Wasted time

Scientists took an overlooked process and created a quicker way to sober up

"It's almost inexplicable why we didn't try this decades ago."

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Once the drinking starts, the liver’s work begins. The beleaguered organ is responsible for processing an entire binge drinking session’s worth of alcohol, clearing it from the bloodstream, and returning the body to its normal (if not hungover) state.

Now, scientists may have harnessed another organ that may help us sober up far quicker.

In a small proof-of-concept study, researchers found that an assisted-hyperventilation device could help people use their lungs to clear alcohol from the bloodstream. The device allows people to hyperventilate safely (without passing out), which increases the amount of alcohol that’s expelled from the body as a gas.

The study was published Thursday in Scientific Reports.

Using this device, five people cleared 50 percent of the alcohol in their bloodstreams at a rate roughly three times faster compared to when they were left to sober up on their own. Without the device, all participants took over an hour to do the same — the time ranging from 102 minutes to 166 minutes. With it, everyone managed to do so under 64 minutes.

Lead author Joseph Fisher, a senior research scientist at Toronto General Hospital Research Institute and the founder of a for-profit company Thornhill Medical, announced in a statement: "It's almost inexplicable why we didn't try this decades ago."

Dr. Olivia Sobczyk, associate scientist at UHN.University Health Network

The five men in Fisher’s study represented the wide age range of 20 to 90-years-old. They were asked to drink 80-proof vodka mixed with mineral water until their blood alcohol content (BAC) was about 0.1. That’s above the legal driving limit in the U.S. (0.08 percent) — enough to impair motor function and maybe lead to some slurred speech.

Once sufficiently intoxicated, the men breathed into the device, slowly increasing their breathing rate until they were hyperventilating.

(It's important to note here that these findings do not mean you should try hyperventilating as a way to get sober. These are preliminary findings based on supervised research and the help of a device. In some instances, hyperventilation can be dangerous.)

The science behind the study — The idea that hyperventilation might help clear alcohol is based on the process of gas exchange between the capillaries — fine, branching blood vessels around the lungs — and the alveoli. These are little air sacs in the lungs.

When we breathe, oxygen-rich air moves from the outside world into our alveoli. It then diffuses into the blood in our capillaries, because, like water flooding out of a dam, the oxygen will go where there’s less of it to start with. The same goes for carbon dioxide present in the capillary blood, which diffuses into the alveoli, and is exhaled into the world.

We know that a certain amount of alcohol in the bloodstream can also participate in this gas exchange process, which is why breath alcohol tests can estimate the amount of alcohol present in the bloodstream. A case study from the 1920s actually suggested that we might be able to up the ventilation rate in people, which would allow more alcohol to be released from the body as a gas with every additional breath.

This current study addressed the crucial problem with that scenario: when you hyperventilate you start to feel dizzy or lightheaded as too much carbon dioxide is expelled from the body.

Fisher’s device, about the size of a suitcase, supplements the body with just enough CO2 to offset the balance, keeping them from feeling those side effects of ventilation.

Blood Alcohol concentration with and without the device, including the "rebound effect."

Ultimately, blood tests and breathalyzer readings revealed that the men were able to clear about half of the alcohol from their bodies far faster compared to tests without the device. They found the process “tedious” but not uncomfortable.

They were, after all, hyperventilating. Still, the difference in timing was clear: For one 154 pound 20-year-old, it took about 1.7 hours of waiting before 50 percent of the alcohol in his blood. With the device, it took him only 21 minutes. It took a 158-pound 34 year-old man about 2.7 hours to clear half the alcohol in his body on his own, and about one hour with the device.

The team also noted there was a “rebound effect." When the men stopped hyperventilating so the scientists could draw blood or do breathalyzer tests, their blood alcohol levels shot back up again.

What’s next – It’s unclear how well this system might work in life-or-death situations where alcohol poisoning is imminent. However, in the study, the authors suggest that the rate of clearance obeys the rules of first-order kinetics – which means the elimination rate of a drug is a consistent fraction of the amount of the drug in the body.

That means, the more drug in the body, the faster it will leave.

As the authors put it:

“...the highest clearance efficiency and the greatest absolute rates of ethanol elimination would occur when most needed: at the highest ethanol blood levels and toxicity, when other available supportive measures are least effective.”

Based on the experiences of only five study participants, it’s hard to know how well this device would do in more complicated situations. However, because of the device's simplicity, Fisher sees it as a tool that would be easily deployed if someone needs to sober up fast — should subsequent studies prove it works.

“It's very basic, low-tech device that could be made anywhere in the world: no electronics, no computers or filters are required,” he said.

Abstract: Ethanol poisoning is endemic the world over. Morbidity and mortality depend on blood ethanol levels which in turn depend on the balance between its rates of absorption and clearance. Clearance of ethanol is mostly at a constant rate via enzymatic metabolism. We hypothesized that isocapnic hyperpnea (IH), previously shown to be effective in acceleration of clearance of vapor anesthetics and carbon monoxide, would also accelerate the clearance of ethanol. In this proof-of-concept pilot study, five healthy male subjects were brought to a mildly elevated blood ethanol concentration (~ 0.1%) and ethanol clearance monitored during normal ventilation and IH on different days. IH increased elimination rate of ethanol in proportion to blood levels, increasing the elimination rate more than three-fold. Increased veno-arterial ethanol concentration differences during IH verified the efficacy of ethanol clearance via the lung. These data indicate that IH is a nonpharmacologic means to accelerate the elimination of ethanol by superimposing first order elimination kinetics on underlying zero order liver metabolism. Such kinetics may prove useful in treating acute severe ethanol intoxication.
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