Citation

Laubichler W, Kuhberger A. Blutalkohol 1997; 34(4): 260-269.

Affiliation

A-5020 Salzburg, Austria.

Copyright

(Copyright © 1997, International Committee on Alcohol, Drugs and Traffic Safety and Bund gegen Alkohol und Drogen im Straßenverkehr, Publisher Steintor Verlag)

DOI

unavailable

PMID

unavailable

Abstract

Among approximately 4,500 reports dealing with culpability of an offender, there were 62 cases in which a total of 78 criminal offences were committed under the influence of alcohol. In none of these cases the offender was liable for the crime. These intoxications were labelled atypical as the witnesses could not detect severe alcoholisation due to the fact that the typical symptoms of intoxication were missing. Pathologic alcohol intoxication is dealt with by looking at these 62 offenders. The former opinion that a pathologic alcohol intoxication be an epileptic semi-conscious state is no longer accepted as none of these occurred in any of the 62 cases. Independently, 12 cases were observed where crimes had been committed while the offenders were in an epileptic semi-conscious state; two of them were preceded by alcohol consumption. However, these cases were diagnosed as psychomotoric seizures rather than pathologic alcohol intoxication. The alcohol levels calculated for the 62 cases varied; in 21 cases it did not exceed 1 per mille, in 18 cases it was between 1.1 and 2 per mille and in 23 cases it exceeded 2 per mille. However, only in 16 cases the alcohol concentration was actually measured either by blood alcohol testing or by using a breathalyzer which would usually confirm a high level of intoxication. 25 of the offenders admitted to taking drugs in addition to the relative moderate alcohol consumption. 2 of them were taking methadone on a regular basis. A urine test was never carried out. It is likely that some offenders would rather cover up their actual alcohol consumption and prefer to blame simultaneous drug use. There were 38 alcoholics in this group all of which had higher BAC levels than the others. 35 offenders mentioned that they had previously had blackouts, but no criminal acts were committed. As a rule those offenders showed very high BAC levels and most of them were alcoholics. On average, the amnestic state lasted about 5 hours, with a maximum of 12 hours in some cases. There were, however, 3 cases where an amnestic state of 3 days was mentioned, which would indicate that the semi-conscious state did not subside despite a decrease of the alcohol level. The pathologic alcohol intoxication, as it is traditionally referred to, may be better looked at as a semi-conscious state induced by alcohol. It is unlikely to occur at low levels of alcohol intoxication, and if it does, only in conjunction with drug consumption. The current definition of the pathologic alcohol intoxication according to ICD-10 and DSM-III-R appears to focus too much on the offender. There may be cases in which there is an intolerance of alcohol, which may result in an inability to act or even in deep unconsciousness due to circulatory irregularities. The only way to obtain better insight is to estimate blood alcohol concentration on a more regular basis and in conjunction with urine samples.