Chapter 33: ALCOHOLISM

DEFINE | TERMS
Alcoholic beverages - primarily a mixture of water and ethyl alcohol with small amount of other
substances which impart the characteristic odors and tastes.
Pathological Drunkenness- A condition wherein a small amount of alcohol intake may be
sufficient to make a person drunk on account of an existing pathological condition of the body.
Brain concussion, sun-stroke, epilepsy and other conditions may predispose a person to the effects
of alcohol.
Punch Drunkenness- This is not a condition of drunkenness. It may be observed among
professional boxers who may have developed a peculiar physical and mental condition on account
of repeated trauma on the head.

KNOW
Classification of Commercially Available Alcoholic Beverages:
1. Wine — A product of natural alcoholic fermentation with wide variety of sugary materials
including fruit juices and contains not less than 7% but not more than 17% of alcohol by
volume. In fermented beverages the alcohol content is expressed in volume percent.
(Red Wine, White Wine, Dry Wine, Sweet Wine, Still Wine, Sparkling Wine, Fortified
Wine, Chinese Medicinal Wine, “Basi”, “Lambanog”)

2. Distilled Liquor — Distilled liquors are alcoholic beverages produced from distillate of
wines, distilled from grains or starch solution or distillate from aromatic substances. In
distilled beverages the alcohol contents are expressed in proofs. "Proof" is approximately
twice the percentage of alcohol by volume.
(Whiskey, Gin, Rum, Alcoholic Cordials and Liquors, Vodka)

3. Malt Liquors — Alcoholic beverages brewed from malt or from a mixture of malt and malt
substitute, like rye, and may contain other cereal grains and starchy saccharine matters. A
characteristic bitter flavor is imparted by the addition of hops. The amount of alcohol need
not be stated in the label.
(Ale, Beer, Stout, Porter)

Provisions of Law Regarding Alcoholism:

1. Intoxication is an alternative circumstance to criminal liability:
Art. 15, Revised Penal Code — Their concept:
Alternative circumstances are those which must be taken into consideration as
aggravating or mitigating according to the nature and effects of the crime and the other
conditions attending its commission. They are the relationship, intoxication, and the degree
of instruction and education of the offender.
 The intoxication of the offender shall be taken into consideration as a mitigating
circumstance when the offender has committed a felony in a state of intoxication, if the
same is not habitual or subsequent to the plan to commit said felony; but when the
intoxication is habitual or intentional it shall be considered as an aggravating circumstance.

1. Mitigating:
a. If intoxication is not habitual; or
b. If intoxication is not subsequent to the plan to commit the felony.
2. Aggravating:
a. If intoxication is habitual; or
b. If intoxication is subsequent to the plan to commit the felony.
2. Public scandal committed by a person while drunk is punishable:
To be drunk is not punishable, but if alarm and scandal happens in a public place
while at the state of intoxication, it is punishable.
Art. 155, Revised Penal Code — Alarms and scandals — The penalty of arresto menor or
fine not exceeding 200 pesos may be imposed upon:
4. Any person who while intoxicated or otherwise, shall cause any disturbance or
scandal in public places.

3. Contracts agreed to in a state of drunkenness are voidable

Art. 1328, Civil Code: Contracts entered into during a lucid interval are valid. Contracts
agreed to in a state of drunkenness or during a hypnotic spell are voidable.

4. The law penalizing manufacture of liquor without license is valid: If a person administers
beverages to another which is injurious to the latter without intent to kill, he is punished for
his wrongful act.
Art. 264, Revised Penal Code: Administering injurious substances or beverages:
The penalties established in the next preceding article (arresto mayor in its
maximum period to prision correccional in its minimum period) shall be applicable in the
respective cases to any person who, without intent to kill, shall inflict upon another any
serious physical injury, by knowingly administering to him any injurious substances or
beverages or by taking advantage of his weakness of mind and credulity.

5. The state may prevent some people from drinking highly spirited wine: The state may
promulgate laws which may prevent people of lower degree of civilization from drinking
scientifically manufactured, highly spirited liquor. The reason is to promote peace and
order.

Factors Responsible for the Tolerance and Susceptibility to Alcohol:

1. Tolerance to Alcohol:
Two or more persons of the same age, sex, weight and environmental up-bringing
may react differently to alcohol. One may be tolerant while others may be sensitive.
Tolerance of a person to alcohol may be a result of two different factors namely:
 a. Consumption Tolerance — A person who has developed tolerance may have
lesser percentage of blood alcohol as compared with another person who is not
used to it when given the same quantity at the same time. The reason is that those
habituated eliminate faster as compared with non-habitual drinkers.
b. Constitutional Tolerance — If a person habitually drinks alcoholic beverages
there develops a certain degree of adaptation by the body, thereby increasing the
body threshold to it. Later, greater quantity and percentage will be tolerated and
will lead to the diminution of its effects.
2. Susceptibility to Alcohol: The following factors render a subject unduly susceptible to the effects
of alcohol:
a. Exposure to extreme cold; or fatigue.
b. Pre-existing post-concussional state.
c. Chronic cerebral vascular state — e.g. hypertension, advanced cerebral
arteriosclerosis.
d. Cerebral depression caused by drugs, like barbiturates.
e. Neurological disorders, like disseminated sclerosis, intracranial tumor.
f. Psychological disorders.

EXPLAIN | DISCUSS
How Alcohol Influences the Production of Trauma:
Alcohol enhances the production of trauma in the following ways:
1. Alcohol increases the irritability and decreases the sense of responsibility of a person
which, in effect, may cause him to become involved in quarrels or accidents.
2. If a person is under the influence of alcohol, the anesthetic effect of alcohol may obscure
pain and other symptoms of injury so that serious trauma may be overlooked.
3. Alcohol, being a depressant, renders the individual susceptible to the effects of traumatic
shock or hemorrhage.
How Alcohol Diminishes the Driving Skill:
The basic of the maxim that "Don't drive when drunk and don't drink when driving" is that alcohol
deteriorates the driving skill in the following ways:
1. It increases the reaction time. The driver becomes sluggish in his reaction in an impending
danger.
2. It creates a false feeling of confidence.
3. It impairs concentration, dulls judgment and degrades muscular coordination.
4. It decreases visual and auditory acuity.
Post-mortem Findings in Death Due to Alcoholism:
Gross post-mortem findings are not characteristic. Most often the pathological findings were
associated with or have developed a complication of alcoholism that had been observed. However,
the following are some of the most common findings:
 1. Presence of "alcoholic odor" of the stomach contents. The odor emitted is not due to alcohol
but most often to that of the congener.
2. Congestion of the mucosa of the stomach.
3. Congestion of brain and its meninges.
4. Heart may be dilated and flabby and lungs congested and frothy, otherwise normal.
5. Blood, alveolar air and urine examinations reveal the presence of alcohol.

Objectives of Alcohol Examination:

1. For Screening
2. For evidentiary purposes
Chemical Test for Intoxication Admissible in Evidence:
Any chemical test for alcohol to determine whether a person is under the influence
of alcohol is admissible as evidence in court. The tendency of our modern court is to accept
scientific methods in crime detection provided that it has gone beyond the experimental
stage and has already been perfected.
Withdrawal of Blood for Alcohol Determination Not Giving Evidence Against the Defendant:
Withdrawal of blood from a person suspiciously drunk to determine the alcohol
concentration in the blood is not self-incriminatory. The act is purely mechanical and it does
not utilize the mental faculties of the subject.
Societal Reaction to the Problem of Alcoholism:
1. Promulgation of laws and regulations:
a. Manufacturing of liquor only to a certain percentage of alcohol in beverages.
b. Restricting the time and place of drinking and the availability of liquor to a
particular age, sex and other socio-economic group.
c. Subjecting drivers at random to an alcohol screening test, and if found positive, it
is to be followed by a quantitative determination of blood alcohol. If blood alcohol
exceeds the maximum tolerable limit prescribed, the driver can be arrested.

2. Various indoctrination methods may be employed to encourage moderation or abstinence,

like education in schools and churches.
3. An institutional-organization approach, introduces substitute form of tension relief into the
social structure. Subsequent removal of the cause of tension and diverting attention to
something else can also be looked into.
4. A variety of therapeutic approaches are taken under the concept that an alcoholic is a
patient:
a. Therapy combines medicine with psychiatry, psychology, social case work and
alcoholic anonymous
b. Pastoral counseling are given in churches
c. Half-way houses are built to bridge the gap between the penal institution and the
community.
DIFFERENTIATE
Methods Used in Alcohol Detection:
CHEMICAL METHOD | ENZYMATIC METHOD | GAS CHROMOTOGRAPHIC METHOD | INFRARED
ABSORPTION METHOD
1. Chemical Method — The sample is distilled and later allowed to react with a known
quantity of oxides, usually chromate, and it determines the amount of chromate which has
not reacted to alcohol. By computation the amount of alcohol in the sample can be
determined. This is the principle involved in the use of breath alcohol determination with
the use of Alco-tester (500), Breath analyzer (900A, 1000) and Alcometer (AE-D1).
2. Enzymatic Method — A known quantity of purified alcohol dehydrogenase and its
coenzyme nicotamide adenine nucleotide (NAD ) is allowed to react to the sample. Alcohol
is oxidized to aldehyde the coenzyme nicotinamide adenine dinucleotide (NAD) , and this
can be measured colorimetrically or spectophotometrically.
3. Gas Chromatographic Method — The specimen may be first purified or injected directly to
the apparatus.
4. Infrared Absorption Method — Alcohol is present as a vapor in breath. It absorbs specific
wave lengths of infrared. An intoxilyzer measures alcohol by detecting the decrease in the
intensity of infrared energy as it passes through the cell.

ENUMERATE:
Causes of Drinking Alcoholic Beverages:
1. Curiosity
2. It is being served as a symbol of friendship and sociability.
3. As an escape from unpleasant realities, it suppresses inner tension, deadens the pain of
failure, frustration and anxieties.
4. Alcohol is a part of religious ceremonies.
5. As a stimulant to combat shyness, inferiorities and to suppress strong inhibition.
6. It is a source of heat and energy.
Causes of Death in Alcoholics:
1. Acute Alcoholic Intoxication:
a. Paralysis of the medullary center — Alcohol depresses the nervous system by affecting the
cerebral cortex, basal ganglia, cerebellum, and finally the brain stem and medulla.
b. Cardiac myopathy — The heart muscles may suffer direct damage from the high
concentration of blood alcohol.
c. Ingestion of alcohol and synergistic drugs, like barbiturates and tranquilizers may cause
fatality. Potentiation of alcohol by psychotrophic drugs has been reported to have caused
death. A blood level of 0.45% or greater is generally accepted as a fatal level, although death
has occurred at a level below 0.35%.
2.Hidden Trauma
3. Unexpected Aspiration of Food ("Cafe Coronary"):
4. Poisoning by Congener or Contaminants in Alcoholic Beverages:
5. Diseases Associated with/or as a Complication of Alcoholism

Diagnostic Points of Drunkenness:

1. Alcoholic smell of the breath or of the vomitus.
2. Dry furred tongue or with excessive salivation.
3. Irregular behavior.
4. Congestion of the conjunctivae.
5. Hesitancy or thickness of speech with impaired articulation.
6. Tremor or error of coordination and orientation.
7. Examination of the blood and the urine shows the presence of alcohol.
8. History of having taken alcoholic beverages

Absorption and Distribution of Alcohol:

The rate of absorption of alcohol in the stomach and intestine depends upon the following :
1. Concentration and total quantity of alcohol taken.
2. Nature of the food in the stomach and intestine.
3. Volume of gastric content
4. Diseased condition of the stomach and intestine.
5. Length of time the gastric content is held in the stomach prior to the opening of the pylorus
and permeability of the stomach or intestinal wall.
6. The optimum concentration of alcohol in beverages between 10 to 20% is the most rapidly
absorbed.