LipsThis is where it all begins. The alcohol passes the lips and moves into the oral cavity. Absorption beings as soon as alcohol touches the body.

Oral CavityOne of the areas of the body that absorbs substances at a rapid rate is under the tongue. Alcohol can also absorb from the oral cavity, albeit in very small amounts.

EsophagusThe esophagus is a long, thin, and muscular tube that connects the pharynx (throat) to the stomach. It forms an important piece of the gastrointestinal tract and functions as the conduit for food and liquids that have been swallowed into the pharynx to reach the stomach.

Important Facts 9-10” long and less than an inch in diameter when relaxed. At the top of the esophagus is the upper esophageal sphincter that keeps the esophagus closed where it meets the pharynx. The upper esophageal sphincter opens only during swallowing to permit food to pass into the esophagus. At the inferior end of the esophagus, the lower esophageal sphincter opens for the purpose of permitting food to pass from the esophagus into the stomach.

SwallowingIt takes approximately four to eight seconds for the substance being swallowed to reach the stomach. That is sufficient time to allow mixing with the mucus in the esophagus.

Barrets EsophagusThere is a condition where chronic backwash of stomach contents into the esophagus causes a transformation of the lining of the esophagus. The lining will actually change into intestinal tissue. It is also referred to a metaplasia.

StomachThe stomach is the main food storage tank of the body. If it were not for the stomach’s storage capacity, we would have to eat constantly instead of just a few times each day. The stomach also secretes a mixture of acid, mucus, and digestive enzymes that helps to digest and sanitize our food while it is being stored

Gastric CanalThe gastric canal is formed by longitudinal ridges found on the interior of the lesser curve of the stomach. It has several other names, including magenstrasse, ventricularis, ventricular canal, and canal of stomach.

Retention of FoodFood can be retained in the stomach for 2-5 hours. Times vary depending on the source. However, the point remains that food stays in the stomach much longer than government experts testify to.

Gastric FoldsGastric folds are found on the interior of the stomach. The folds create a larger surface area inside the stomach.

Pyloric OpeningThe pyloric opening, also known as pyloric canal or the canalis pyloricus, is the junction of the pylorus with the small intestine. This is the gatekeeper of the small intestine, where a majority of absorption takes place.

Pyloric SphincterThe pyloric sphincter is at the end of the pyloric canal, where the circular layer of fibers in the muscular pyloric canal walls thicken to form this powerful muscle. The pyloric sphincter muscle serves as a valve that prevents regurgitation of food from the intestine back into the stomach.

Bad ScienceMost experts agree that for full absorption of alcohol to take place, there must be gastric emptying. This takes time. In many cases hours to occur. Government experts will usually admit this. However, they state an opinion that this occurs rapidly, in as little as 15 minutes and rarely longer than 90 minutes.

They are Wrong!There are numerous sources that food can, and does, stay in the stomach for 2-6 hours in normal conditions. These include medical texts, online informational sites, and generally accepted facts. Also common knowledge.

Don’t Eat or Drink for 8 Hours Before SurgeryDoctors instruct patients not to eat or drink for several hours before surgery. Many times the duration is around 8 hours or longer

Trust your DoctorsThis is stop aspiration from the stomach from coming up during surgery. Doctors don’t instruct people to wait 2-3 hours. Doctors want to be sure, jury’s have a duty to be sure beyond a reasonable doubt. Trust the doctor on the medical opinions, not the government expert trying to convict a person.

Small IntestineA long, highly convoluted tube that absorbs about 90% of the nutrients from the food we eat. It is only 1 inch in diameter, making it less than half the diameter of the large intestine. The small intestine is about twice the length of the large intestine.

Small Intestine IIIs about 10 feet long. Blood vessels, nerves, and lymphatic vessels pass through the mesentery to support the tissues of the small intestine and transport nutrients from food in the intestines to the rest of the body.

Portal VeinThe Portal Vein carries nutrients and freshly absorbed alcohol from the small intestine to the Liver. This saturates the blood in the liver with alcohol, leading to a lack of equilibrium of alcohol in the blood during the absorption stage.

Large IntestineAfter the substances leave the small intestine they move to the large intestine.

HeartThe heart is the pump that circulates blood. It is a muscle and requires oxygen to carry out its function. The heart receives deoxygenated blood from the trunk and liver, then pumps it to the lungs where the gas exchange takes place. Then the re-oxygenated blood returns to the heart, and circulates to the rest of the body.

LungsThe lungs are large, spongy organs optimized for gas exchange between our blood and the air. The lungs provide us with that vital oxygen while also removing carbon dioxide before it can reach hazardous levels.

Lungs IIIf the inner surface of the lungs could be stretched out flat, they would occupy an area of around 80 to 100 square meters – about the size of half of a tennis court!.

Gas ExchangeThe blood from the heart reaches the lungs. In the alveolus the oxygen enters the blood and the carbon dioxide exists through the capillary walls. Alcohol also exits into the air that is exhaled. The freshly oxygenated blood returns to the heart, now more red than blue.

Back to the HeartThe blood returns from the lungs saturated with oxygen. This provides the heart with much needed oxygen so it can perform its job circulating the blood through the body.

How does circulation work?As you can see on the blue portion of the diagram the blood leaves the liver and connects with trunk blood. The alcohol saturated blood from the liver will combine with the trunk blood, pass through the heart and to the lungs.

Overview of the Circulatory SystemsThe alcohol is being absorbed from the digestive system into the liver. When the portal vein collects nutrient rich blood from the intestinal region, and brings it to the liver.

Overview Part IIThe venous blood brings the nutrients, and alcohol, absorbed from the intestinal region to the liver, where it is, in part, stored.

Overview Part IIIThe blood exiting the liver in carried by the hepatic venae cava to the heart. Upon exiting the hear, it travels directly to the lungs. This is where the gas exchange takes place, and the sample is provided for the breath alcohol analysis.

Cardiovascular System of the Upper Torso

Shows the blue veins and red arteries conducting blood in the chest region.

Circulation, Absorption, & Inaccurate BAC resultsNow that we’ve finished with the absorption portion, we will look at why this matters in a Breath Test DUI Case.

Inaccurate Breath Alcohol ReadingThe BAC of the blood entering the lungs, during the absorption phase will be higher than the BAC in other areas of the body until absorption has decreased to a level where the BAC of the blood in the liver is no longer higher than that in the rest of the body. Often referred to as equilibrium.

Don’t let a wrong answer cause a bad conviction.Because this alcohol saturated blood is what passes through the lungs, prior to equilibrium, the breath test will show a result based upon the alcohol saturated blood in the lungs, rather than the whole of the blood in the body.

ResourcesYou will need resources to back your assertions. These are resources that you may rely upon, your expert may rely upon, and you may use them to cross examine the government’s expert.

A.W. JonesPhysiological Aspects of Breath-Alcohol Measurement which was published in Alcohol, Drugs and Driving Vol 6, Number 2 in 1990

Overstates BACThe BAC is overstated during the absorption period. Peak blood alcohol levels were reached in 10-110 minutes.Keep in mind, there is a difference between full absorption and peak BAC.

G. Simpson’s ArticleAccuracy and Precision of Breath Alcohol Measurements for Subjects in the Absorptive State was published in The Journal of Clinical Chemistry, Volume 33 No. 6, in 1987

Important PointsUsing specific examples from the data provided by the previous studies, Simpson reports that that the true BAC was overstated by +190%, +230%, +30%, and +60%.

Simpson ConcludesBreath testing is not a reliable means of estimating a subject’s BAC while he is in the absorptive stage. Due to the large variations between venous and arterial BAC during absorption, breath testing will consistently overestimate the true BAC of the subject during absorption.

Kurt M. Dubowski, Ph.DAbsorption, Distribution and Elimination of Alcohol: Highway Safety Aspects

PEAK BAC:14-138 minutes, with mean times for men and women at 57 and 42 min, respectively.

Oral ContraceptivesWomen taking oral contraceptives reached a lower peak BAC and had significantly lower body alcohol elimination rates and blood alcohol disappearance rates than women not on oral contraceptives (Jones and Jones, 1984).

Why This MattersWhen the Government expert starts attempting a retrograde extrapolation, and calls our clients liars, we can ask if they factored in oral contraceptives.

Absorption TimeAlcohol absorption is not always complete within 60-90 minutes as often claimed

Goldfrank’s Toxicological Emergencies

P. 1149- An approximate absorption of 20% from the stomach. The remainder is absorbed from the small intestine.

Goldfrank’s Under optimal conditions for absorption, 80-90% of an ingested dose being absorbed within 60 minutes.Factors that delay absorption such high concentrations of ethanol (causing pyloric spasms), presence of food, and coexistence of GI disease, co-ingestion of drugs (e.g. aspirin and N-butylscopolamine).

Goldfrank’s – P. 1149Factors that can affect the absorption of alcohol included rapid gastric emptying, ingesting alcohol on an empty stomach, ethanol intake absent food intake, and the absence of congeners, dilution of ethanol (maximum absorption occurs at a concentration of 20%), and carbonation.

Goldfrank’sFurther factors include the time taken to ingest the drink, individual variation is also a factor which may delay the absorption for 2-6 hours.

Goldfrank’s The subject of Goldfrank’s is treating a patient in a toxicological emergencies. If Doctors rely on Goldfrank’s, and assume absorption may be continuing for hours, then our clients deserves the same treatment.

Overstatement of BACIf absorption is occurring, we will have an overstatement of BAC from a breath alcohol analysis.