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One Of The Doctors On This Service Wrote Me That
Question: One of the doctors on this service wrote me that alcohol leaves the system/body at a rate of 20 mg/dl per hour. All my online research says 15/16 mg/dl. So which is right? I monitor alcohol intake because I am on various medications that are contraindicated with alcohol in the system. Please confirm the dissipation rate for me. Also please verify that 20 mg/dl is the same as .02 on a BAC chart. Similarly, 16 mg/dl would be .016 on a BAC chart. I am a 63 year old male, 6 1%E2%80%9D and 215 pounds. Thanks.
Brief Answer:
cannot say in your particular case
Detailed Answer:
because there is considerable variation in the rate of alcohol removal. First, people vary in the level of liver metabolism. It is increased by previous exposure to some chemicals. It is increased slightly by previous alcohol exposure and more by exposure to a few different drugs that really change liver metabolism. And, it just varies genetically.
We're ignoring the metabolism of alcohol by the gut PRIOR to entering the body (about 10% of it; varies. it is MUCH less on an empty stomach as you probably KNOW). We're ignoring elimination of alcohol that does not depend on liver metabolism. Breathing it out. sweating it out, peeing it out.
The MAXIMUM is about 8 grams out per hour.
https://pubmed.ncbi.nlm.nih.gov/0000-clinical-pharmacokinetics-of-ethanol/?from_term=%22Ethanol%2Fpharmacokinetics%22%5BMeSH%5D&from_page=1&from_pos=5
IN short, everything everyone told you is totally right. They are all in the published range of alcohol elimination
https://pubmed.ncbi.nlm.nih.gov/0000-evidence-based-survey-of-the-elimination-rates-of-ethanol-from-blood-with-applications-in-forensic-casework/
0.15 to 0.2
oh, and your math and all the numbers are all correct also. It's just there's variabiity between 0.15 to 0.2 so, most people fall in that range but there IS a range of variability
cannot say in your particular case
Detailed Answer:
because there is considerable variation in the rate of alcohol removal. First, people vary in the level of liver metabolism. It is increased by previous exposure to some chemicals. It is increased slightly by previous alcohol exposure and more by exposure to a few different drugs that really change liver metabolism. And, it just varies genetically.
We're ignoring the metabolism of alcohol by the gut PRIOR to entering the body (about 10% of it; varies. it is MUCH less on an empty stomach as you probably KNOW). We're ignoring elimination of alcohol that does not depend on liver metabolism. Breathing it out. sweating it out, peeing it out.
The MAXIMUM is about 8 grams out per hour.
https://pubmed.ncbi.nlm.nih.gov/0000-clinical-pharmacokinetics-of-ethanol/?from_term=%22Ethanol%2Fpharmacokinetics%22%5BMeSH%5D&from_page=1&from_pos=5
IN short, everything everyone told you is totally right. They are all in the published range of alcohol elimination
https://pubmed.ncbi.nlm.nih.gov/0000-evidence-based-survey-of-the-elimination-rates-of-ethanol-from-blood-with-applications-in-forensic-casework/
0.15 to 0.2
oh, and your math and all the numbers are all correct also. It's just there's variabiity between 0.15 to 0.2 so, most people fall in that range but there IS a range of variability
Above answer was peer-reviewed by :
Dr. Kampana
OK. Thank you. For my purposes then and for general safety, I will use 15 in my dissipation calculations. FYI, this is important to me as I have been taking Xanax for over 20 years for occasional panic and general anxiety. I used to take 4 mgs a day but now i just take 2 mgs at bedtime. My drinking behaviors have not changed in those 20 years but with all the recent press re opioids, and by association Benzodiazepines, there is a heightened awareness and sensitivity to mixing with alcohol. For this reason, and because I take the 2 mgs every night, I like to know I am taking it safely. I appreciate your prompt response and will rate as excellent 5 stars. Thank you Dr. Wachsman.
Brief Answer:
several points.
Detailed Answer:
Ok, if they aren't in the body at the same time alcohol and xanax cannot interact to affect respiration/overdose. BUT they can still interact with dependence issues. Of course if someone is talking about boundaries about ONE xanax a day and ONE drink of alcohol a day, then dependence/loss of control does NOT seem to be an issue.
And, just something you should know is the TAKING of them is one thing and we are looking at the same numbers and doing the same math and coming up with the same answers.
BUT, the not taking them is quite another. and there is likely to be some withdrawal if one were to stop even a reasonable and safe amount of two depressants suddenly. THis is generally a withdrawal that is NOT going to get someone admitted...a raise of 10 points in blood pressure and pulse. But you should be aware that a sudden change in your routine can be a problem.
several points.
Detailed Answer:
Ok, if they aren't in the body at the same time alcohol and xanax cannot interact to affect respiration/overdose. BUT they can still interact with dependence issues. Of course if someone is talking about boundaries about ONE xanax a day and ONE drink of alcohol a day, then dependence/loss of control does NOT seem to be an issue.
And, just something you should know is the TAKING of them is one thing and we are looking at the same numbers and doing the same math and coming up with the same answers.
BUT, the not taking them is quite another. and there is likely to be some withdrawal if one were to stop even a reasonable and safe amount of two depressants suddenly. THis is generally a withdrawal that is NOT going to get someone admitted...a raise of 10 points in blood pressure and pulse. But you should be aware that a sudden change in your routine can be a problem.
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. Prasad
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