is drunk during non-working hours or works overtime, drawing up an act will not serve as a reason for dismissal. The manager has the right to make a remark.
Women in position, mothers raising children from 3 to 6 years old or disabled people, as well as single mothers, can also avoid punishment for drinking alcohol.
Before drawing up the protocol, general signs of alcohol intoxication according to the law are identified, which are subsequently entered into the document. These include:
- Smell of alcohol from the mouth;
- The worker cannot maintain his balance;
- Atypical behavior;
- Speech becomes confused;
- Facial redness.
If at least one of the symptoms is present, most often it is fumes, the employee is sent for a medical examination, which will confirm the presence of ethanol in the blood. In a hospital, the procedure is carried out on the basis of an order from the Ministry of Health.
To correctly draw up the act, it should indicate:
- Full name of the organization;
- Date and time of the detected violation;
- Violator details.
- Testimony of at least two witnesses;
- Explanatory note from the employee.
- A complete description of the signs of intoxication.
- Indicate in detail what happened, pay special attention to eyewitness testimony, especially if the employee refuses a medical examination.
Dismissal is carried out on the basis of an order indicating the conclusion of a medical examination. It must indicate the amount of ethanol in the employee’s blood. If its level exceeds the norm, this will serve as grounds for dismissal and an entry about this will be made in the work book.
Drunk driving
The law provides for more severe penalties for drivers who violate traffic rules, unlike for officials.
The Code of Administrative Offenses states that for driving while intoxicated, a motorist is subject to a fine of 30,000 thousand rubles. Traffic police officers are also required to deprive him of his driver’s license for up to two years. Repeated violation entails a fine of 50,000 thousand rubles, and withdrawal of rights for three years. In some cases, the offender may be detained for 10-15 days by court decision.
According to the law, blood should not contain more than 0.3 ppm of alcohol.
The signs of driver intoxication are the same as for grounds for dismissal. If there are no symptoms, the inspector does not have the right to force a medical examination. But at the same time, if he insists that the person driving the vehicle is drunk, he can undergo an inspection on the spot. To check, an examination is carried out using a breathalyzer. All data on the examination is included in the protocol.
Motorists should know:
- If there is a smell of fumes, and he drank the day before, this does not mean that he is drunk.
- There are medications that contain alcohol and leave an odor behind; this is also not a reason.
If clinical signs are noted by the inspector, but the breathalyzer shows a negative result, then a sample of the biological object is taken to determine the substance that caused intoxication.
The problem of alcohol addiction in our country does not lose its acute relevance. The reasons for the widespread nature of this addiction include the availability of alcohol, the unwiseness of consuming alcoholic beverages, and the mentality of Russians. Those who drink alcohol constantly have to face difficulties at work and in ordinary social life.
The procedure for examining a person for the degree of intoxication is outlined in the legislation of the Russian Federation. And this resolution, in particular, the signs of alcohol intoxication for the act, should be known to everyone. To protect yourself from illegal actions of law enforcement officials and shortcomings of inspections, noticing possible errors and errors in time.
You need to know the rules for conducting a sobriety test and drawing up a report
A drinker at work will sooner or later have to deal with drawing up an official document. After completing this paper in the service, the drinker is threatened with loss of work or (as a minimum punishment) disciplinary action. A drunk person who is caught driving a vehicle will also have to face problems.
According to the law, persons who were driving while drunk face punishment ranging from a large fine to administrative arrest. The penalties in this case are tougher, since a person driving a car while drunk creates a threat to the lives of other road users and pedestrians.
Alcohol and dismissal
A person who is intoxicated loses the ability to control himself and take responsibility for his actions. Which is what deserves the administration to apply various educational measures. The protocol drawn up in this case can play a decisive role in punishment and become the basis for dismissing a person.
But it happens that a person becomes a victim of unverified accusations and biased assessments. Therefore, each person should know the exact order of the legal relationship that exists between him and the person holding a managerial position.
Degrees of intoxication
The first thing you should know is that the act (protocol) itself, indicating that a person is drunk at work, is drawn up exclusively in cases where the employee was seen drinking alcohol in the following places:
- At various branches of the company.
- Directly at your workplace.
- On the territory that belongs to the working area.
But you should also know that not in all cases the execution of the relevant act serves as the reason for further dismissal. In this case, the determining factor is the time when the employee was noticed drunk or drinking alcohol. If this happened outside of working hours, then the maximum that could threaten the violator is a warning from management.
In some cases, a report documenting that an employee is drunk at work is not drawn up. These are the following situations:
- If the employee was at work after hours.
- When an employee took a dose of alcohol before starting work and was allowed to work.
- The drinker turned out to be a pregnant employee or the mother of a young child (under 6 years old), the mother of a disabled child or someone who has single status.
- A minor employee of the organization is intoxicated. In this case, he can be fired only with permission from the State Labor Inspectorate (STI).
A certain paradoxical situation arises. After all, instead of receiving a well-deserved punishment, these categories of citizens calmly avoid censure. But the rest of the employees in the same case have to answer to the fullest extent of the law.
How is the fact of intoxication established by law?
Verification by representatives of the authorities and the law of the fact of detection of intoxication is carried out in strict accordance with the procedure established by law. It is carried out by adhering to the following points:
- External symptoms of intoxication.
- Analysis of the air exhaled by a person.
- Testing blood for the presence of alcohol.
- Urine sample to detect residues of alcohol metabolites.
How does alcohol intoxication manifest?
The initial examination is carried out directly on duty or when the driver is stopped. Police officers or representatives of administrative management check and record the person’s external symptoms of alcohol intoxication.
Visual cues
All visible symptoms, the detection of which will indicate intoxication, are prescribed in the current Code of Administrative Offenses. All external signs of alcohol intoxication, clearly indicated in the law, are as follows:
- unsteadiness and instability of gait and posture;
- a distinct alcoholic odor from a person;
- inappropriate behavior that does not correspond to the situation;
- difficulties with speech functions (meaningless, incomprehensible speech);
- dilated pupils of the eyes (this sign is also evidence of drug intoxication);
- change in skin color (ethanol increases venous blood flow, as a result of which the skin turns sharply red).
Air vapor research
After an analysis of the external symptoms of intoxication has been carried out, the next step is to measure the concentration of alcohol vapors in the air exhaled by a person. A special device is used - a breathalyzer.
What can serve as confirmation of intoxication in a person?
The maximum permissible norm for the volume of ethyl alcohol in air masses during exhalation is also prescribed in the Law of the Code of Administrative Offenses of the Russian Federation. It is 0.16 mg/l.
If this level is exceeded, a person is considered drunk, which in certain situations leads to administrative fines, withdrawal of rights or service problems, up to and including dismissal under the article. If a driver is detained, traffic police officers confiscate the car, and the owner of the car is sent to a narcologist for a medical examination.
But in this case, a visit to the doctor is not always carried out. But only in the following situations:
- when a drunk driver (by external signs) refuses to voluntarily take a breathalyzer test;
- the driver claims that he is sober and categorically disagrees with the final data of the device after measuring the air.
Before escorting a violator to a narcologist, traffic police officers are required to issue a referral protocol for a medical check. The official document states the following points:
- information about the witnesses present;
- time of the breathalyzer test;
- external symptoms indicating intoxication;
- complete information about the device used.
Table of ppm used to determine the degree of intoxication
An official document is also attached to the protocol, which records all the instrument readings obtained during the test. And only then the traffic police officer accompanies the offender to a narcologist for a medical examination.
How is the medical examination carried out?
A medical examination carried out by a narcologist is regulated by officially established instructions with the obligatory completion of a certificate in form 307/u-05 (“Medical examination report to detect intoxication”). In this document, the narcologist fills in all the information about the person being tested and notes the identified external signs of the presence of ethanol in the body, in particular:
- features and nuances of speech;
- visual appearance of the skin;
- description of the offender's behavior;
- whether there is a smell of alcohol from the person;
- type of pupils (dilated, normal, constricted).
When drawing up an official conclusion act, the use of ordinary colloquial speech is unacceptable. All characteristics and descriptions must have clear wording, not deviate from those outlined in the legislation, and have clear, legible official definitions.
Before carrying out direct clinical tests, a repeated measurement of a person’s exhaled air is taken using devices that have the appropriate certificate. The evidence received is entered into an official act.
Then the biomaterial is collected from the offender and a medical examination takes place. What kind of research will be organized is determined by the narcologist himself. The main goal of this procedure is to identify ethanol and confirm the fact of drunkenness.
External signs of intoxication depending on the stage
Based on the results of the inspection, an official conclusion is drawn. This paper is also drawn up in accordance with all established rules and should not be described by the physician in any form. There are only two final conclusions:
- The state of intoxication has been established.
- The state of intoxication has not been established.
In the case where external signs of intoxication are evident, and the measurement of exhaled air does not show intoxication, a repeat measurement is carried out after 15-20 minutes. This can happen if a person has recently taken alcohol and the alcohol has not yet been absorbed by the gastrointestinal tract and has not reached the bronchopulmonary system.
If a repeated test does not show the presence of alcohol, but there are obvious external signs of intoxication, biomaterial (blood or urine) is collected. Based on the results of these checks, an official conclusion is made about the presence of drunkenness. But sometimes the stages of alcohol intoxication and their signs can give ambiguous results if you rely only on a blood test.
Therefore, one cannot make a conclusion about a person’s condition based on the indicators of analysis alone. The final result is made based on two measurements (urine and blood):
It is the totality of these indicators and the description of all external, visible signs that becomes the basis for determining a person’s intoxication/sobriety. At the same time, the absence of one of the necessary indicators indicates a gross violation of the rules for conducting a medical examination. In this case, a person can calmly challenge the findings in court.
All violators, and especially drivers, should know that they do not have the right to refuse to undergo a medical examination. In this case, such a refusal entails the withdrawal of rights and the imposition of an administrative fine on the violator.
If all checks are completed according to the completed referral and you do not agree with the results obtained, the person can undergo a re-examination at an independent clinic (but no more than 4-5 hours later).
This procedure will be paid, but it will become a fundamental fact for confirming a person’s innocence in court. It is also necessary to understand that it is the presence of external signs of intoxication that serves as a reason for traffic police officers and management representatives (if the case occurs at work) to send a person for a medical examination. And you cannot refuse it.
You cannot refuse to undergo any of the examination methods (blood sampling, urine sampling, breathalyzer testing). In this case, this will be regarded as a refusal to undergo a medical examination, and the person himself will be subject to administrative punishment.
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ALCOHOL INOXISONATION (acute alcohol intoxication) - a comprehensive syndrome of the effects of alcohol on the body, a kind of transient condition that occurs after drinking alcohol, which is accompanied by disturbances or changes in physiological, psychological or behavioral functions and reactions.
ETIOLOGY AND PATHOGENESIS
Alcohol and its metabolites are toxic substances that affect the central nervous system and the entire body as a whole. The occurrence of alcohol intoxication indicates a pronounced impairment of the individual’s ability to control his behavior under normal conditions, which may be associated both with the amount of alcohol taken and with individual sensitivity to it.
CLASSIFICATION
- Simple alcohol intoxication.
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- Dysphoric variant.
- Paranoid option.
- With hebephrenic features.
- With hysterical features.
- Pathological intoxication (transient psychosis, the relief of which is dealt with by psychiatrists).
- Epileptoid form.
- Paranoid form.
CLINICAL PICTURE
Alcohol intoxication includes pathological changes in the mental sphere and behavior, disorders in the autonomic-vascular regulation system, movement disorders, the smell of alcohol on the breath and positive chemical reactions to ethyl alcohol.
- The main symptom of simple alcohol intoxication is euphoria. It usually occurs after taking relatively small doses of alcohol and is relatively short-lived: it lasts for the first 1-3 hours after drinking alcohol. Often euphoria is not stable enough and is easily replaced by dysphoric outbursts. For its occurrence and maintenance, it is necessary to maintain a favorable psychological environment. Increased speech and motor activity, expressive behavior, distractibility, disinhibition and increased self-esteem are the main signs of euphoria.
- Altered forms of simple alcohol intoxication.
- The dysphoric variant of alcoholic intoxication occurs in patients with alcoholism, as well as in various types of organic brain failure. This option is characterized by the absence of euphoria, the presence from the very beginning of a gloomy mood with irritability, anger and conflict, and a tendency to aggression. A dysphoric shade of mood also occurs when the state of intoxication ends.
- The paranoid version of alcohol intoxication is characterized by suspicion, touchiness, pickiness, and a tendency to interpret the words and actions of others as a desire to humiliate, ridicule, or gain the upper hand over the interlocutor.
- Alcohol intoxication with hebephrenic features is manifested by foolishness, antics, and senseless violence.
- Alcohol intoxication with hysterical features occurs in the presence of a similar personal predisposition and is accompanied by theatrical sad affect, violent scenes of despair, “madness,” and demonstrative suicidal attempts.
- The main sign of pathological intoxication is considered to be a relatively long stupor of consciousness with a disorder of orientation in place, time, situation, and sometimes in one’s own personality. At the same time, they note the external orderliness and expediency of the actions and deeds of an individual who is in a state of intoxication, although essentially his behavior lacks a clear motivation and is inadequate to reality. These disorders, as a rule, arise unexpectedly and are accompanied by a sharp change in the affective sphere with the appearance of rage, fear, anger, and unprovoked aggression.
Depending on the nature and severity of clinical manifestations, mild, moderate and severe degrees of alcoholic intoxication, as well as alcoholic coma, are distinguished.
- Mild degree of alcohol intoxication
- Minor changes in mental activity (for example, isolation, delayed reaction, hot temper, demonstrative reactions, attempts to dissimulate, euphoria, emotional instability, difficulty concentrating, distractibility, etc.).
- Increased vegetative-vascular reactions (hyperemia of the skin and mucous membranes, scleral injection, increased sweating, tachycardia, etc.).
- Individual disturbances in the motor sphere (possible changes in gait, staggering when walking with quick turns, instability in the sensitized and simple Romberg position, inaccuracy in performing small movements and coordination tests, horizontal nystagmus when looking to the side, positive Taschen test).
- Smell of alcohol on the breath.
- Positive chemical reactions to alcohol (in the body’s media - exhaled air, urine or blood).
- Moderate alcohol intoxication
- Pronounced changes in mental activity: behavior accompanied by a violation of social norms, incorrect assessment of the situation, lethargy, agitation with aggressive or auto-aggressive actions and inappropriate statements, euphoria, dysphoria, violation of the sequence of thoughts, fragmentation of statements, elements of perseveration, slowing down and impoverishment of associations, etc.
- Vegetative-vascular disorders: hyperemia or pallor of the skin and mucous membranes, tachycardia, increased breathing, fluctuations in blood pressure, increased sweating, salivation, dilated pupils, sluggish reaction to light (photoreaction).
- Motor and neuromuscular disorders: severe dysarthria, instability in a standing position and when walking, distinct disturbances in coordination of movements, decreased tendon reflexes and pain sensitivity, horizontal nystagmus.
- Positive chemical tests for ethyl alcohol.
- Severe degree of alcohol intoxication
- Severe mental disorders: disturbances in orientation, severe lethargy, drowsiness, low availability of contact with others, lack of understanding of the meaning of questions, fragmentary meaningless statements.
- Severe vegetative-vascular disorders: tachycardia, arterial hypotension, hoarse breathing due to the accumulation of mucus in the oral cavity and nasopharynx, pallor of the skin and mucous membranes, sweating, in some cases involuntary urination, weak reaction of the pupils to light.
- Severe motor and neuromuscular disorders: inability to stand independently and perform purposeful actions, suppressed tendon reflexes, decreased corneal reflexes, sometimes spontaneous nystagmus.
- Pungent odor of alcohol from the breath.
- Positive chemical tests for ethyl alcohol. As a rule, more than 3 ppm of alcohol is found in the blood.
- Alcohol coma
- There are no signs of mental activity (unconsciousness, lack of reactions to the environment).
- Severe disturbances of autonomic regulation and activity of the cardiovascular system (collapsed state, involuntary urination and defecation, respiratory disorders).
- Severe neuromuscular disorders (sharp decrease in muscle tone, absence of pain, corneal, tendon reflexes, in some cases pathological reflexes, hyperkinesis, etc.).
- Strong smell of alcohol.
- Blood alcohol concentrations above 3-4 ppm.
From a medical point of view, alcohol intoxication is a set of changes that occur in a person's neurological, physiological and behavioral functions after consuming a dose of ethanol. The extent of the influence of alcohol on the body directly depends on age, individual physiology and general health.
Based on the established list of signs, you can determine the degree of alcohol intoxication. In a mild form, there may be no behavioral changes, but more severe intoxication contributes to the loss of one’s personality.
The procedure for testing for intoxication is regulated by Russian legislation. There are cases when law enforcement officers behave unlawfully and in order to competently protect themselves, it is necessary to know all the signs of alcohol intoxication prescribed in the Code of Administrative Offenses (CAO).
A competent determination of the fact of a person’s consumption of alcoholic beverages is carried out according to four indicators:
- visual manifestations;
- ppm in exhaled air vapor;
- blood test for the presence of ethyl alcohol molecules;
- Analysis of urine.
External signs of alcohol intoxication
Visual manifestations include the following characteristics:
- Changes in pupils. As the dose of alcohol increases, a person develops a “brilliant” look. The pupils lose the ability to constrict, and in cases of severe intoxication, anisocoria may occur - different sizes of pupils around the eyes.
- Overexcited. Emotional and motor activity is stimulated (excessive talkativeness, excessive gesticulation).
- Loss of coordination: unsteady gait, involuntary twitching, slow blinking.
- Incoherent speech.
- Smell of alcohol from the mouth.
- Skin changes: red or white face with characteristic spots.
Signs depending on the degree of intoxication
Depending on the stage, the symptoms of alcohol intoxication have some differences. The larger the dose, the more the human psyche changes. In general, based on the level of ethanol in the blood, several stages of intoxication are distinguished.
Mild degree (0.5-1.5%)
In this state, a person experiences a surge of energy, a cheerful mood and general relaxation. But even when drinking a small amount of alcohol, a decrease in concentration is observed, which negatively affects driving any kind of transport or performing complex work tasks that require special attention.
Average degree (1.5-2.5%)
As the dose of alcohol increases, a person's behavior becomes more aggressive. Irritability, anger and rudeness appear. At the same time, coordination of movements is impaired, and the excited state is replaced by a sharp loss of strength. Often, the middle stage of alcohol intoxication ends with sleep.
Severe degree and alcoholic coma (2.5-3%)
In the presence of severe intoxication, severe neurological disorders occur. Orientation in space is lost, consciousness is diminished, and breathing problems arise. A person falls into an alcoholic coma. In this condition, the swallowing and cough reflex is impaired, creating a dangerous risk of choking on vomit. The best solution would be to admit the patient to a hospital.
Dependence of signs of intoxication on the stage of alcoholism
The intensity of passion for alcoholic beverages can be determined in three main stages.
First stage
The craving for alcoholic beverages gradually increases, ranging from one-time episodes to short binges. Involvement in social life gradually decreases, and changes in personality occur. Initial symptoms include:
- vegetative-vascular dystonia;
- insomnia;
- loss of appetite;
- problems with the gastrointestinal tract;
- anxiety and panic attacks.
Second stage
The craving for alcoholic beverages intensifies even more. During periods without drinking, a person experiences irritability, fatigue and low concentration. In this state, a small dose of alcohol gives a feeling of satisfaction and comfort. Such a hobby jeopardizes not only your personal life, but also your work. New symptoms appear:
- aggressiveness;
- memory impairment;
- weight loss;
- fast fatiguability.
Third stage
Characterized by pronounced mental disorders. For most, drinking occurs on a regular basis. Dependence on alcohol becomes so strong that withdrawal symptoms can be extremely dangerous for a person. Symptoms appear as follows:
- epilepsy attacks;
- hallucinations;
- delirium tremens;
- apathy;
- oppression of the intellect.
Intoxication in teenagers
Alcohol intoxication in adolescents does not have any special characteristics. It’s just that in this case all the symptoms are expressed more clearly than in adults. Since the body is not accustomed to alcohol, the most severe manifestation is loss of coordination and hangover syndrome.
The most dangerous is the fact that alcohol abuse at this age forms psychological and physiological alcohol dependence much faster (within 1.5 years).
The state of pathological intoxication is characterized by an episodic outbreak of inappropriate behavior, the duration of which varies from 10 minutes to 1 hour. At this moment, a person’s reality is completely distorted, and he can harm not only others, but also himself.
In modern medicine, it is customary to distinguish two main forms of pathological intoxication - paranoid and epileptoid.
Paranoid form
The main feature characterizing this state is severe overexcitation. In addition to impulsive movements, screams and attacks of aggression, the behavior is accompanied by states of delirium and paranoia. In this case, it is almost impossible to establish productive contact with the person before the attack ends.
Epileptoid form
Pathological intoxication of this kind occurs quite often. First of all, the sense of reality and control over time is lost. Groundless attacks of fear and panic occur, accompanied by aggression and irritability.
In this state, a motor rise is observed, rough and sharp gestures appear. Combined with irritability and anger, a person can hit or even kill a stranger, since at this moment he does not give an account of his actions.
Signs of alcohol intoxication for the act
A harmful attraction to alcohol often leads to problems in a person’s social life. It is especially alarming when the professional sphere of activity and driving safety are affected.
Reasons for punishment for drunkenness (act)
A drunk person shows obvious signs of intoxication.
During the examination, the following points are confirmed or refuted in the report:
- smell of alcohol from the mouth;
- lack of coordination;
- slurred speech;
- changed complexion of the face;
- behavior inappropriate to the situation.
Drunk driving
The initial examination is carried out by law enforcement officers at the stop or workplace.
It must be remembered that the driver has the right to refuse or disagree with the test results from the on-site examination. In this case, the traffic police inspector sends the subject for a medical examination to a hospital, which is prohibited by law to refuse.
If there are any such signs, police officers offer to undergo rapid testing on the spot. The examination is carried out using a special device - a breathalyzer. It measures the concentration of exhaled ethyl alcohol vapor. If the indicator is less than or equal to 0.16 ppm, the person is declared sober and released with an apology. If the standard is exceeded, the fact of alcohol intoxication is recorded, entailing administrative consequences in the form of a fine and deprivation of rights, and sometimes an administrative arrest is imposed. Next, the offender is escorted for examination and medical examination to a specialized medical institution.
Since a person’s adequate reaction to reality is dulled, the consequences of drunk driving can be the most dire.
Drunkenness in the workplace
In this case, drawing up an act at the workplace threatens the employee not only with punishment for violation of discipline, but also with dismissal.
Your Narcologist recommends: Alcohol intoxication at work as a reason for dismissal
An alcohol intoxication examination report is issued only if the employee was noticed to be drunk or in the very fact of drinking alcohol:
- at work;
- in company branches;
- in the territory adjacent to the company.
It is important to understand that the execution of this act does not guarantee subsequent dismissal. The determining factor will be the time when the employee was noticed to be intoxicated. If this happened during non-working hours, then the maximum punishment would be a reprimand from management. In another situation, the violator will face dismissal.
