Ethyl Alcohol (ALC)

EPIC Test Name

ETHYL ALCOHOL LEVEL

EPIC Code

LAB2507

Clinical Indications

Ethanol is the most widely used and commonly abused substance. Ethanol effects on CNS vary depending on the blood ethanol concentration and an individual’s tolerance level. A blood alcohol concentration of 80 mg/dL (0.08%) or less has been established as the statutory limit for operation of a motor vehicle in the USA and most other countries.
Symptoms ethanol effects vary from euphoria, to disorientation and incoordination, and then even to coma and death. When consumed with other CNS depressant drugs (e.g., sedative, hypnotic, and anesthetic agents, including barbiturates, benzodiazepines, and volatile anesthetics), ethanol has a potentiation or synergistic depressant effect even at relatively low alcohol concentrations. Deaths may be resulted from combined ethanol and drug ingestion.
Abrupt withdrawal from chronic and heavy ethanol use may lead to a physical abstinence syndrome, featuring with CNS excitation, e.g., anxiety, irritability, insomnia, muscle tremor and cramps, hallucinations, and increased temperature, blood pressure, heart rate, and seizures. This syndrome can be fatal if not monitored properly and treated promptly.
Ethanol is metabolized mainly by a liver enzyme (alcohol dehydrogenase, ADH) to acetaldehyde, which is subsequently oxidized to acetic acid by aldehyde dehydrogenase. The ethanol is eliminated from blood, though with significant variation individually, similar to Aspirin, follows zero-order kinetics, or in the enzyme saturation status. Average elimination rate is about 15 mg/dL (3.2 mmol/L) per hour for males and 18 mg/dL (3.9 mmol/L) per hour for females. At both low (<20 mg/dL, <4.3 mmol/L) and high (>300 mg/dL, <65.1 mmol/L) ethanol concentrations, elimination however more closely resembles first-order kinetics.
Alcohol consumption during pregnancy can cause fetal alcohol spectrum disorder (FASD) to the baby (http://www.nofas.org). The effects can be on baby’s physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. FASD is 100% preventable when a woman completely abstains from alcohol during her pregnancy.

Additional Information

Do not use alcohol or other volatile disinfectants at the site of venipuncture. Aqueous Zephiran (benzalkonium chloride), aqueous Merthiolate (thimerosal), or povidone-iodine may be used.

Common Synonyms

Blood Alcohol

Interpretative Information

The positive results suggests ethanol exposure which may result in intoxication, CNS depression, and metabolic acidosis.

CPT

80320

LOINC

5643-2

References

1. Weathermon R, Crabb DW. Alcohol and medication interactions. Alcohol Res Health. 1999;23(1):40-54. PMID: 10890797; PMCID: PMC6761694.
2. Newman RK, Stobart Gallagher MA, Gomez AE. Alcohol Withdrawal. [Updated 2021 Sep 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441882/
3. Dubowski KM: Absorption, distribution and elimination of alcohol: highway safety aspects. J Stud Alcohol. 10:98-108 1985
4. Dubowski KM: Human pharmacokinetics of alcohol. Alcohol Tech Rep. 1976 55-63
5. Wagner JG, Wilkinson PK, Sedman AJ, et al.: Elimination of alcohol from human blood. J Pharm Sci. 65:152-154 1976 1255425
6. Bogusz M, Pach J, Stasko W: Comparative studies on the rate of ethanol elimination in acute poisoning and in controlled conditions. J Forensic Sci. 22:446-451 1977 618161
7. Dubowski KM. Alcohol determination in the clinical laboratory. Am J Clin Pathol. 1980 Nov;74(5):747-50. doi: 10.1093/ajcp/74.5.747. PMID: 7446484.

Contact Information

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