High tolerance for alcohol

airguy

airguy

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airguy
http://www.avweb.com/avwebflash/new...runk_lavoie_court_blood_alcohol_208823-1.html

Wow - I don't think anything is going to help this guy...

Tested at 0.27 two and a half hours after landing. :yikes:

What is the FAA's view on this kind of high-tolerance? To be functional enough for 2.5 hours of verbal discussion with investigators before going for a BAC draw, and then still show a .27? Isn't that pretty much a permanent death sentence for you medical?
 
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I think this has been discussed ad nauseum in another thread. I'm too lazy to find it.

Short answer: FAA takes a dim view.

Sac answer: Can't be condoned, but all things considered, probably a good thing he had such a high tolerance, given a .27 BAC.
 
220px-DryToast.jpg
 
From the FAA's perspective, anything over .15 is a very big deal and it's very expensive and time-consuming to get past it. Bruce has the details.
 
At 0.27 most normal would be in danger of alcohol respiratory arrest, not operating a motor vehicle, let alone an aircraft. This is alcohol dependency.

This inpatient rehab, monitoring, minimum of 8 months down (more likely 12), continuing care, eval near the end by a HIMS certified neuropsych and HIMS psychiatrist, determination by the FAS, continued monitoring for at least 2 years if approved for return to service.

Inability to pay for this is not the FAS' problem. It's not unfair. The FAS did not get the DUI, this pilot did.
 
What is the FAA's view on this kind of high-tolerance? To be functional enough for 2.5 hours of verbal discussion with investigators before going for a BAC draw, and then still show a .27? Isn't that pretty much a permanent death sentence for you medical?
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Are you sure that the BAC in the article isn't a typo? Because it seems like .27 would be a permanent death sentence, period.
 
Headspace said:
Are you sure that the BAC in the article isn't a typo? Because it seems like .27 would be a permanent death sentence, period.
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Just heard a story yesterday about a woman in Bridgeview who was allowed to leave the police station with a BAL of .295, and they mentioned it was over 3x the legal limit. So it may have been incorrect, but it wasn't a typo. (The sergeant was suspended for setting her free.)
http://southtownstar.suntimes.com/news/20726638-418/bridgeview-police-sergeant-suspended.html
 
No Virgin Mary, but I think I can make out the image of Warren Silberman.
 
Headspace said:
Are you sure that the BAC in the article isn't a typo? Because it seems like .27 would be a permanent death sentence, period.
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Heck no. Back in my Emergency Room days, we'd have coffee cans where we'd throw in a quarter each and bet on the level the lab would get, based on the behavior. We had:
<0.1
0.10- <0.15
0.15- <0.20
0.20- <0.25
0.25- <0.30
.30 or greater.

You'd be amazed how many were in the right hand coffee can.
 
I was working in the ER one night and I had a guy who had been stabbed in the shoulder After getting his blood work back we found he had a .42% BAC. For someone who was as lucid as he was, I was surprised, though I guess the stabbing had left him a bit high strung.

As Doc says, I've seen some +0.30 a few times. I've also seen some in the low .20's that were DEAD as a result.
 
bbchien said:
Heck no. Back in my Emergency Room days, we'd have coffee cans where we'd throw in a quarter each and bet on the level the lab would get, based on the behavior. We had:
<0.1
0.10- <0.15
0.15- <0.20
0.20- <0.25
0.25- <0.30
.30 or greater.

You'd be amazed how many were in the right hand coffee can.
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I don't doubt it for a second. But in this case the dude was flying and apparently managed to land the plane. So you have to expect that he was way more lit when he took off than when he finished the flight and landed.
 
Headspace said:
I don't doubt it for a second. But in this case the dude was flying and apparently managed to land the plane. So you have to expect that he was way more lit when he took off than when he finished the flight and landed.
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Based on the account of the incident, he wasn't doing such a great job with the flying thing that night.
Alcohol elimination is near linear, so while his BAC was higher earlier 2 hrs earlier, it was only another .03 or so. The other possibility is that he was drinking while flying, not unheard of.

We didn't have Bruces coffee cans, but a number was listed with every head trauma that made it into the ER that night.
 
flyingron said:
I was working in the ER one night and I had a guy who had been stabbed in the shoulder After getting his blood work back we found he had a .42% BAC. For someone who was as lucid as he was, I was surprised, though I guess the stabbing had left him a bit high strung.

As Doc says, I've seen some +0.30 a few times. I've also seen some in the low .20's that were DEAD as a result.
Click to expand...

Deputy friend told me of a guy who blew .43 and was making perfectly normal conversation with him.
 
Headspace said:
Are you sure that the BAC in the article isn't a typo? Because it seems like .27 would be a permanent death sentence, period.
Click to expand...

My sis-in-law manages the lab at a large hospital and they had a large individual walk into the hospital on his own with a BAC over .30. They were beyond surprised.
:hairraise:
 
I ran across a guy at the boat launch ramp yesterday. He was stiff drunk at 11:30am. Too drunk to respond to verbal greetings.

It took awhile to figure out whether he was launching his jet ski or recovering it (he was launching it). He finally pulled his car away with water draining out of all 4 doors. Based on the fishing rod, I guess he was going bass fishing on the jet ski.

I figured the sun would get him first... 50-some, no hat, shorts, very red, no clouds, temps quickly rising to 90+F. Tolerance? Oh yeah.

He gave me a hangover just watching.
 
flyingron said:
As Doc says, I've seen some +0.30 a few times. I've also seen some in the low .20's that were DEAD as a result.
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How does that happen? Shouldnt the same percentage of alcohol in someones blood kill someone? Like, a big guy could drink more but he could keel over dead at .25, and someone else doesn't? Sorry for the poorly worded question. I can't think of a better way to put it.
 
DavidWhite said:
How does that happen? Shouldnt the same percentage of alcohol in someones blood kill someone? Like, a big guy could drink more but he could keel over dead at .25, and someone else doesn't? Sorry for the poorly worded question. I can't think of a better way to put it.
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Tolerance games, these drunks have trained their bodies not to die at these retarded BAC levels, often they cannot function with out them
 
I know of 2 doctors that have prescribed beer to their inpatients to keep them from getting DTs.
 
Skylane81E said:
Tolerance games, these drunks have trained their bodies not to die at these retarded BAC levels, often they cannot function with out them
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Follow up stupid question.

Is this tolerance such an incredibly bad thing because it may be indicative of immeninent or ongoing organ failures or simply the higher likelihood that they will fly under the influence?
 
When you are alcohol dependent you function normally when you are in a very narrow range of blood alcohol concentrations. Trouble is, you don't stay there for long.

We use tolerance as a pretty good marker for repetitive chronic exposure, and therefore dependence. A really skilled alcoholic (like one of my sponsorees) was just stellar at getting the titration just right before stepping out on the flight deck.
 
Headspace said:
Are you sure that the BAC in the article isn't a typo? Because it seems like .27 would be a permanent death sentence, period.
Click to expand...

There are a couple of 'walking' 2.0's in my area. Those are the ones that have been serious alcoholics for years, that they function normally at that BAC. had one day before yesterday that was out wandering down by the bus station that was a .28. He was mouthing off to the officer while the officer was on the radio to me. I could hear him in the background, didn't even sound drunk.

Only reason he went to jail was because he wasn't supposed to be drinking and his parole officer was a bit ticked about that.
 
Doc, what is behavior like for a 'normal' person at let's say .2, or let's make it .15 since that seems to be the magic number for the FAA. Me, I know that after about 2 drinks I'm no longer comfortable driving, though I wouldn't consider myself really 'impaired' yet, but I've never had a BAC test.

Either way, drinking and flying just blows my mind. I know plenty of pilots who drink on their weekends, but I can tell you that all my piot friends take very seriously the 8 hour rule and the .04 rule. Even the ones that often have 'too much' on the weekends don't touch it when/before flying.
 
A normal, nondrinker at 0.200 needs an endotracheal tube, or the probablilty of death from respiratory arrest is VERY significant. This person gets out of the car and falls face down on the curb, if he can move at all.
 
Ok,
As i am actually working tonite and having 17+ years of full time ED experience I can contribute a couple of things.

1. Your alcoholics are profoundly weak! The best alcoholics in the world inhabit the town of Seattle, Washington. Where I have had cogent, lucid conversations with people with BAC>600, have watched someone suffer a withdrawl seizure at 400 and have witnessed the intubation and subsequent survival of someone with a BAC of 1376. No that isn't a typo.

2. On rare occasion, the young, healthy liver can allow a person with an BAC of 200 to avoid the ET tube, but not often.

3. Highest BAC in the last week that I have seen.... 435

Tolerance is a powerful thing

Dr.Mike
 
flyingron said:
...As Doc says, I've seen some +0.30 a few times. I've also seen some in the low .20's that were DEAD as a result.
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Something needs to be done! That guy took food out the mouths of the family of the embalmer!
 
DavidWhite said:
How does that happen? Shouldnt the same percentage of alcohol in someones blood kill someone? Like, a big guy could drink more but he could keel over dead at .25, and someone else doesn't? Sorry for the poorly worded question. I can't think of a better way to put it.
Click to expand...

We all look different because we all have different genes. The extends down to the molecular level, we all have slightly different versions of those proteins that function in metabolism and lipids that coat our cells. This extends to those proteins that process and detoxify ethanol. Some have a higher inborn tolerance for the stuff because their processing is that much more robust. And of course the larger you are the more you can drink. Good for us small guys, we get drunk cheap.

If you drink constantly the level of these detoxifying enzymes will rise, and other systems within your body will change to withstand the alcoholic challenge. As a result you'll have to drink more to experience the same level of drunkenness. I'm certain many of us have experienced this latter phenomenon.
 
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