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Hello! I Know An Individual That Was In A Car
Question: Hello! I know an individual that was in a car accident and was wearing his seatbelt who had been drinking alcohol. Upon impact, his bladder ruptured. My question is, could the rupture of the bladder and the Ieaking of urine in the abdominal cavity in any way effect a breathalyzer? Thank you!
Brief Answer:
Tricky.....
Detailed Answer:
Thanks for asking...
The alcohol in the bladder would be reabsorbed, but, that is a relatively small contribution to the overall amount of alcohol in the system.
Furthermore, one can be impaired regardless of the alcohol level as a judgment call. So... if the level was just barely and they were otherwise not impaired, it's still quite a stretch.
Mostly they are going to be 50% or more above the limit... most DUI's aren't close....and then, I don't think the small amount in the bladder is going to do that.
Let me know if I can assist you further.
Tricky.....
Detailed Answer:
Thanks for asking...
The alcohol in the bladder would be reabsorbed, but, that is a relatively small contribution to the overall amount of alcohol in the system.
Furthermore, one can be impaired regardless of the alcohol level as a judgment call. So... if the level was just barely and they were otherwise not impaired, it's still quite a stretch.
Mostly they are going to be 50% or more above the limit... most DUI's aren't close....and then, I don't think the small amount in the bladder is going to do that.
Let me know if I can assist you further.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
I understand. Due to the liver metabolizing most of the alcohol before it reaches the bladder I figured it would be a very small amount, if any, but could not find any studies on the matter. Secondly, in your medical opinion, could an individual with a BAC of .23 make an informed medical decision to go to the hospital at that time? I am an RN and to me at that level of intoxication, one would not be able to make a medical decision. Especially since alcohol would dull one’s senses and response to pain.
Brief Answer:
It's impossible to say
Detailed Answer:
I've had patients who were literally double that amount and did not seem drunk. That is quite a dangerous dose and not being impaired at high levels of alcohol is a recognized risk for alcoholism.
There is considerable variability and you can't say what effect being about 3x the legal limit will do.
People are responsible for getting into trouble with alcohol. If someone is unable to make a decision, they are still responsible for having gotten that way.
It's impossible to say
Detailed Answer:
I've had patients who were literally double that amount and did not seem drunk. That is quite a dangerous dose and not being impaired at high levels of alcohol is a recognized risk for alcoholism.
There is considerable variability and you can't say what effect being about 3x the legal limit will do.
People are responsible for getting into trouble with alcohol. If someone is unable to make a decision, they are still responsible for having gotten that way.
Above answer was peer-reviewed by :
Dr. Kampana
I see what you are saying. To be honest, the individual I am describing is my father and he has been a highly functional alcoholic my entire life (I%E2%80%99m 25). I was not expecting to get a reply from an Addiction Specialist, so my final question will be regarding this. My dad is an extremely successful businessman who has never had any criminal charges until this incident. He has a high level of anxiety ranging from having social anxiety to having anxiety if someone even watches him sign his name. This is something he hides extremely well and self-medicates with alcohol. It has been a week since the accident and my dad has shown zero signs of any withdrawal symptoms. Which is unheard of considering he has drank 10 beers a day at minimum for the past 25 years. With your experience, I%E2%80%99m wondering if you have any advice with how to approach him with treatment options?
Brief Answer:
There are many.
Detailed Answer:
Wow. The surprising thing is if panic attacks are involved there has to be a lot of drinking during the day at work. Amazing things didn't totally fall apart.
Ok, it's pretty obvious the guy's a genius. AND has enablers. Less obvious is the truly awful situation he's been in. The amount of withdrawal varies and most people just don't go into DT's or seizures. HOWEVER, most people do have their wiring significantly altered by alcohol both in the short and the long term and this sets up for a lot of withdrawal manifesting as panic attacks.
It's EASY in this case for the treatment options. His is on the easier side of the people I see. First of all increasing guilt, pain, sadness, regret triggers the parts of the brain that run addiction. But it's pretty easy to NOT do that in this case. Expressing love and admiration for being able to hold it together. AND YOU have been the recipient of his being able to hold things together which was an amazing feat. At this point it's a blameless corner he's gotten stuck in with ingrained patterns and real brain chemistry problem that can be helped a lot and he'll have a much better life. It's real easy to phrase things positively.
BUT, here's the kicker.... YOU don't have to do anything but be supportive and loving. HIS LAWYER has to be instructed on:
1) the court will treat him much nicer if he is in SEVERAL treatment options.
2) if he gets an addiction doctor to talk about the disease nature of alcoholism and the high likelihood it can be treated (easier than diabetes in his case).
3) and that he better get into treatment or he's in big legal/job/health problems
In general, most alcohol treatments have about a 25% success rate which isn't that much higher than placebo
https://cda.cochrane.org/our-reviews
but not in his case.....
Cognitive behavioral therapy. He'll just have a much better life with it. And, you don't have to present the need for it. He doesn't have to even buy into his having a problem. CBT runs well over a 50% success rate; closer to 90% on social anxiety and panic. It's about the most effective psychological intervention and this is the thing it works best on.
The courts like 12 step programs with being reliable on showing up to meetings and seeing addiction specialists and being on medication. And these have a lot more success with panic attacks than they do with alcoholism.
--------------------------------------------
some specific tactics; but the lawyer will handle it, you need to make sure the lawyer doesn't screw things up by overemphasis on 12 step and not doing any cognitive behavioral therapy nor medications (mainly for panic attacks).
Medications and CBT are quite likely to work. He is quite likely to follow through on them. The time frame to see benefits is relatively fast like a couple months.
There are many.
Detailed Answer:
Wow. The surprising thing is if panic attacks are involved there has to be a lot of drinking during the day at work. Amazing things didn't totally fall apart.
Ok, it's pretty obvious the guy's a genius. AND has enablers. Less obvious is the truly awful situation he's been in. The amount of withdrawal varies and most people just don't go into DT's or seizures. HOWEVER, most people do have their wiring significantly altered by alcohol both in the short and the long term and this sets up for a lot of withdrawal manifesting as panic attacks.
It's EASY in this case for the treatment options. His is on the easier side of the people I see. First of all increasing guilt, pain, sadness, regret triggers the parts of the brain that run addiction. But it's pretty easy to NOT do that in this case. Expressing love and admiration for being able to hold it together. AND YOU have been the recipient of his being able to hold things together which was an amazing feat. At this point it's a blameless corner he's gotten stuck in with ingrained patterns and real brain chemistry problem that can be helped a lot and he'll have a much better life. It's real easy to phrase things positively.
BUT, here's the kicker.... YOU don't have to do anything but be supportive and loving. HIS LAWYER has to be instructed on:
1) the court will treat him much nicer if he is in SEVERAL treatment options.
2) if he gets an addiction doctor to talk about the disease nature of alcoholism and the high likelihood it can be treated (easier than diabetes in his case).
3) and that he better get into treatment or he's in big legal/job/health problems
In general, most alcohol treatments have about a 25% success rate which isn't that much higher than placebo
https://cda.cochrane.org/our-reviews
but not in his case.....
Cognitive behavioral therapy. He'll just have a much better life with it. And, you don't have to present the need for it. He doesn't have to even buy into his having a problem. CBT runs well over a 50% success rate; closer to 90% on social anxiety and panic. It's about the most effective psychological intervention and this is the thing it works best on.
The courts like 12 step programs with being reliable on showing up to meetings and seeing addiction specialists and being on medication. And these have a lot more success with panic attacks than they do with alcoholism.
--------------------------------------------
some specific tactics; but the lawyer will handle it, you need to make sure the lawyer doesn't screw things up by overemphasis on 12 step and not doing any cognitive behavioral therapy nor medications (mainly for panic attacks).
Medications and CBT are quite likely to work. He is quite likely to follow through on them. The time frame to see benefits is relatively fast like a couple months.
Note: In case of any other concern or query related to prevention, evaluation, diagnosis, treatment, or the recovery of persons with the any type of addiction or substance use, follow up with our Addiction Medicine Specialist. Click here to book a consultation now.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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