Stay Safe on New Year’s Eve

December 31, 2014

Mark L. Friedman, MD, FACEP, FACP

We’ve all heard the usual advice before: Don’t drink on an empty stomach, no more than a drink per hour, intermix non-alcoholic beverages, etc.

Now for something totally different. I’ll call it “Friedman’s Principles of Alcohol.”

  • Alcohol is a drug. Like any drug it has a loading dose, therapeutic dose, maintenance dose, toxic dose, and lethal dose. Your goal, if a drinker, is to never exceed the “therapeutic“ dose.
  • Alcohol interacts with many other drugs. Sedatives, narcotic painkillers, antihistamines, many other medications, and a variety of non-medical drugs (marijuana, nicotine, caffeine) react in a variety of ways with alcohol. Death due to respiratory arrest, for example, can occur with combination doses of alcohol and narcotics that are individually sub-lethal.
  • While the “dose-response” level varies greatly between individuals, based on body size and enzymatic activity in the liver, for any one individual it is fairly predictable based on prior experience.
  • Alcohol levels are easily measurable and correlate fairly well to levels of mental and physical impairment.
  • Even small amounts of alcohol make certain activities exceedingly dangerous.

So how is all this useful on New Year's Eve?

If you measure your blood alcohol content (BAC) with a simple breathalyzer or calculate it via an online source you can see exactly where (or if) you can stand. The “legal” limit (to drive) in most states is below 0.08 (80mg/dl). Note that in the scheme of things this would not seem to be a terribly high level. However, if we refer back to principle #5, we understand that driving is one of those “exceedingly dangerous activities” (along with operating machines, using firearms, flying airplanes, etc.) that requires total sobriety.

Don’t mix alcohol and other drugs (refer to principle # 2). The death stories are too downbeat for this article.

Once you are equipped with a breathalyzer, bring it with you to the next party, tavern, or drinking event (or use it at home). Correlate your BAC to how you feel and act. Pretty soon you will begin to “feel” your BAC and to some degree know when you are sober and when you are not. Test your family and friends (buy / clean extra mouthpieces). Then guess one another’s BACs. This makes a great party game. If anyone’s level is > .08 (or whatever the limit in your state), don’t let them drive home!

Have a happy (and safe) New Year’s Eve.

Originally published Dec 31, 2014 12:06:00 PM.