Behavioral Effects Of Alcohol

Studies have shown that the behavioral effects of ethanol and its associated impairment of performance are more pronounced when the BAC is rising than when it is falling. This observation seems to depend, at least in part, on the distribution of etha-nol between blood and tissue. The arterial blood concentration of ethanol is pumped to the brain and this exceeds the concentration measured in the venous blood, which is returning to the heart from skeletal muscles. This arterio-venous difference is most pronounced shortly after drinking; it decreases as ethanol diffuses equally into all body fluids. It seems that this is not the whole story, because some evidence points to the development of acute cellular tolerance to ethanol's effects—an aspect of tolerance that quickly develops.

Despite extensive studies of ethanol pharmaco-kinetics spanning many years, there are still a number of unsettled issues and areas of debate. Two such issues are (1) the practical advantages of Mi-chaelis-Menten kinetics as opposed to Widmark's zero-order model and (2) the role of gastric ADH in presystemic disposal of ethanol. The importance of blood source (artery, capillary, or vein) and the sampling site (arm or leg) on ethanol pharmacoki-netics deserves further study, as does whether mul-ticompartmental models should be invoked.

(SEE ALSO: Accidents and Injuries from Alcohol; Addiction: Concepts and Definitions; Alcohol; Chinese Americans, Alcohol and Drug Use among; Drug Interactions and Alcohol; Drug Metabolism;

Drunk Driving; Psychomotor Effects of Alcohol and Drugs; Vulnerability As Cause of Substance Abuse)

BIBLIOGRAPHY

Holford, N. H. G. (1987). Clinical pharmacokinetics of ethanol. Clinical Pharmacokinetics 13, 273-292. Von Wartburg, J. P. (1989). Pharmacokinetics of Alcohol. In K. E. Crow & R. D. Batt (Eds.), Human metabolism of alcohol. Boca Raton, FL: CRC Press. Widmark, E. M. P. (1981). Principles and applications of medicolegal alcohol determination. Davis, CA: Biomedical Publications. (English translation of Widmark's 1932 monograph, in German) Wilkinson, P. K. (1980). Pharmacokinetics of ethanol: A review. Alcoholism: Clinical and Experimental Research 4, 6-21.

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