Legal Medicine

Lecture 7
Topic: Alcoholism

John Yves D. Esteves, RN, MD, MBA

Registered Nurse
Licensed Physician
Master in Business Administration
 Alcoholic Beverages
• Are primarily a mixture of water and ethyl alcohol with
small amount of other substances which impart the
characteristic odor and tastes
• Drunkard – a person who habitually takes or uses any
intoxicating alcoholic liquor and while under the
influence of such, or is consequence of the effect
thereof, is either dangerous to himself and to others.
• Habitual Drunkard- one who is excessively uses
intoxicating drink. Habit should be actual or confirmed
 Classification of commercially available
Alcoholic Beverages
• Wine – a product of natural alcoholic fermentation
with wide variety of sugary materials including fruit
juices. Contains 7-17% alcohol (red wine, white wine,
lambanog)
• Distilled Liquor- produced from distillate of wines,
distilled from grains or starch soultion or from
aromatic substances. 12-14% alcohol. (Whiskey, Gin,
Rum, Vodka)
• Malt – brewed from malt or malt substitute. 2-10%
alcohol (Ale, Beer, Stout, Porter)
Causes of Drinking Alcoholic Beverages

• Curiosity
• As a symbol of friendship
• An escape from unpleasant realities
• Part of religious ceremonies
• A stimulant to combat shyness
• It is a source of hear and energy
Provisions of Law Regarding Alcoholism
• Intoxication is an alternative circumstance to
criminal liability
• Public scandal committed by a person while drunk
is punishable
• Contracts agreed to in a state of drunkenness are
voidable
• The law penalizing manufacture of liquor without
license if valid
• The state may prevent some people from drinking
highly spirited wine
 Effects on the Special Sense
• Vision- acuity is progressively diminished
• Hearing- diminished ability to hear sound
• Touch- diminished
• Taste- decreased sense of taste
• Smell- depressed
 Clinical Signs and Symptoms in Relation to
Blood Alcohol Level
• 10mg % Pleasant Clearing of head
• 20mg % Physical feeling of well-being
• 50mg % The feeling of being at the top of the world. Increases
self-confidence; depressed attention, judgment, and control
• 100mg % “Under the influence”; Mental confusion, impaired
judgment, impaired memory and comprehension.
• 150mg % “Intoxicated” deterioration of skills and performance
• 150mg-300 % Inability to walk and do coordinated body
movements, disorientation, exaggerated emotions
• 300mg % Impaired consciousness, sleep, stupor
• 400mg % Anesthetic level. Death may occur. Coma. Urine and
fecal incontinence.
Symptomatic Changes following Ingestion of
Alcoholic Beverages
• Stage of Excitement – feeling of well-being
• Stage of Incoordination – coordination is lost
• Stage of Narcosis or Coma – deep sleep
 Degree of Intoxication
• Slight Inebriation – Flushing face, exaggerated
mood, but able to control behavior
• Moderate Inebriation – talkative,
argumentative, overconfident
• Drunk – mind is confused, uncontrolled
behavior, uncoordinated movement
• Very Drunk – disoriented and can not walk
• Coma
 Romberg’s Test
• Test to determine drunkenness
• Let the subject stand straight with heels
together and with closed eyes for at least one
minute. If he is not drunk, he will not sway to
the front or sides, but if he is drunk, the body
will not be stable.
Conditions Simulating Alcoholic Intoxication

• Severe head injury

• Metabolic disorders
• Neurological Conditions
• Effect of Drugs
• Psychological Disorders
• High fever
• Exposure to carbon monoxied
 How Alcohol Diminishes Driving Skills

• It lengthens the reaction time. The driver

becomes sluggish in his reaction in an
impending danger
• It creates a false feeling of confidene
• It impairs concentration, dulls judgment, and
degrades muscular coordination
• It decreases visual and auditory acuity
 Causes of Deaths in Alcoholics
• Acute Alcoholic Intoxication
• Hidden Trauma
• Unexpected Aspiration of Food
• Poisoning by contaminants in beverages
• Disease Associated with Complications of
Alcoholism
 Laboratory Examination in Alcoholism

• Analysis of Blood
• Analysis of Breath
• Analysis of Urine
• Analysis of Body Tissue
• Analysis of Saliva, Perspiration, Spinal Fluid