Alcohol intoxication
Classification and external resources
The Drunkenness of Noah by Michelangelo
ICD-10	F10.0, T51
ICD-9	305.0, 980
MeSH	D000435

Alcohol intoxication (also known as drunkenness or inebriation) is a physiological state that occurs when a person has a high level of ethanol (alcohol) in his or her blood.

Common symptoms of alcohol intoxication include slurred speech, euphoria, impaired balance, loss of muscle coordination (ataxia), flushed face, vomiting, reddened eyes, reduced inhibition, and erratic behavior. In severe cases, it can cause coma or death.

Toxicologists use the term “alcohol intoxication” to discriminate between alcohol and other toxins.

Acute alcohol intoxication results from a very high level of alcohol in the blood. This term is used by health care providers, often in emergencies.

Pathophysiology[link]

Development of a rational scale to assess the harm of drugs of potential misuse, The Lancet, 2007

Alcohol is metabolized by a normal liver at the rate of about one ounce (one "highball", a normal beer, a regular sized glass of wine) every 90 minutes. An "abnormal" liver with conditions such as hepatitis, cirrhosis, gall bladder disease, and cancer will have a slower rate of metabolism.

Ethanol is metabolised to acetaldehyde by alcohol dehydrogenase (ADH), which is found in many tissues, including the gastric mucosa. Acetaldehyde is metabolised to acetate by acetaldehyde dehydrogenase (ALDH), which is predominantly found in liver mitochondria. Acetate is used by the muscle cells to produce acetyl-CoA using the enzyme acetyl-CoA synthetase, and the acetyl-CoA is then used in the citric acid cycle.^[1] It takes roughly 90 minutes for a healthy liver to metabolize a single ounce, approximately one hour per standard unit.

Ethanol's acute effects are largely due to its nature as a central nervous system depressant, and are dependent on blood alcohol concentrations:

• 20–99 mg/dL - Impaired coordination and euphoria
• 100–199 mg/dL - Ataxia, poor judgement, labile mood
• 200–299 mg/dL - Marked ataxia, slurred speech, poor judgement, labile mood, nausea and vomiting
• 300–399 mg/dL - Stage 1 anaesthesia, memory lapse, labile mood
• 400+ mg/dL - Respiratory failure, coma

As drinking increases, people become sleepy, or fall into a stupor. After a very high level of consumption, the respiratory system becomes depressed and the person will stop breathing. The most important thing for friends who witness someone "passing out" from too much alcohol is to get them emergency medical treatment. Comatose patients may aspirate their vomit (resulting in vomitus in the lungs, which may cause "drowning" and later pneumonia if survived). CNS depression and impaired motor co-ordination along with poor judgement increases the likelihood of accidental injury occurring.^[2] It is estimated that about one third of alcohol-related deaths are due to accidents (32%), and another 14% are from intentional injury.^[3]

In addition to respiratory failure and accidents caused by effects on the central nervous system, alcohol causes significant metabolic derangements. Hypoglycaemia occurs due to ethanol's inhibition of gluconeogenesis, especially in children, and may cause lactic acidosis, ketoacidosis and acute renal failure. Metabolic acidosis is compounded by respiratory failure. Patients may also present with hypothermia.

Pharmacology[link]

In the past alcohol was believed to be a non-specific pharmacological agent, affecting many neurotransmitter systems in the brain.^[4] However, molecular pharmacology studies have shown that alcohol has only a few primary targets. In some systems these effects are facilitatory and in others inhibitory.

Among the neurotransmitter systems with enhanced functions are: GABA_A,^[5] glycine,^[5] serotonin,^[6] nicotinic acetylcholine receptors.^[7]

Among those that are inhibited are: NMDA,^[6] dihydropyridine-sensitive L-type Ca2+ channels^[8] and G-protein-activated inwardly rectifying K+ channels.^[9]

The result of these direct effects are a wave of further indirect effects involving a variety of other neurotransmitter and neuropeptide systems, leading finally to the behavioural or symptomatic effects of alcohol intoxication.^[4]

Diagnosis[link]

Definitive diagnosis relies on a blood test for alcohol, usually performed as part of a toxicology screen.

Law enforcement officers often use breathalyzer units and field sobriety tests as more convenient and rapid alternatives to blood tests. The reliability of field sobriety tests is somewhat questionable, although they are commonly used in various jurisdictions.^{[citation needed]}

There are also various models of breathalyzer units that are available for consumer use. Because these may have varying reliability and may produce different results than the tests used for law-enforcement purposes, the results from such devices should be conservatively interpreted.

Many informal intoxication tests exist, which are generally unreliable and not recommended as deterrents to excessive intoxication or as indicators of the safety of activities such as motor vehicle driving, heavy equipment operation, machine tool use, etc.

For determining whether someone is intoxicated by alcohol by some means other than a blood-alcohol test, it is necessary to rule out out other conditions such as hypoglycemia, stroke, usage of other intoxicants, mental health issues, and so on. It is best if their behavior has been observed while the subject is sober to establish a baseline. Several well known criteria can be used to establish a probable diagnosis. For a physician in the acute treatment setting, acute alcohol intoxication can mimic other acute neurological disorders, or is frequently combined with other recreational drugs that complicate diagnosis and treatment.

Epidemiology[link]

Common causes for excessive alcohol consumption include:

• alcoholism
• depression
• inexperience with the effects of alcohol

Alcohol poisoning[link]

Signs and symptoms[link]

The signs and symptoms of alcohol poisoning include:

• confusion
• vomiting^[10]
• dangerous anger
• seizures (fits)
• slow breathing (fewer than eight breaths a minute)
• pale, bluish skin
• cold and clammy skin^[11]

Management[link]

Emergency treatment for acute alcohol intoxication strives to stabilize the patient and maintain a patent airway and respiration, while waiting for the alcohol to metabolize:^[12] Also:

• Protect vital signs by monitoring ABCs, or Airway, Breathing, and Circulation; that is, if the person is thought to be at risk for severe respiratory depression, consider an endotracheal tube to protect the airway and assist with breathing.
• Protect the airway from aspirating stomach contents that could cause aspiration pneumonia.
• Treat hypoglycaemia (low blood sugar) with 50ml of 50% dextrose solution and saline flush, as ethanol induced hypoglycaemia is unresponsive to glucagon.
• Administer the vitamin thiamine to prevent Wernicke-Korsakoff syndrome, which can cause a seizure (more usually a treatment for chronic alcoholism, but in the acute context usually co-administered to ensure maximal benefit).
• Check urea and electrolytes to guide fluid replacement.
• Apply haemodialysis if the blood concentration is dangerously high (>400 mg%), and especially if there is metabolic acidosis.
• Provide oxygen therapy as needed via nasal cannula or non-rebreather mask.

Additional medication may be indicated for treatment of nausea, tremor, and anxiety.

Prognosis[link]

A normal liver detoxifies the blood of alcohol over a period of time that depends on the initial level and the patient's overall physical condition. An abnormal liver will take longer but still succeed, provided the alcohol does not cause liver failure.^[13]

People who have been drinking heavily for several days or weeks may have withdrawal symptoms after the acute intoxication has subsided.^[14]

A person who consumes a dangerous amount of alcohol persistently can develop memory blackouts and idiosyncratic intoxication or pathological drunkenness symptoms.^[15]

Long-term persistent consumption of excessive amounts of alcohol can cause liver damage and have other deleterious health effects.

Society and culture[link]

Legal[link]

Laws on drunkenness vary between countries. In the United States, for example, it is a criminal offense for a person to be drunk while driving a motorized vehicle (driving under the influence), operating an aircraft, or (in some states) assembling or operating an amusement park ride.^[16] This is also the case in the United Kingdom and many other countries. In some countries it is also an offense to serve alcohol to an already intoxicated person and often alcohol can only be sold by staff qualified to serve responsibly through alcohol server training.

The blood alcohol content (BAC) for legal operation of a vehicle is typically measured as a percent of unit volume of blood. This ranges from a low of 0.00% in Romania and the United Arab Emirates, to 0.05% in Australia, South Africa and Germany, to 0.08% in the United Kingdom, the United States, and New Zealand.^[17]

Additionally, the U.S. Federal Aviation Administration prohibits crewmembers from performing their duties with a BAC greater than 0.04%, within 8 hours of consuming an alcoholic beverage or while under the influence of alcohol.^[18][19]

In the UK, US, and Australia, people can be arrested for public intoxication, being "drunk and disorderly" or being "drunk and incapable".^[20] There are also often legal penalties for the sale of alcoholic beverages to intoxicated persons.^[21]

In some jurisdictions, intoxication may be a defense against some criminal charges, or a mitigating factor in sentencing.

Religious views[link]

Some religious groups permit the consumption of alcohol, some permit consumption but prohibit intoxication, and some prohibit alcohol consumption altogether. In the Qur'an,^[22][23][24] there is a prohibition on the consumption of grape-based alcoholic beverages, and intoxication is considered as an abomination in the Hadith. Islamic schools of law (Madh'hab) have interpreted this as a strict prohibition of the consumption of all types of alcohol and declared it to be haraam ("forbidden"), although other uses may be permitted.^[25]

Some Protestant Christian denominations prohibit the drinking of alcohol^[26] based upon Biblical passages which condemn drunkenness (for instance, Proverbs 23:21,^[27] Isaiah 28:1,^[28] Habakkuk 2:15.^[29]), but others allow moderate use of alcohol.^[30] In some Christian groups, wine is part of the rite of communion (see Christianity and alcohol). However, in The Church of Jesus Christ of Latter-day Saints, alcohol consumption is forbidden,^[31] to the point where teetotalism has become a distinguishing feature of its members.

In Buddhism, the consumption of intoxicants is generally discouraged for both monastics and lay followers. Many followers of Buddhism observe a code of conduct known as the Five Precepts, of which the fifth precept prohibits consumption of intoxicating substances (except for medical reasons). In the Bodhisattva Vows of the Brahma Net Sutra, observed by some monastic communities and some lay followers, distribution of intoxicants is likewise discouraged as well as consumption.

In Vaishnavism, specifically Gaudiya Vaishnavism, one of the four regulative principles forbids the taking of intoxicants, including alcohol.

See also[link]

Wikisource has the text of the 1911 Encyclopædia Britannica article Drunkenness.

• Short-term effects of alcohol
• Long-term effects of alcohol
• Driving under the influence
• Alcohol and sex
• Alcohol flush reaction

References[link]

Bibliography[link]

• Bales, Robert F. "Attitudes toward Drinking in the Irish Culture". In: Pittman, David J. and Snyder, Charles R. (Eds.) Society, Culture and Drinking Patterns. New York: Wiley, 1962, pp. 157–187.
• Gentry, Kenneth L., Jr., God Gave Wine: What the Bible Says about Alcohol. Lincoln, Calif.: Oakdown, 2001.
• Rorabaugh, W.J. "The Alcoholic Republic," Chapter 2 & 5, Oxford University Press.
• Sigmund, Paul. St. Thomas Aquinas On Politics and Ethics. W.W. Norton & Company, Inc, 1988, p. 77.
• Walton, Stuart. Out of It. A Cultural History of Intoxication. Penguin Books, 2002. ISBN 0-14-027977-6.

External links[link]

• Alcohol Poisoning: NHS Choices

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Simon Pegg
Pegg at the San Diego Comic-Con International in July 2010.
Born	Simon John Beckingham (1970-02-14) 14 February 1970 (age 42) Brockworth, Gloucestershire, England
Other names	The Fresh Pegg
Occupation	Actor, comedian, writer, producer, singer, director
Years active	1995–present
Spouse	Maureen McCann (2005–present)
Children	Daughter
Website
www.peggster.net

Simon Pegg (born Simon John Beckingham; 14 February 1970) is an English actor, comedian, writer, film producer, and director. He is best known for having co-written and starred in various Edgar Wright features, mainly Shaun of the Dead, Hot Fuzz, and the comedy series Spaced.

He also portrayed Montgomery "Scotty" Scott in the 2009 Star Trek film, Benji Dunn in Mission: Impossible III and its sequel Mission: Impossible – Ghost Protocol, and Thompson in The Adventures of Tintin. Much of his major work has been in collaboration with some combination of Wright, Nick Frost, Jessica Hynes, and Dylan Moran. He also starred in and co-wrote Paul (with Frost) and Run Fatboy Run (with Michael Ian Black).

Early life[link]

Pegg was born in Brockworth, Gloucestershire, England, the son of Gillian Rosemary (née Smith), a civil servant, and John Henry Beckingham, a jazz musician and keyboard salesman.^[1] His parents divorced when he was seven and he took on the surname "Pegg" after his mother re-married.^[2][3] He attended many schools, including Castle Hill Primary School;^{[citation needed]} Brockworth Comprehensive Secondary School;^{[citation needed]} The King's School, Gloucester;^[4] and later Stratford-upon-Avon College to study English literature and Theatre.^[5]He studied drama at the University of Bristol and wrote his undergraduate thesis on "A Marxist overview of popular 1970s cinema and hegemonic discourses".^[3] At Bristol he appeared in a Drama Society production of Howard Barker's Victory alongside Sarah Kane and David Greig.^{[citation needed]}

Career[link]

Early appearances in TV series and films include Asylum, Six Pairs of Pants, Faith in the Future, Big Train and Hippies. Between 1998 and 2004, Pegg was regularly featured on BBC Radio 4's The 99p Challenge. In 1999, he created and co-wrote the Channel 4 sitcom Spaced with Jessica Stevenson. For this project Pegg brought in Nick Frost. For his performance in this series, Pegg was nominated for a British Comedy Award as Best Male Comedy Newcomer. Pegg co-wrote (with Spaced director Edgar Wright) and starred in the "romantic zombie comedy" film Shaun of the Dead, released in April 2004. At George A. Romero's invitation, Pegg and Wright made cameo appearances in Romero's film, Land of the Dead. In 2004, Pegg also starred in a spin-off of the television show Danger! 50,000 Volts! called Danger! 50,000 Zombies!, in which he played a zombie hunter named Dr. Russel Fell.

Pegg at a premiere for Star Trek in April 2009

Pegg's other credits include the World War II mini-series Band of Brothers, guest appearances on Black Books, Brass Eye Special, I'm Alan Partridge, The Parole Officer and in the Factory Records story 24 Hour Party People. He also played the mutant bounty hunter Johnny Alpha, the Strontium Dog, in a series of Big Finish Productions audio plays based on the character from British comic 2000 AD and featured in Guest House Paradiso, a film based on the sitcom Bottom.

Pegg appeared in the Big Finish Productions Doctor Who audio story Invaders From Mars as Don Chaney, and portrayed the Editor in the 2005 Doctor Who episode "The Long Game". He also narrated the first series of the documentary series Doctor Who Confidential.

Upon completion of Shaun of the Dead, Pegg was questioned on whether he would be abandoning the British film industry for bigger and better things, to which he replied "It's not like I'm going to run off and do Mission: Impossible III!" However, he then went on to play Benji Dunn, an I.M.F. technician who assists Tom Cruise's character, Ethan Hunt.^[6] In 2006 he played an American character, Gus, in Big Nothing alongside David Schwimmer.

In 2006, Pegg and Wright completed their second film, Hot Fuzz, released in February 2007. The film is a police-action movie homage and also stars Nick Frost. Pegg plays Nicholas Angel, a London policeman who is transferred to rural Sandford, a fictional village situated in Pegg's home county of Gloucestershire, where grisly events take place.

In 2007, Pegg starred in The Good Night (directed by Jake Paltrow) and Run Fatboy Run directed by David Schwimmer and co-starring Thandie Newton and Hank Azaria.

In 2008, Pegg wrote the dialogue for an English language re-release of the cult 2006 animated Norwegian film, Free Jimmy. Pegg received screenwriting credit for this, and Pegg also voiced one of the main characters in the English language version, which has an international range of actors including Woody Harrelson.

Pegg co-wrote and starred with Frost in the film Paul, about two young men who encounter a comedic extraterrestrial alien during a road trip across the US.^[7][8] The completed script appeared on the 2008 Black List, a film-industry-compiled list of the best unproduced screenplays. Paul received two votes.^[9]

Pegg also announced that he and Wright had the idea for "the concluding part in what we are calling 'The Three Flavours Cornetto Trilogy" (the first two being Shaun of the Dead and Hot Fuzz). It is provisionally called The World Ends.^[10]

In those films and in Spaced, Pegg typically plays the leading hero while Frost plays the sidekick. However, he has revealed that Paul will reverse this dynamic.^[11]

Pegg in New York City

Pegg played engineer Montgomery "Scotty" Scott in the eleventh Star Trek film,^[12] released 8 May 2009. In 2010 he appeared as William Burke in Burke and Hare, a film directed by John Landis about the Ulster men who were notorious murderers and bodysnatchers in early 19th-century Edinburgh. His likeness was also used for the character of Wee Hughie in the comic book series The Boys; while this was done without Pegg's permission, he quickly became a fan of the title, and even wrote the introduction to the first bound volume.^[13] He also voiced Reepicheep, the heroic mouse in Chronicles of Narnia: Voyage of the Dawn Treader.^[14]

Pegg reprised the role of Benji Dunn in Mission: Impossible – Ghost Protocol, making him the third actor in the film series, after Tom Cruise and Ving Rhames, to appear in more than one of the films.^[15] Despite having a minor role in his first appareance, Pegg became a member of the main cast in this film.

Personal life[link]

Pegg married Maureen McCann on 23 July 2005.^[16] On 21 February 2009, Pegg announced his wife was five months pregnant with the couple's first child.^[16] Their daughter Matilda^[17] was born circa early July, 2009.^[18] Pegg has stated on his personal Twitter feed that he is an atheist.^[19]

Along with Jonny Buckland, Pegg is godfather to Apple, daughter of close friends Chris Martin and Gwyneth Paltrow^[20] in return Martin is godfather to Pegg's daughter.^[21] Pegg's parents and sister briefly appeared in Spaced while his mother alone appeared in both Shaun of the Dead and Hot Fuzz.

Pegg was awarded an honorary fellowship by the University of Gloucestershire on 4 December 2008.^[22]

Filmography[link]

Television[link]

Film[link]

Video games[link]

References[link]

External links[link]

Wikimedia Commons has media related to: Simon Pegg

• Official website
• Simon Pegg at the Internet Movie Database
• Simon Pegg at AllRovi
• Simon Pegg at Memory Alpha (a Star Trek wiki)
• Simon Pegg in Gloucestershire
• BBC Radio Gloucestershire interview with Simon and John Beckingham (his father) – from the set of Run Fatboy Run

Shotgun Jimmie is the stage name of Jim Kilpatrick, a Canadian singer-songwriter.^[1] Formerly associated with the band Shotgun & Jaybird, since that band's breakup he has released several albums as a solo artist.

His 2011 album Transistor Sister was named as a longlisted nominee for the 2011 Polaris Music Prize.^[2]

Discography[link]

• The Onlys (2007)
• Still Jimmie (2009)
• Paint it Pink (2009, EP)
• Transistor Sister (2011)

References[link]

This article about a Canadian musician is a stub. You can help Wikipedia by expanding it. v t e