BAC–Blood Alcohol Content and Related Issues
The BAC or blood alcohol content is a measure of how intoxicated a person is. It is also sometimes called the blood alcohol concentration or blood alcohol level. The BAC is a percentage of alcohol in the blood and is used legally to define intoxication such as in driving under the influence, when an accident has occurred, or when a crime has been committed. As it stands now, there are variations in how the BAC is used legally across jurisdictions in the U.S. However, a BAC of 0.08% or greater is considered legally intoxicated.
It is generally thought that the BAC corresponds to levels of impairment for the intoxicated person. For example, the higher the BAC, the more impairment. And, as the BAC lowers, it is thought that a person is ‘sobering up’, having less impairment. Also, the BAC can be used medically during emergencies to determine medical protocol. Certain medicines that could be medically indicated in an emergency, for example, should not be mixed with alcohol.
The legally allowed BAC in the United States is the highest allowable level of intoxication in the world in legal terms. However, there are certain states in which there can be a liability with lower levels. For instance, a BAC of lower than 0.08% can incur legal sanctions if in combination with certain other offenses, or when involving an individual, not of legal drinking age.
Testing the BAC
Measurements of BAC can be taken in several ways–through blood, urine, breath, or saliva tests. Of the various ways to measure blood alcohol content, lab tests involving drawn blood are considered the most accurate. However, they are not always the most practical, and other tests give similar results that are useful.
Probably the most well-known test of BAC is the Breathalyzer. Breathalyzers can be used to determine blood alcohol content ‘in the field’ –that is, outside a lab–and are commonly used by police during traffic stops, or in the workplace when an employee appears intoxicated. A Breathalyzer test uses a small handheld device that registers the amount of alcohol exhaled through the breath. Breathalyzers are considered by many to be the most practical device used to determine intoxication in most situations outside of a medical setting. They are non-invasive, easily carried, and easily administered.
The Breathalyzer was developed in the 1940s primarily for police use and is an effective estimate of the BAC in a very short time. Alcohol can be detected in the breath because it is not totally digested and metabolized for some time after ingestion. Chemically, alcohol remains unaltered as it enters the bloodstream. Consequently, as blood moves through the lungs, it carries alcohol that is released into the breath through evaporation. Therefore, alcohol in the breath consistently relates to the BAC or amount of alcohol in the blood.
There are several types of breath alcohol testing devices. Each of them works in a different way but produces similar results. All of them are devices into which a person blows through a mouthpiece. The devices then use different mechanisms to detect the alcohol content of the breath.
Factors Affecting the BAC
There are many factors that impact a blood alcohol concentration. Because not everyone absorbs and metabolizes alcohol in the same way, there is no exact method to determine how many drinks a particular individual must consume to reach a particular blood alcohol level. However, overall, body weight is a common and significant factor. A general rule is that the smaller the person is, the less alcohol one can consume before reaching legal limits of intoxication. Consequently, a small person will become more intoxicated than someone larger who drinks the same amount of alcohol. For example, a person who weighs 100 pounds can have a BAC of 0.032 with one drink. In contrast, a person who weighs 200 pounds can have a blood alcohol concentration of 0.016 with one drink—half the level of intoxication for the smaller person. Also, those with an Alcohol Use Disorder that involves regular heavy use may not become intoxicated as quickly as someone with such a disorder. One drink is considered 1.5 ounces of liquor, 12 ounces of beer, or 5 ounces of wine.
The BAC and Binge Drinking
Binge drinking is the most common pattern of alcoholic drinking in the United States. It is a pattern of heavy episodic use in which a person becomes intoxicated quickly by consuming a large amount of alcohol in a short period of time. Binge drinking is usually considered to be an episode of use in which women consume at least four drinks in approximately two hours. Because men are typically larger and metabolize alcoholic drinks differently than women, a binge episode for them is defined as consuming at least 5 drinks in 2 hours.
Binge drinking rapidly elevates the blood alcohol content. It essentially raises the BAC level to .08 or above in a relatively short period of time. Most binge drinkers seem to pursue rapid intoxication, preparing for an event, or perhaps ‘cramming’ their drinking into a limited schedule. Many who binge drink also report having lost control of their consumption with the first or second drink of the binge. Consequently, there are many health risks involved which include alcohol poisoning or overdose, accidents and injuries, neurological damage, high blood pressure, stroke and other cardiovascular problems, liver disease and impaired judgment. Binge drinkers also tend to engage in high-risk behaviors such as unprotected sex.
Apart from the health risks, there are other consequences of binge drinking that can be quite severe. For example, it was estimated in 2010 that binge drinking cost the United States approximately 190 billion dollars. This sum includes lost work productivity, healthcare costs, and crime-related expenses.
Binge Drinking and Denial
Binge drinking is one of the most difficult patterns of problem drinking to overcome. A significant reason is that binge drinkers typically have a great deal of denial. Because they do not drink daily or even weekly, binge drinkers can rationalize their behavior as not problematic, and their use as not alcoholic.
There is a pervasive and mistaken view of the “alcoholic” as someone who must drink every day, and who does not function well in daily life. Not every binge drinker can be diagnosed as having an Alcohol Use Disorder—the medical terminology for alcoholism–but many can. Loved ones can have a great deal of difficulty confronting a binge drinker’s behavior, and the drinker’s denial can be intense. Binge drinkers may become seriously impaired when binging, but otherwise, can compare themselves to mistaken beliefs about alcoholism and decide they do not have a drinking problem.
Also, between binges people can return to some level of functioning in which they do well enough to dismiss problematic drinking as interfering in their lives. Even though they may have a period in which they must recover in several ways from a recent binge, this is easy to ‘forget’ after a time. During those recovery times, however, there can be problems with fatigue, poor concentration, declined work production, increased irritability, and unstable mood. Also, many binge drinkers have social consequences to ‘clean up’ after an episode in which their intoxicated behavior was offensive or injurious in some way.
Blackouts can occur in binge drinking that compound denial. Unless others report behavior the binge drinker can’t remember there may be no recollection of the events at all. Blackouts are memory loss, and so even with feedback from others, the events may not surface in the drinker’s memory. Some people may not believe the reports given by observers because they cannot remember them. All in all, these types of issues complicate denial for binge drinkers and are the direct result of high BAC levels during their binge.
BAC and Related Impairments
The level of BAC can have varying degrees of impairment for some individuals, particularly those who have a very high tolerance for alcohol consumption. Tolerance for large amounts of alcohol develops after chronic use and is one of the symptoms of an Alcohol Use Disorder or what is commonly called alcoholism. Therefore, comparing BAC levels to specific impairments is a general guideline, but can vary. For example, a person with no tolerance developed for alcohol can have fatal alcohol poisoning with less consumption than another who has developed a high tolerance. Generally, a BAC of .2% indicates severe intoxication and one of .35% indicates poisoning.
General guidelines for BAC levels and their related impairments are:
0.02-0.03 BAC: Mild relaxation, slightly euphoric, slightly less socially inhibited, perhaps feeling ‘a little tipsy’
0.04-0.06 BAC: Deeper relaxation, greater loss of social inhibitions, feelings of warmth, well-being, minor reasoning impairment, euphoria, greater social risks
0.07-0.09 BAC: Impaired coordination, balance, reaction time, reasoning and judgment.
0.10-0.125 BAC: Significant impairment of motor coordination and loss of good judgment. Speech may be slurred; balance, vision, reaction time and hearing will be impaired. Euphoria, low inhibitions, sense of being able to function than one can.
0.13-0.15 BAC: Loss of physical control over coordination, balance, and movement. Blurred vision, perceptions are altered and judgment is significantly impaired. Irritability, restlessness, sense of distress.
0.16-0.19 BAC: Low mood, feeling sad, depressed, angry. GI distress. Impairments above continuing and worsening.
0.20 BAC: Standing and walking are difficult. Nausea and vomiting are typical. Confused and disoriented.
0.25 BAC: Severe impairment in all realms. Serious risk of injuries and accidents. Risk of asphyxiation from vomiting and lying on back, not cognizant of vomiting.
0.30 BAC: Stupor commonly called ‘passing out’, not readily responsive to be aroused or addressed.
0.35 BAC: Coma similar to state induced by anesthesia.
0.40 BAC and up Possible respiratory arrest and death.
If you or a loved one need help due to problematic drinking, don’t hesitate. Get help today. We will provide a free consultation by phone to clarify needs, and we will check your insurance coverage for you. From there, we can make recommendations for treatment options that can address clinical needs and that are covered by your insurance, or have financial arrangements within your means.