Question: How is it possible for someone, after a very intensive alcohol consumption, to have a permillage count (checked twice by the police) of 0.35? These persons also do not experience the effects of alcohol. One possible indication is perhaps to be found in the fact that they need ten times the normal amount of anaesthetics during an operation without having taken drugs!

Seraina

Answer: It is known that very considerable individual differences can occur as regards concentration of alcohol in the blood, caused by personal characteristics, by weight, how fast you drink, drinking on an empty stomach or with a meal, blood pressure, etc. However, none of this can offer a satisfactory explanation for the extreme phenomenon that you describe. Alcohol quickly enters the bloodstream directly after intake. Between 92 and 98% of the ethanol (alcohol) is converted via enzymes in the liver into (toxic) acetaldehyde and then into (non-toxic) acetic acid that can be burnt off by the body at a rate of 0.1 to circa 0.25 permille per hour. One to three percent is passed out via the urine, while one to five percent disappears via respiration and perspiration.

A number of hypotheses may be advanced as possible explanation for the absence of alcohol in the blood after liberal consumption, necessarily based on the fact that the alcohol that we drink somehow or other exits the body sufficiently rapidly before being detected.

- In certain cases the level of the enzyme alcoholhydrogenase in the stomach is sufficient to trigger the metabolism in the stomach before the alcohol is absorbed;

- the liver function is abnormally strong;

- Alcohol is soluble in fat. In this case a quantity of alcohol can be taken out of the blood and stored directly in the fat tissue;

- The passing of alcohol via exhalation is abnormally low, or the partial excretion via the urine abnormally high;

Insensitivity to anaesthetics may point to another phenomenon: the blood-brain barrier may be less permeable, which may contribute to the absence of the familiar effects of alcohol. It should be stressed here that your case is exceptional, probably caused by a convergence of different factors; it is therefore recommended to seek the advice of specialist researchers.

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