How does surrogate alcohol affect the body? What to do in case of alcohol poisoning. Toxic effects of surrogates on the body

When they talk about alcohol, they mean wine (ethyl) alcohol. Various alcoholic drinks contain alcohol from 2-8% (beer) to 70-80% (cognacs, liqueurs, rum).

Alcoholic drinks are widely consumed in everyday life. However, as is known, excessive use alcohol, causing intoxication, is often accompanied by various kinds of conflicts. For this reason, the forensic medical definition of intoxication, that is, acute alcohol poisoning, is one of the most common examinations in the study of corpses and living persons. Acute alcohol poisoning is often associated with official misconduct, crimes, and accidents. For example, during car accidents, the question always arises about the possible intoxication of the driver of the car, his victim or passengers.

Acute poisoning with ethyl alcohol ranks first among ethyl poisonings studied in forensic practice. Alcohol can enter the body in various ways: by ingestion, subcutaneous, intravenous, rectal and by inhalation of its vapor.

Alcohol poisoning can also be fatal. Acute alcohol poisoning, called intoxication, is quite well known in its manifestations.

Alcohol is a narcotic poison that affects the central nervous system and ultimately causes paralysis of important vital functions. Initially, alcohol causes excitement, followed by depression of the central nervous system and then paralysis. During the period of excitement, talkativeness, noisy talkativeness, and swagger appear. Speech becomes incoherent, coordination of movements is impaired. During this period, signs of paralysis of the retaining centers also appear. A drunk becomes frank, sometimes gentle, sometimes rude. Often strives for violence, fighting, swearing. During this period, aggressiveness can end in murder with a vague consciousness, so that the drunk subsequently does not remember his actions.

The period of excitement gives way to depression. Movements become sluggish, drowsiness gives way to sleep, turning into deep sleep and, finally, complete anesthesia. The pupils stop responding, breathing is slow and hoarse, body temperature drops significantly, muscle and heart weakness progresses, and death occurs. Strong alcoholic drinks can cause death in a very short time a short time. After short-term excitement, loss of consciousness quickly occurs. Breathing becomes slow, hoarse, the face turns red, the pupils are dilated; Involuntary urination, bowel movements, and vomiting occur. Pulmonary edema develops, and death can occur within half an hour or in the first hours after drinking alcohol.

A lethal dose of pure alcohol for a non-drinker is considered to be 100-150 grams, i.e. 250-350 grams of vodka. Deaths from one bottle of vodka or two bottles of wine have been described. For children under 10 years of age, the lethal dose is already 15-25 grams of pure alcohol. It is well known, however, that individual sensitivity to alcohol, in particular, addiction to it, is of great importance. People who drink alcohol regularly can tolerate significantly larger amounts - 500-600 grams or more. In the same way, large quantities of alcohol, taken not at once, but over a period of time and especially on a full stomach, have a weaker and slower effect. When assessing alcohol poisoning, these additional circumstances must be taken into account.

Death in acute alcohol poisoning may occur for various reasons. Besides deaths from the direct effects of alcohol on the peripheral nervous system. It causes a short narcotic period, which is quickly followed by a period of paralysis. The activity of the cerebral cortex is disrupted (inhibition occurs), and the subcortical centers are excited; if the dose increases, coma occurs. There is a loss of coordination of the antagonist muscles, gait becomes uncertain, dilation of the body's blood vessels occurs, which is perceived as a feeling of warmth and heat transfer increases (cardiac paralysis is possible in people with a sick, weak heart). Possible death from hyperglycemia, due to a sharp increase in blood glucose levels. Vomiting that occurs in an unconscious state often leads to the entry of vomit into the respiratory tract and asphyxia. Finally, death can occur from certain complications, such as pneumonia. Death is also observed the next day after alcohol poisoning or every other day, for the most part from heart weakness.

When drinking alcohol on an empty stomach, its content in the blood reaches a maximum after 40 minutes, less often after 15 minutes; on a full stomach, the maximum in the blood occurs 1.5-3 hours after drinking alcohol. If the stomach contains food rich in proteins, then absorption occurs more slowly. With repeated intakes of alcohol, absorption accelerates due to the preparedness of the gastrointestinal mucosa. Sparkling wines contain carbon dioxide, as a result of which the absorption time of alcohol sharply accelerates. From the moment alcohol enters the body, it begins to be broken down and eliminated under the action of a special enzyme, alcohol dehydrogenase, which is significantly less in alcoholics than in a healthy person. When excreted from the body, the condition of the kidneys and lungs is of key importance; in addition, alcohol is excreted through the sweat glands and intestines. Normally, alcohol is eliminated from the body within 24 hours after intake, but taking into account the characteristics of the body, especially the state of organs and systems, it can be detected in the body after 2 or 3 or more days.

The main difficulty is to establish the period of time that passed from the moment of drinking alcohol to the onset of death. If this circumstance is not established, then the expert’s action is reduced only to interpreting the degree of intoxication of the subject at the time of death on the basis of data on the quantitative content of alcohol in the blood of the corpse. The expert cannot determine the amount of alcoholic beverages taken shortly before death; it is also difficult to obtain this information through investigative means, so the capabilities of the examination are reduced only to establishing alcohol intoxication. To do this, the expert must have a good knowledge of the distribution patterns of alcohol in fluids, organs, and tissues of the body.

Blood is a universal material in this type of examination of living persons and corpses. It is possible to examine exhaled air.

There are three degrees of intoxication: mild, moderate, severe.

Approximate scheme for determining the severity of alcohol intoxication. Blood alcohol content in ppm - Functional assessment

less than 0.3 - no influence of alcohol

0.5 - 1.5 - slight intoxication

1.5 - 2.5 - moderate intoxication

2,5 - 3 - severe intoxication

3 - 5 - severe, death may occur

more than 5 - fatal

During autopsies of those who died from alcohol poisoning, they find severe plethora internal organs, swelling of the brain and lungs, pronounced cadaveric spots, overflowing with urine bladder. From opened body cavities and from organs - the brain, lungs,... muscles - the smell of alcohol or the peculiar smell of fusel oils is felt. It should be noted, however, that the smell of alcohol is usually not felt when opening a stomach full of food masses, where it is masked by the sour fermentation smell. With an empty stomach, the smell of alcohol in fresh corpses is noticeable. The gastric mucosa is irritated, reddish in color, and covered with mucus. The blood is usually thin, especially in cases of rapid death. In case of pronounced symptoms of poisoning, one can limit oneself to the diagnosis of alcohol poisoning during an autopsy. However, if there is the slightest doubt, the autopsy should be supplemented with a forensic chemical examination of the internal organs, and not limited to identifying the smell of alcohol from the organs and from the cavities of the corpse. A quantitative determination of alcohol is required.

The most difficult and responsible is to determine the mild degree of intoxication, since moderate and severe degrees of intoxication usually do not raise doubts due to their clarity. However, one cannot be guided only by the presence of the smell of alcohol on the breath, which can also be caused by a small amount of alcoholic beverage consumed. In the most serious and critical cases, you can resort, with the consent of the person being examined, to forensic chemical examination of gastric contents.

Urine can also be tested. When diagnosing severe alcohol poisoning, there is a danger of mistaking a drunk patient for a severe febrile illness or not recognizing a severe head injury, or carbon monoxide poisoning, such as exhaust fumes. Therefore, it is necessary to make it a rule in each such case to conduct the most thorough examination of the subjects.

When poisoning with alcohol, you need to keep in mind that most alcoholic drinks contain harmful, toxic impurities, the so-called fusel oils. They are found in insufficiently purified vodka, grape wines, especially in moonshine, raw alcohol, and also have their toxic effect. Determination of degree alcohol intoxication in living individuals is based on the severity of the clinical phenomenon

The examination of alcohol intoxication in living persons is carried out according to certain rules. When examining a corpse, blood for examination is taken from peripheral vessels within 24 hours after death, urine and organ tissue are taken. Cases of combined effects of alcohol and medicines. If the corpse was in water, then alcohol is not determined quantitatively, but only the fact of drinking alcohol is determined. If injuries with hemorrhages are found in the corpse, then they are sent for examination and blood clotting to determine the alcohol in them. If alcohol is found in the blood of a corpse, but there is no alcohol in the blood clot, then we can say that he received the injury while sober and took alcoholic drinks later.

Alcohol substitutes incorrectly name different chemical composition liquids that are sometimes used to replace alcoholic drinks. At one time, the use of cologne was common, i.e. bad alcohol with an admixture of aromatic substances and essential oils. Poisoning with denatured alcohol has occurred. The latter is alcohol, to which poisonous, foul-smelling substances and some kind of dye are added to make it undrinkable.

During the war, cases arose of the use of technical liquids as alcohol substitutes, widely used for various purposes in industry. All these liquids have toxic properties. Ignorance of the toxic properties of these liquids led to single and sometimes group poisonings.

The occurrence of poisoning is facilitated by improper or careless storage of technical fluids, as a result of which their theft, as well as deviation from the technical rules of use, becomes possible.

Poisoning with alcohol surrogates always requires a thorough investigation, establishing the causes of poisoning and taking preventive measures. Before the examination, the question is usually raised about what liquid caused the poisoning. Denatured alcohol has a pungent odor due to a large percentage of fusel oils. The admixture of methyl alcohol causes blindness, otherwise the clinical picture of poisoning is similar to ethyl alcohol poisoning.

Methyl alcohol- wood alcohol, the breakdown products of this alcohol are poisonous and block respiratory enzymes in cells. There are 3 forms of poisoning:

ocular (manifested by decreased vision, up to blindness)

generalized (manifested by coma, convulsions and death)

Methyl alcohol is easy to determine during forensic chemical testing.

Amyl alcohol(part of moonshine, home brew) is a poison that causes damage to the central nervous system, it causes paralysis of the centers of the medulla oblongata. This alcohol has a significantly greater narcotic effect than ethyl alcohol.

Ethylene glycol - lethal dose 250 ml. First, intoxication appears, then after a latent period, brain disorders develop, including coma. Ethylene glycol is part of brake fluid and antifreeze, so a significant percentage of poisoning with this substance occurs. A feature of the diagnosis is the detection during internal examination of a corpse of multiple necrosis and hemorrhages in the kidneys and brain tissue. Ethylene glycol is found in internal organs during forensic chemical examination.

Alcohol surrogates (from the Latin surrogatus - put in place of another) are inferior substitutes for approved alcoholic beverages. It should be noted that this concept exists only in domestic literature and combines substances that are different in their chemical structure and physical and chemical properties, as well as their mixtures. Due to the fact that the term alcohol surrogates is a collective concept based solely on a subjective characteristic (consumption instead of alcoholic beverages), in our opinion, it is not possible to talk about any strict scientific classification.

An easy-to-use gradation proposed by E. A. Luzhnikov has now become widespread, according to which all alcohol surrogates are divided into two large groups: containing insufficiently purified ethyl alcohol as a base and containing various impurities or mixtures of substances, but without ethanol .

The first group includes:

Hydrolysis and sulfite alcohols (ethyl alcohol obtained by hydrolysis of wood);

Denatured alcohol (technical ethyl alcohol with an admixture of methanol and aldehydes);

Raw alcohol (distillation product of fermented biomass containing ethanol and fusel oils: propyl, butyl,
amyl and other alcohols and their isomers);

Colognes and lotions (50-60% ethanol solutions with the addition of essential oils);

BF glue based on phenol-formaldehyde resin, polyvinyl acetal, dissolved in a mixture of ethyl alcohol and acetone;

Polish (technical ethyl alcohol with acetone, chloroform, butyl and amyl alcohols);

Wood stain (contains ethyl alcohol and dyes), etc.

All of the above substances, when taken orally, cause intoxication similar to alcohol, although poisoning with some of them (BF glue, polishes) also has significant differences.

Alcohol surrogates of the second group include chemical compounds with different characteristics such as alcohols, aldehydes, ketones, hydrocarbons, etc. However, due to the limited scope of the manual, it seems advisable for us to consider only the poisonings that are most often encountered in clinical practice. In accordance with statistical data, intoxication with various alcohols (ethylene glycol, methyl, propyl, butyl, amyl, tetrahydrofurfuryl) and related compounds is of greatest practical importance. As for poisoning with chlorinated hydrocarbons, which also belong to the surrogates of the second group, they were described in the previous manual.

Depending on the toxicity of metabolites, alcohol surrogates can be divided into toxifying (biotransformation products are more toxic than the original compound - methanol, ethylene glycol and its ethers, tetrahydrofurfuryl alcohol, etc.) and detoxifying (metabolites are less toxic than the substance itself - ethanol, propanol, butanol, etc. .). This division is not generally accepted, but it can greatly facilitate the understanding of the processes occurring in the body and determine the main approaches to the treatment of intoxications.

84. Surrogate alcoholism. Methyl alcohol poisoning, assistance.

Alcohol surrogates include liquids of different chemical composition and purpose that are consumed for the purpose of intoxication. Forensic medical observations concerning fatal poisonings with technical liquids indicate that 97.9% of victims took them for the purpose of intoxication, and in 44.9% of cases they had no idea about the degree of harmfulness of the consumed liquids to the body. A wide range of alcohol-containing liquids are used as alcohol substitutes: medicinal tinctures, dosage forms for external use, technical liquids, household chemicals, cosmetics. In intoxication, stupor quickly appeared, followed by the development of soporous and comatose states. Intoxication was accompanied by the appearance of focal symptoms of brain damage, circulatory and vascular tone disorders, acute respiratory failure and vascular phenomena. Of those delivered to the hospital by ambulance with poisoning by alcohol substitutes, 24.9% required intensive resuscitation efforts, the mortality rate was 6.9%. One of the variants of surrogate alcoholism is alcohol alcoholism, which develops with the abuse of various food and technical alcohols. The fact that in modern hydrolysis production purified hydrolysis ethanol is no different in toxic properties from food grade ethanol indirectly indicates the potential for abuse.

The most common variant of surrogate alcoholism is moonshine. Moonshine is a highly toxic product that causes persistent irreversible changes throughout the body. The most harmful effect on human body has fusel oil, which is a by-product of alcoholic fermentation. Isolated from alcohol, it really is an oily liquid of various colors (from light yellow to brown-red) with a pungent, unpleasant odor. Fusel oil contains various toxic impurities: isopropyl alcohol, acetaldehyde, ethyl acetyl ether, propyl alcohol acetyl, acetyl, amyl alcohol, isobutyl alcohol, pyridine, butyl alcohol, ethyl oil ether, furfural. If poisonous properties ethyl alcohol taken as one, then for fusel oil this figure is 19, and for furfural 83. Moonshine vodka is made from various food products: rye flour, sugar, corn, barley, potatoes, etc. When analyzing moonshine, a high content of fusel was found in each of its types oils So, in moonshine made from rye flour, the percentage of fusel oil depends on its strength: at 12° - 0.30%, at 18.7° - 0.32%. Moonshine of any strength, made from sugar, also contains a lot of fusel oil (from 0.21 to 0.42%). Its percentage is very high in moonshine vodka made from “bread” flour (up to 0.63%), corn (0.82%), and barley (C.52%). Sometimes it is suggested that the moonshine currently produced is quite well purified from impurities. Meanwhile, specialist research indicates the opposite. It has been proven that the poisonous effect of moonshine, even well-purified, is 1.3 times greater than that of wine alcohol. In the clinic of drunkenness, formed under the influence of moonshine consumption, there is no consistent increase in the severity of symptoms. First of all, forms of behavior that indicate social degradation appear: loss of family, conflicts at work, frequent changes of jobs, showing up at work drunk, antisocial behavior in a state of intoxication. After several months of drinking, a pronounced hangover syndrome develops, physical dependence, alcoholic bragging, and intolerance quickly appear. Unexpectedly for the drinker himself, states of stupor and dysphoria may arise. If a person suffering from alcoholism begins by drinking regular alcoholic beverages, and then switches to taking moonshine and other substitutes, then the clinical picture of the disease develops differently. At first, the sense of control is lost. At the same time, patients are increasingly resorting to the use of surrogates. During this period, they lose not only control over the dose of alcohol and the time of drinking, but also their behavior, and they lose their critical attitude towards their condition. The next very significant mental disorder should be considered the emergence of a craving for alcohol. At first it is mild and the drinker can fight it. In the future, if you continue to drink alcohol, the strength of attraction increases (especially quickly when drinking moonshine). Usually, when using natural alcoholic drinks, even strong ones, withdrawal syndrome appears in stage II of alcoholism, first after taking large doses, then after taking even small doses. When drinking moonshine, a hangover syndrome develops much earlier, sometimes after several months of drinking.

Alcoholism caused by surrogates often occurs with a qualitatively different clinical withdrawal syndrome. With a hangover syndrome associated with ordinary alcohol intoxication, vegetative (tremor, sweating, tachycardia) and mental disorders (anxiety, paranoid attitude) are pronounced. In the clinic of a hangover caused by moonshine, vegetative disorders are less pronounced and mental disorders are more pronounced. The latter often contain delirious components. The binge drinking pattern in ordinary alcoholism appears in stage II of drunkenness, and when using surrogates in approximately 1/3 of patients, drunkenness becomes binge drinking already in stage I. Amnesia of intoxication during moonshine alcoholism is observed in almost all cases in the first stage of alcoholism, i.e., much earlier than in chronic alcoholism caused by ordinary alcoholic drinks. Due to severe toxicosis under the influence of drinking moonshine, intolerance is formed not in stage III of alcoholism, as usual, but in stage II. Moonshine causes an early change in the picture of intoxication: unmotivated anger, dysphoria, fear, and pickiness appear. In the psyche of a chronic alcoholic, under the influence of poisoning, such dramatic changes occur that his moral character changes, qualities such as deceit, tactlessness, weakness of will, irresponsibility, and indifference to the fate of his relatives arise, i.e., personality degradation occurs. People who abuse moonshine quickly experience a decline in memory, attention, and physical and mental performance.

There are three groups of patients with alcoholism depending on the chemical and technological characteristics of the substances used:

1. When consuming drugs containing ethyl alcohol (hydrolytic and sulfite alcohols, denatured alcohol, colognes, lotions, BLO, nithinol, BF glue, dental elixirs, polish, etc.), shortened euphoria and rapidly increasing somnolence are noted (“knocks out” , "knocks you down"). For some people, colognes and lotions do not cause any sensations at all, except for somnolence. BF glue causes instant intoxication, a repeated dose causes sleep. Intoxication is qualitatively different from alcoholic in the absence of hyperthymia. During abstinence, all patients report a particularly severe condition, depressed mood, and suicidal thoughts. It is typical that attempts to recover from a hangover initially cause severe vomiting. The smell of rubber from the mouth and “some kind of white mucus in the eyes” are specific. If the consumption of BF continues for 3-4 days, then withdrawal becomes barely bearable, and pain in watery and red eyes is specific.

2. When consuming surrogates containing higher alcohols (deodorants, antistatic agents, windshield cleaners, “air fresheners,” etc.), some patients become intoxicated no different from alcohol, and some develop stupefaction (“dope” is a difficult to differentiate disorder of consciousness). Drowsiness develops quickly. Some deodorants have a characteristic feature: there is no smell from the mouth when taking the drug, but in the morning a strong smell of cologne appears. Abstinence is very severe and prolonged with an abundance of vegetative and somatic sensations. It is noted that the clinical picture of abstinence is different than with vodka alcoholism. Antistatics such as "Lana" only cause hyperemia and intoxication, reminiscent of ordinary alcoholic intoxication, in only a small part of patients. Most describe the same state: a bad head, like a “cauldron”, drowsiness, apathy. During abstinence, severe headache and severe somatovegetative disorders. When consuming windshield wipers, intoxication is qualitatively different from ordinary alcoholic intoxication. Characterized by a “dope” in the head, incomplete orientation, and rapid falling asleep. Withdrawal is extremely difficult physically, the mood is sharply depressed. What is specific to this drug is that there is no need for a hangover - patients do not want or even cannot consume any alcoholic beverages in the morning.

3. When consuming substances that do not contain alcohols (stain removers, ethers, Corvalol, etc.), there is a very rapid intoxication. When taking large doses of Corvalol, anxiety, agitation (motor and mental) are noted, followed by either deep sleep or coma. In a state of abstinence - severe physical weakness, anorexia, insomnia, abundant vegetative-vascular symptoms. As with the consumption of windshield wipers, there is no desire to get drunk. Compared to “ordinary” alcoholism, surrogate alcoholism is characterized by intellectual decay, noted by the patients themselves. They notice that they feel “stupid,” difficulty concentrating, and the inability to quickly perform logical operations. The patients themselves and those around them speak of an increase in emotional hardening, and it is happening catastrophically quickly. The world is perceived by them as impoverished, dimly (“everything is brilliant”). The inability to recover from a hangover is especially noted (with a hangover, surrogates cause disgust, and an attempt to recover from a hangover with them causes severe vomiting with an abundance of severe vegetative disorders). Observations indicate the need to develop differentiated therapy for alcoholism when consuming surrogates. The situation is complicated by the fact that patients with alcoholism have a pronounced tolerance to a number of substances, and the experiment has proven the ability of ethanol to increase the tolerance of methyl, isopropyl and other alcohols, which is associated with the induction of microsomal enzymes. This suggests that patients with alcoholism can tolerate large doses of undoubtedly toxic substances without signs of immediate poisoning, and the constant effect of drugs will negatively affect the somatic and mental spheres. In addition, the inducing influence of “surrogate alcoholics” on individuals who only abuse alcohol can lead to fatal poisoning the latter.

Poisoning with methyl alcohol is characterized by a phased development of clinical manifestations. In the clinical picture of intoxication, it is customary to distinguish the following periods: initial, latent, pronounced clinical manifestations and consequences.

Immediately after taking the poison, a state similar to alcohol intoxication develops; its distinctive features are the following: firstly, it is less pronounced than when taking similar doses of ethyl alcohol, and secondly, if it is caused only by methanol, then, as a rule, it does not reach the narcotic phase. Intoxication may give way to heavy sleep, the duration of which depends on the dose of poison. Already during this period, patients may notice malaise, general weakness, dizziness, headache, and nausea.

Following intoxication, a latent period begins, the duration of which can vary from 1-2 to 12 or more hours. In some cases, with mild and in some cases moderate intoxication, the latent period can reach 2-3 days.

The period of pronounced clinical manifestations is manifested by symptoms of toxic gastritis (nausea, repeated vomiting, pain mainly in the epigastric region, tension in the muscles of the abdominal wall), toxic encephalopathy (from psychomotor agitation to impaired consciousness up to coma) and general intoxication (malaise, dizziness, headache , muscle weakness, pain in the calf muscles). The phenomena of toxic ophthalmopathy gradually increase (flickering spots before the eyes, double vision, blurred vision, blindness, mydriasis, sluggish reaction of the pupils to light or its absence). In severe intoxication, acute cardiovascular and respiratory failure quickly progresses.

Among metabolic disorders, the leading one is decompensated metabolic acidosis. In more late dates toxic hepatopathy (I-II degrees), nephropathy (usually I degree) and myocardial dystrophy are added. There are 3 degrees of severity of poisoning: mild, moderate (ophthalmic) and severe (generalized).

At mild degree patients complain of malaise, nausea, repeated vomiting, headache, dizziness, fog or flashing “spots” before the eyes, decreased visual acuity, and, less often, abdominal pain. Some patients may experience deep and prolonged sleep, after which they remain unwell with subsequent recovery; others, in the absence of general symptoms of poisoning, develop visual impairment. An objective examination reveals a moderate dilation of the pupils and a weakening of the photoreaction. Typically, the duration of these symptoms does not exceed 3-5 days; asthenia phenomena persist longer. Vision is restored completely.

At the poisoning clinic moderate severity Complaints of visual impairment up to blindness prevail, with general symptoms more pronounced than with mild intoxication. The decrease in vision can be gradual (within 3-4 days) or rapid (in the first day), uniform or uneven (if one eye is blind, vision in the second eye can be preserved). With moderate intoxication, visual impairment can be reversible, but a temporary improvement is often observed (on the 3rd and 4th days) with the further onset of partial or complete blindness due to atrophy of the optic nerve, which is usually irreversible.

Ophthalmoscopic examination is of particular importance in case of methanol poisoning. Thus, in the early stages of intoxication, swelling of the retina and optic nerve, dilated veins, and sometimes minor hemorrhages are observed; in later stages, pale nipples, narrowing of the arteries, narrowing of the visual fields and scotoma (signs of optic neuritis) are observed.

Methanol poisoning severe are characterized by a relatively rapid development of clinical symptoms (although there is no clear relationship between the severity of intoxication and the time elapsed from the moment of ingestion of the poison). After the latent period, severe weakness, headache, pain in the epigastrium, calf muscles, lumbar region, repeated vomiting, and rapid visual impairment appear. Psychomotor agitation increases, which is replaced by deep depression of consciousness up to coma. In some cases, sudden agitation and clonic convulsions may develop. Breathing quickly becomes impaired, cyanosis increases, and cardiovascular failure progresses. Already in the toxicogenic stage of intoxication, complications such as toxic myocardial dystrophy, hepato-, nephropathy, pneumonia, acute pancreatitis, pulmonary and cerebral edema are observed.

When examining patients, a purplish cyanotic coloration of the skin, face, neck, collar area, and upper half of the chest is noted. The pupils are sharply dilated, there is no reaction to light, in some cases meningeal symptoms and pathological pyramidal signs are determined. Breathing is acidotic (deep, noisy), pathological types are possible. The most severe form of acute cardiovascular failure is exotoxic shock. Toxic concentration of methanol in the blood is 0.3, fatal - 0.8 or more g/l.

In case of unfavorable course of intoxication, deaths are observed, as a rule, on the 1st-2nd day due to central respiratory and circulatory disorders. With a favorable course, there is a gradual restoration of all functions, and visual impairment and complications of intoxication come to the fore.

Dilation of the pupils with suppression of the photoreaction is a typical sign of methanol poisoning, which can be observed even in the latent period, before the appearance of pronounced visual impairment.

Similar to that for an alcoholic coma: gastric lavage followed by administration of 20-30 g of sodium sulfate dissolved in a glass of water through a tube. The fight against breathing disorders is inhalation of pure oxygen, and, if necessary and possible, artificial ventilation of the lungs. Gastric lavage should be repeated several times over 2-3 days, since methyl alcohol is absorbed from gastrointestinal tract slowly. In the first hours after poisoning, the administration of ethyl alcohol in the form of a glass of cognac orally or as a 2-5% solution into a vein, drip injection at the rate of up to 1 ml of pure alcohol per 1 kg of the patient’s weight, is indicated. The introduction of ethyl alcohol prevents the oxidation of methyl alcohol to formic acid and formaldehyde and accelerates its elimination. To combat eye damage, one should resort to early lumbar punctures and the administration of ATP, atropine, prednisolone, vitamins (retinol, ascorbic acid, thiamine, riboflavin, etc.) in prescribed doses.

Heating pads for the legs, cardiac medications, an isotonic solution of sodium chloride and glucose under the skin, a spinal puncture to remove 5-15 ml of cerebrospinal fluid, B vitamins are also prescribed. In severe poisoning, resuscitation measures are prescribed.

Prevention. To prevent the possibility of ingesting methyl alcohol, strict control over its consumption, storage and transportation is necessary, as well as appropriate sanitary and educational work. Persons who, due to the nature of their work, are forced to have long-term contact with methyl alcohol or methanol are subject to periodic medical examinations.

Diagnosis of alcoholism.

In response to the question “what is surrogate alcohol,” it is worth conveying to the reader the information that surrogate alcoholic beverages are considered to be those that were produced in an artisanal way in violation of the recipe or those that have expired their shelf life/sales. Such alcohol is so toxic to the human body that in ICD 10 (the international classification of diseases) such conditions have their own code. In particular, it is poisoning of this type that is indicated by coding in the range T51.1-T52.9. Moreover, according to ICD-10, each component, which is the main active ingredient in a surrogate drink, is classified with certain codes.

All low-quality (surrogate) alcoholic drinks can be divided into two main groups:

• Alcohol containing ethyl alcohol and its derivatives. These include drinks based on butyl alcohol (lethality within an hour when taking 30 ml), sulfite and hydrolytic alcohol, industrial alcohol or denatured alcohol. Also included in this category are all lotions/colognes/varnishes and stains. In the latter case (when using stain), the patient’s skin and mucous membranes become blue.
• False surrogate. This is the most dangerous category of low-quality alcoholic beverages for human life. To reduce the cost of alcohol production, methyl alcohol or ethylene glycol is used here instead of ethanol. Both lead to paralysis or death of a person.

Clinical picture of poisoning with alcohol surrogates

It is worth understanding that in case of poisoning with alcohol surrogates, the symptoms may have a different picture depending on the original alcohol included in the drink. Therefore, let's look at everything in detail.

Symptoms of poisoning from ethylene glycol drinks

The consumption of such alcohol affects the human kidneys and liver. If medical care is not provided in a timely manner, failure of these organs occurs. In particularly serious cases, the patient’s central nervous system suffers. But it is worth knowing that ethylene glycol poisoning can divide symptoms into periods:

Signs of ethyl alcohol poisoning and first aid

• Early period. It is characterized by standard signs of human intoxication, but at the same time lasts 12 hours while maintaining the image of an intoxicated person. The patient's state of health remains normal.
• Damage to the central nervous system. After a marked period of 12 hours, the poisoned person shows signs of damage to the central nervous system. Blueness of the skin and mucous membranes is noted. Nausea and gag reflexes occur. Diarrhea is present. Against this background, the patient experiences an increase in body temperature and a significant dilation of the pupils. Problems with the respiratory center begin (shortness of breath, cardiac dysfunction). In the worst case, the patient loses consciousness followed by convulsions.
• Damage to the liver and kidneys. This period takes 2-5 weeks from taking the first dose of the surrogate drink. All the symptoms of renal and liver failure become evident. There is a lack or decrease in diuresis, yellowing of the skin, and severe itching.

Symptoms of methyl alcohol poisoning

These methanol-containing drinks affect the body, affecting the kidneys and central nervous system. In particular, the psyche and vision suffer. The lethal dose of methanol for a healthy person is only 50-70 ml. It is worth knowing that alcohol substitutes with methyl alcohol are very quickly absorbed into the blood from the stomach and small intestine.

Signs of methanol poisoning are:

• Dyspeptic disorders (nausea, gag reflex, diarrhea);
• Visual disturbances (black flickering goosebumps before the eyes, periodic blindness or double vision);
• Lack of response to light stimuli and dilated pupils;
• Cramping abdominal pain, body and muscle aches that appear 1-2 days after taking a dose of methanol;
• Temperature rises to 38 degrees;
• Drop in blood pressure;
• Dryness and itching of the skin;
• Malfunction of the heart muscle;
• Periodic attacks of excitement, followed by attacks of apathy.

If the patient is not helped in time, then as symptoms increase, the patient may fall into a coma with subsequent paralysis of the arms and legs.

Important: in case of poisoning with ethylene glycol or methyl alcohol, the prognosis for a person is less favorable than in case of poisoning with surrogates from the first group above.

Clinical picture of poisoning with surrogates from the first group (ethyl alcohol)

In this case, the primary signs of alcohol poisoning will be the standard symptoms of intoxication. Then, in the future, the patient will develop the following symptoms:

• Strong excitement, both motor and emotional;
• Hyperemia of the facial skin;
• Increased sweating and salivation;
• Falling into euphoria.

Later, a number of such signs develop:

Types of alcohol poisoning and first aid

• Increased urination;
• Pallor of the skin;
• Dry mouth;
• Pupil dilation;
• Decreased coordination of movements;
• Incoherent consciousness.

First aid for poisoning with surrogates

It is worth knowing that if you suspect poisoning with surrogates or in case of obvious poisoning with surrogate alcohol, you should immediately call ambulance. Even if outwardly the person is in a more or less normal state and conscious. The toxic effects of surrogates are fleeting and the picture can change literally within a few tens of minutes (depending on the dose taken). While the person is conscious, a number of measures should be taken to prevent severe alcohol poisoning. Namely, first aid looks like this:

• Clear the stomach of toxins by inducing vomiting. Drink water or manganese pink solution and vomit until the vomit takes the form of clean water.
• Provoke loosening of stool. That's why they drink saline solution. For 1 liter of water, a teaspoon of salt.

If the patient has lost consciousness, then the following must be done before the doctors arrive:

• Free the chest and throat from constricting clothing.
• Provide a flow of fresh air into the room.
• Place the patient on his side to avoid choking on vomit.
• Clean the mouth from vomit, if any.
• Perform artificial respiration when it stops.
• Try to revive the patient using ammonia or rubbing the ears.

Important: if the patient is conscious and there is a suspicion of methanol poisoning, then it is worth knowing that ethanol in this case is an excellent antidote. That is, someone who has been poisoned with methyl alcohol should be given a glass of good vodka. It neutralizes methyl toxins. The same should be done for yourself if you are poisoned.

What applies to surrogates?

Surrogates are liquids containing alcohol, but not intended for ingestion to obtain euphoria. They can be used for technical and medical purposes. Surrogates can be true (contain ethanol) or false (contain other alcohols). These include:

• varnish;
• medicines used for heart diseases (hawthorn tincture);
• technical alcohol;
• moonshine;
• antifreeze;
• brake fluid;
• glass cleaning products;
• lotions and colognes;
• stain;
• “scorched” vodka;
• White Spirit;
• methyl and butyl alcohols;
• ethylene glycol.

Homemade drinks

Many women and men use homemade alcohol solutions. These include moonshine liquid. It is obtained using a special apparatus by distilling mash. This process produces many volatile compounds, including methyl alcohol. If distillation is improper (cleaning the solution from impurities), toxic substances may remain. Home-produced alcoholic drinks are in great demand in rural areas. Such people often experience poisoning from alcohol substitutes.

Medicines containing alcohol

In order to achieve a state of intoxication, alcoholics can use alcohol-based medications. Most in demand:

• hawthorn tincture;
• valerian tincture;
• motherwort tincture.

Hawthorn tincture can be purchased at any pharmacy. affordable price. This medicine contains alcohol and fruits and is used for diseases of the heart and nervous system. Hawthorn improves blood flow and has a calming effect. When consumed in high doses, heart function is disrupted and blood pressure drops. People who use this medicine often develop heart failure.

How to determine

Surrogates can be distinguished from alcoholic products intended for mass consumption by smell, color and method of application. All household products (solvents, industrial alcohol) should not be ingested.

Many surrogates contain dyes and are sold in specialized stores.

Simple alcoholic products are sold in grocery stores and alcohol supermarkets.

Toxic effects on the body

The severity of poisoning with alcohol surrogates depends on the composition of the solution, the rate of administration and its volume. Alcohol breakdown products can quickly spread throughout the body and be excreted through the kidneys, lungs, skin and intestines. Ethanol is processed in the liver, resulting in the formation of water and carbon dioxide.

When toxic substances from alcohol enter the bloodstream, the following are affected:

• Gastrointestinal organs (stomach, intestines, liver, pancreas, gall bladder);
• heart;
• brain;
• lungs;
• kidneys;
• organs of vision;
• nerves;
• blood vessels.

Poisoning with alcohol surrogates causes necrosis of hepatocytes (liver cells), death of neurons, hemolysis (destruction of blood cells), disruption of water and mineral metabolism and has a negative effect on the gonads. The toxic effect of methanol will be weaker if a person has previously consumed ethyl alcohol. This is due to the fact that ethanol is a specific antidote to methanol. The toxic effect of toxic substances largely depends on absorption. Strong drinks (alcohol) enter the bloodstream most quickly.

Dangerous doses of alcohol

The liver of a healthy person weighing about 80 kg processes only 8 ml of alcohol in 1 hour. The lethal dose is the consumption of 100 ml of 96% ethyl alcohol. Coma develops when the concentration of ethanol in the blood is 3 g/l. Methanol is more dangerous. Lethal outcome is possible when consuming 100 ml of the substance, and acute poisoning is observed at 7-8 ml. The toxic dose of ethylene glycol is 50 ml.

You can be poisoned not only by surrogates, but also by regular alcohol. Vodka poisoning leads to serious consequences.

Causes of intoxication

The cause of severe poisoning and death of a person can be a single use of surrogates in large dosages or their regular use over many years. Predisposing factors are:

• antisocial lifestyle;
• bad Company;
• alcohol addiction;
• burdened heredity;
• addiction;
• lack of permanent residence;
• difficult family incidents.

Ethanol is found in alcohol tinctures for medical purposes, hydrolysis and sulfite alcohols, colognes, denatured alcohol, glue, dental elixirs, lotions and polishes. Their intentional use is possible in case of unavailability of simple alcohol (during holidays, in the absence of money).

The best alcoholic drinks are those made from Lux, Extra or Alpha alcohol.

Methanol

The most dangerous surrogate is methanol (wood alcohol). It is a colorless liquid that is a monohydric alcohol. It mixes well with water and organic solvents. The source of methanol is anti-freezing fluids for car operation.

Amyl alcohol

Poisoning can occur when consuming solvents. This is a limiting monohydric alcohol, which is obtained as a result of the sublimation of fusel oils.

Ethylene glycol

Ethylene glycol is a flammable substance widely used in industry. The danger to humans is the ingestion of antifreeze, brake fluid, coolants, cooling solutions, cleaning detergents and perfumes. The cause of poisoning is the ingestion of oxalic acid, which causes acidosis (a shift in the reaction to the acidic side) and the formation of kidney stones.

Symptoms of poisoning with alcohol substitutes

Signs of poisoning with alcohol surrogates are:

1. Sensory disorders in the form of decreased attention and memory.
2. Impaired consciousness (stupor, stupor) up to coma. Observed in severe poisoning.
3. Suppression of reflexes.
4. Movement disorders.
5. The presence of an alcohol odor from a person.
6. Decreased body temperature.
7. Dyspeptic disorders in the form of pain in the abdomen or right hypochondrium, vomiting, nausea and diarrhea. These symptoms can appear quickly. The occurrence of pain is associated with the direct damaging effect of toxic breakdown products of alcohols on the mucous membrane of the stomach and intestines. Vomiting is caused by brain damage and stimulation of the vomiting center.
8. Neurological symptoms (euphoria, headache, dizziness, impaired perception in the form of delirium and hallucinations, incoordination of movements, agitation, euphoria, slurred speech).
9. Signs of defeat of cardio-vascular system(redness of the face, pallor of other parts of the body, tachycardia, drop in pressure). The cause of tachycardia is fluid loss. In severe cases, blueness of the mucous membranes and increased blood pressure are observed.
10. Autonomic disorders (increased salivation, sweating).
11. Visual disorders (decreased vision up to complete blindness, the presence of fog and spots before the eyes, double vision).
12. Respiratory symptoms (shortness of breath, rapid and noisy breathing). The causes may be damage to the respiratory center, reflux of vomit into the respiratory tract and pulmonary edema.
13. Urinary dysfunction. In cases of mild to moderate poisoning, an increase in diuresis is observed. In severe cases, oliguria or anuria (lack of urine) occurs.
14. Cramps. Characteristic of severe poisoning.
15. Yellowness of the sclera and skin. A sign of toxic liver damage.

Severe poisoning with alcohol surrogates is accompanied by coma. It can be superficial and deep. In the first case, loss of consciousness, decreased pain sensitivity, uncontrolled movements of the eyeballs, different pupil sizes, defensive reactions to irritants, shortness of breath and rapid heartbeat are observed. Deep coma due to poisoning with alcohol surrogates is characterized by a complete loss of pain sensitivity, absence of tendon reflexes, muscle hypotension, rare and shallow breathing, hypotension and tachycardia.

First aid

In case of poisoning by surrogates, emergency assistance must be provided. It includes:

1. Ensuring air access and patency respiratory tract. If necessary, a triple Safar maneuver is performed (throwing back the head, opening the mouth with the hand and extending the jaw). If your tongue gets stuck, you need to take it out and suck out the mucus using a bulb.
2. Give the victim the correct body position. The person is placed on his side and his tongue is fixed.
3. Call for help. You should call an ambulance immediately if signs of poisoning appear. A person’s life largely depends on the speed of her arrival.
4. Resuscitation measures (indirect cardiac massage and artificial respiration) are carried out in case of cardiac and respiratory arrest. For 2 breaths there should be 30 chest compressions.
5. Bringing a person to consciousness with a solution of ammonia.
6. Facilitating the passage of vomit. Vomiting is artificially induced only if the person is conscious.
7. Gastric lavage. This is carried out until clean wash water is obtained.
8. Warming a person.
9. Use of sorbents (Polysorb, activated carbon).

Inpatient therapy

In a hospital setting, infusion therapy and symptomatic correction are carried out. If necessary, the patient is transferred to an IVL (assisted pulmonary ventilation) or mechanical ventilation (artificial pulmonary ventilation) device. Hemodialysis (blood purification) is often required. Antiemetics, hepatoprotectors, antidotes and saline solutions. In case of poisoning with ethanol-based surrogates, Metadoxil and B vitamins (pyridoxine, thiamine) are used. In case of methanol poisoning, the administration of ethyl alcohol and 4-methylpyrazole is indicated.

Short description

Acute poisoning with alcohol surrogates is associated with the intake of ethyl alcohol containing impurities of various substances prepared on the basis of ethanol or other monohydric or polyhydric alcohols.

Code according to the international classification of diseases ICD-10:

• T51 Toxic effects of alcohol

Alcohol surrogates prepared on the basis of ethyl alcohol containing various impurities. The clinical picture, course and treatment are similar to those for alcohol intoxication (see Acute alcohol poisoning) Hydrolytic and sulfite alcohols are obtained from wood by hydrolysis; more toxic than ethyl alcohol Denatured alcohol - technical ethyl alcohol with an admixture of methyl alcohol, aldehyde, etc.; more toxic than ethyl alcohol Colognes and lotions contain up to 60% ethyl alcohol, methyl alcohol, acetaldehyde, essential oils, etc. Polish (technical ethyl alcohol with acetone, butyl and amyl alcohols) Nigrosin (alcohol wood stain containing ethyl alcohol and dyes) . When taken orally - alcohol intoxication; intense staining of the skin and mucous membranes in a blue color, which persists for 3–4 months. Differential diagnosis - methemoglobinemia.
Alcohol surrogates that do not contain ethyl alcohol and are other monohydric or polyhydric alcohols (false surrogates) Methyl alcohol (methanol, wood alcohol). The lethal dose when taken orally is about 100 ml (without prior intake of ethanol). Toxic concentration in the blood is 300 mg/l, lethal - more than 800 mg/l Ethylene glycol is classified as dihydroxyl higher alcohols; Part of antifreeze and brake fluid. The lethal dose when taken orally is 100 ml.

Causes

Pathogenesis Methanol is quickly absorbed in the stomach and small intestine, metabolized mainly in the liver by alcohol dehydrogenase with the formation of formaldehyde and formic acid. Oxidation of methanol occurs much more slowly than ethyl alcohol. Methanol and its metabolites are excreted by the kidneys, and part (15%) - unchanged through the lungs. Toxic effect - selective psychotropic (narcotic), neurotoxic (optic nerve dystrophy and retinal damage), nephrotoxic, metabolic (severe metabolic acidosis) Ethylene glycol Rapidly absorbed in the stomach and intestines, excreted unchanged by the kidneys (20–30%); about 60% is oxidized in the liver under the influence of alcohol dehydrogenase with the formation of glycolaldehyde, glyoxal, oxaloacetic acid. Products of biotransformation of ethylene glycol penetrate into the cells of the liver and kidneys, sharply increasing the osmotic pressure of the intracellular fluid, which is accompanied by the development of hydropic (balloon) degeneration. Toxic effect - balloon degeneration of hepatocytes and nephrothelium of the renal tubules, leading to acute hepatic renal failure; in severe cases, damage to the cells of the central nervous system is possible with the development of cerebral edema; severe metabolic acidosis.

Symptoms (signs)

Clinical picture
Methanol poisoning Intoxication is mild; nausea, vomiting; sometimes - flashing of flies before the eyes. After 1–2 days, symptoms of intoxication increase - thirst, vomiting, abdominal pain, headache, dizziness, pain in the calf muscles, diplopia, blindness. The skin and mucous membranes are dry, hyperemic, with a cyanotic tint; the tongue is covered with a gray coating, the pupils are dilated with a weakened reaction to light. Possible psychomotor agitation, convulsions, hypertonicity of the muscles of the extremities, stiff neck, coma Tachycardia followed by a slowdown and disturbance of the heart rhythm. Blood pressure is increased, then falls.

Ethylene glycol Iridocyclitis (if it gets into the eyes) At first, mild intoxication with good health. After 6–8 hours - pain in the abdomen, lower back; severe thirst, headache, vomiting, diarrhea Dry, hyperemic skin; mucous membranes with a cyanotic tint. In case of moderate poisoning - psychomotor agitation; dilated pupils; increased body temperature; dyspnea; tachycardia In severe poisoning - loss of consciousness; stiff neck; clonicotonic seizures; breathing is deep, noisy; acute heart failure, pulmonary edema; for 2–5 days - anuria, toxic hepatopathy and nephropathy up to acute renal or acute hepatic-renal failure.

Diagnostics

EEG research methods Gas-liquid chromatography.
Differential diagnosis is carried out with acute alcohol poisoning.

Treatment

TREATMENT
Management tactics (see also Poisoning, general provisions) Gastric lavage through a tube Specific (antidote) therapy Infusion therapy, forced diuresis with plasma alkalization Early hemodialysis, peritoneal dialysis Lumbar puncture (for cerebral edema) In case of visual impairment due to methanol intake - supraorbital administration of atropine , hydrocortisone If ethylene glycol gets into the eyes, rinse.
Specific (antidote) therapy For poisoning with methanol and ethylene glycol - ethyl alcohol 100 ml 30% solution orally, then every 3 hours 50 ml or 5% solution ethyl alcohol IV drip 1-2 g/kg/day, maintaining the required concentration of ethanol in the blood (100 mg%) In case of poisoning with ethylene glycol - calcium chloride or gluconate (10–20 ml of 10% r – ra) intravenously again (to bind the resulting oxalic acid).
Nonspecific drug therapy(see also Poisoning, general provisions) For acidosis - 4% solution of sodium bicarbonate intravenously up to 1,000–1,500 ml/day For agitation and convulsions - 10 ml of 25% solution of magnesium sulfate intramuscularly Prednisolone, thiamine, triphosadenine, ascorbic acid, glucose-procaine mixture (200 ml of 40% glucose solution and 20 ml of 2% procaine solution) intravenously.

The course and prognosis depend on the concentration and amount of the toxic substance, the timeliness and adequacy of the assistance provided. In general, the prognosis is quite serious (especially in case of ethylene glycol poisoning due to the often developing acute renal failure, sometimes there is a need for a donor kidney transplant) In severe cases, methanol poisoning develops rapidly progressive acute cardiovascular failure in combination with central respiratory disorders.

ICD-10 T51 Toxic effects of alcohol

Types of surrogates

Surrogate alcohol is considered to be an alcohol-containing drink that contains foreign impurities or contains other monohydric and polyhydric alcohols (not only ethyl). Accordingly, alcohol surrogates are divided into 2 main groups:

• true;
• false.

The former contain ethyl alcohol and impurities that are extremely harmful to the body, which give the main toxic effect. Most often, poisoning with alcohol surrogates of the first group is observed after consuming moonshine, polish, denatured alcohol, and even alcohol-based wood stain.

The second group contains not ethanol, but other alcohols. These drinks cause severe intoxication many times faster, but also have a more destructive effect on the body. The breakdown of such alcohols produces metabolites that are extremely toxic. This group of drinks includes brake fluid and antifreeze. Drinking such substances is typical for people at the stage of alcoholic personality degradation.

Poisoning with alcohol substitutes is most often observed in people who suffer from chronic alcoholism. Dependence on alcohol is at the stage when a person becomes indifferent to the quality of the drink and the dangers of drinking alcohol to health.

Symptoms of poisoning

Since there are 2 groups of surrogates, it is important to understand that the symptoms will vary greatly depending on the cause of the poisoning. Even if it is known which group the surrogate that provoked the poisoning belonged to (for example, it was a true surrogate), it is necessary to know what kind of impurity was contained in the drink in order to competently provide assistance to the victim.

Symptoms of poisoning by true surrogates

The signs of poisoning by surrogates are similar to the symptoms that indicate that the patient has consumed ethyl alcohol, but in the first case the ailment is more pronounced and is observed after a shorter period of time. The consequences of poisoning from low-quality alcoholic beverages depend on the amount of alcohol ingested.

In case of poisoning with true surrogates, intoxication occurs due to toxic impurities. For example, after drinking hydrolytic alcohol, all the same symptoms appear as after drinking high-quality alcohol:

• nausea;
• vomit;
• weakness;
• drowsiness;
• sudden changes in blood pressure.

However, the speed at which the first signs appear is much higher. Intoxication is often reported when taking alcohol-based heart medications. In this case, the following will be added to the symptoms of poisoning:

• bradycardia;
• decompensated dysfunction of the myocardium.

Poisoning with surrogate alcohol is often caused by the use of alcohol-containing products for external use. In this case, the patient will experience a sharp blueing of the lips and mucous membranes, and the blood will become more brown. This is due to the presence of anesthesin in the composition, which tends to prevent oxygen from entering tissues and internal organs.

Alcohol consumption in the form of cosmetics leads to disruption of the functioning of the digestive tract along with signs of simple alcohol poisoning. This is due to the presence of butyl and methyl alcohols, which can lead to acute gastritis and even provoke the development of hepatitis. When using stain, a change in the color of the mucous membranes is observed, but this is due to the presence of dyes in the composition.

The main harm of moonshine lies in the danger of fusel oils, which have an extremely destructive effect on the liver and lead to acute liver failure, and in the most advanced cases, even cirrhosis. To provoke severe poisoning by surrogates of this group, you need to drink a relatively small portion of alcoholic liquid.

Symptoms of poisoning by false surrogates

The most common “substitute” for ethyl alcohol is methyl alcohol, which in itself does not carry special harm for the human body. The main danger is represented by its breakdown products - formic acid and formaldehyde.

It is possible to avoid acute poisoning surrogate alcohol, if ethyl alcohol is also present in the drink along with methyl alcohol. The thing is that ethanol is an “antidote” that prevents the transformation of methanol into substances harmful to the body. Therefore, people suffering from chronic alcoholism mix two types of alcohol, but such experiments are extremely dangerous for health.

A small dose of the surrogate causes a mild stage of intoxication, during which the person feels satisfactory, only the main signs of alcohol intoxication appear. Poisoning low-quality alcohol occurs at the end of this “hidden” period. If quantity alcohol taken a little more, signs of intoxication appear instantly: in just a few hours, death can occur if the person is not given proper assistance.

In cases of mild to moderate poisoning, the following are observed:

• sharp deterioration of vision followed by its restoration;
• dizziness;
• nausea.

In the severe stage, very pronounced symptoms of acute alcohol poisoning are present. A person can fall into an alcoholic coma within 2 hours after the first symptoms appear:

• drowsiness;
• violation of self-control;
• sudden changes in blood pressure;
• strong thirst;
• joint pain.

Another common substitute for ethyl alcohol is ethylene glycol, which is present in brake fluid. The danger comes from the breakdown products of this substance, the most toxic of which is oxalic acid, which causes kidney destruction. Main symptoms:

• redness of the skin;
• change in color of mucous membranes;
• increase in heart rate;
• hyperthermia;
• disturbance of perception of the surrounding world;
• psychomotor disorders;
• convulsions.

Oxalic acid leads to acute heart failure, disrupts liver function and provokes acute renal failure, which is the most common cause of death in human poisoning with ethylene glycol.

Treatment

At the first signs of poisoning by surrogates, it is necessary to seek qualified help, as the ailment progresses at a very high speed. First aid should always be gastric lavage with warm water.

Further treatment measures directly depend on the cause of poisoning:

1. Methanol. For treatment, ethanol is used in small doses, which prevents the breakdown of methanol. Atropine and prednisolone are used to restore vision.
2. Ethylene glycol. A sodium bicarbonate solution is used. It is necessary to adjust the water-electrolyte balance and take diuretics to restore kidney function.
3. True surrogates. Here, treatment is prescribed depending on which organs and systems of the body are affected. It all depends on the amount of alcohol taken and its type.

Poisoning with alcohol and any of its substitutes can be extremely dangerous. Surrogate alcohol very often leads to death, and many people who have undergone treatment after poisoning with surrogates become disabled. It is important to protect people from drinking such alcohol.

Sources

• https://alkotraz.ru/zdorove/posledstviya-upotrebleniya/surrogatnyj-alkogol.html
• https://opohmele.ru/alkogol-i-zdorove/otravlenie-surrogatam.html
• http://gipocrat.ru/boleznid_id35551.phtml
• https://ObOtravlenii.ru/alkogolnoe/otravlenie-surrogatami-alkogolya.html

What drinks are considered surrogate and is it possible to replace alcohol with them?

First you need to understand what these drinks are classified as. These are different chemical liquids that are far from related to alcoholic beverages, but are still used instead of them. Also, the market is quite extensively overcrowded with alcohol surrogates. You can come across counterfeit alcohol even in a “trusted” store or supermarket. News on this topic occupies one of the leading articles in the news feed. As for mortality from surrogates or technical liquids, almost 98 percent of patients took them for the purpose of intoxication. Also included in this category are people with alcoholism. After all, addiction to alcohol forces a person to resort to various tricks just to temporarily remove the hangover.

What are there

In fact, there are quite a lot of surrogates for alcoholic beverages; they are divided into two groups:

• With ethanol. These are medicines, lotions and technical alcohol. All products that people use in everyday life belong to this group. They may contain various poisons, which can cause very severe poisoning and lead to death.
• No ethanol. These are false surrogates, but they still lead to a hazy state similar to intoxication. These are methyl, butyl, amyl alcohols, gasoline, dichlorvos.

Counterfeit alcohol also includes cologne, disinfectants, alcohol tinctures from the pharmacy, as well as moonshine.

The latter is a rather toxic product that disrupts the functioning of the entire body due to the harmful oils it contains. This is a product that is a liquid similar to oil of different colors, mostly light yellow, with an unpleasant odor. It is produced from alcohol during the fermentation of moonshine. This type of surrogate drink is made at home from various food products: sugar, rye flour, peas, wheat, even potato peels. And any product contains these oils in large quantities.

The news that moonshine is one and a half times more toxic to the human body than wine alcohol has been proven by experts.

If drunkenness and drinking moonshine do not stop long time, then the person develops alcoholism. This results in hangover syndrome, physical dependence on alcohol, and aggression during a hangover.

A strong addiction to a surrogate also entails mental disorders and degradation; the drinker can no longer imagine his life without a glass of moonshine. The strength of attraction to this type of surrogate is much stronger than to other varieties of this drink.

Binges when drinking moonshine are much more common than with ordinary alcoholism. Also a constant companion of this disease is amnesia in a state of intoxication, aggression, deceit, indifferent attitude towards one’s family, decreased performance and attention.

Effect on the body

A fairly large assortment of surrogate alcohol products on store shelves leads to uncontrolled consumption by people with alcohol addiction.

It would seem that brake fluid is needed for cars, but an alcoholic uses it in his own way - internally. And, once in the body, it decomposes, forming very toxic breakdown products. The victim experiences a sharp excitement of the nervous system, then depression and sleepiness. If the dose of alcohol is very large, loss of consciousness may occur, convulsions may occur, breathing and heart function may be impaired. News of this type of poisoning is often hidden, and doctors classify it as poisoning from unknown alcoholic beverages. In this case, urgent medical attention is needed, since if left like this, acute renal failure will occur in a couple of days, which can lead to failure of this organ.

The effect of solvents on organs is even stronger. When taking just a teaspoon, a person experiences severe vomiting, weakness, and loss of consciousness. If the poisoned person is not urgently hospitalized and comprehensive treatment is not applied, the consequences can be very dire.

So popular among alcoholics and people with low incomes and a great desire to drink, when taken orally it breaks down into formic acid and formaldehyde. These two components cause headaches and dizziness. If the poisoned person is not hospitalized, then within a day he may become completely blind.

In many countries, news about the tragic outcome of poisoning with alcohol surrogates is disseminated by the media so that the population monitors the quality of drinking and does not cross the threshold of what is permitted due to drunken recklessness.

After ingestion of acetone, a burn to the gastric mucosa and kidney damage occurs. The victim develops acute gastritis. The same thing happens when you ingest perfumes and cosmetics. BF glue leads to instant intoxication, and with a repeated dose leads to the onset of sleep.

In all cases of taking surrogate drinks, patients experience a serious condition, depression, and even suicide attempts are possible. All this suggests that the poisons contained in these products, when entering the body, destroy it, causing toxic poisoning and severe disturbances in the functioning of the nervous system.

Medicinal alcoholism is the second most common, after moonshine. A large assortment of alcohol tinctures is freely available and at a low price at any nearby pharmacy, giving alcoholics the opportunity to drink these medications without restrictions. This is a tincture of hawthorn, motherwort, propolis, and ginseng. All of them contain alcohol and must be used as directed strictly in doses prescribed by a doctor. However, news about poisoning with these tinctures suggests that there are no boundaries for alcoholics. In such patients, the liver, stomach, and heart are gradually destroyed. This condition, in which convulsions occur and loss of consciousness can lead to cardiac arrest and death of a person. Therefore, all patients require compulsory treatment in a hospital.

Help with poisoning

However, surrogate alcoholism greatly disrupts all body functions, and this leads to the fact that a person can withstand a large dose of a toxic substance and not feel immediate poisoning. And this, undoubtedly, leads to even greater complications.

Before the ambulance arrives, the victim should try to rinse his stomach. There are several proven methods for this. The first and easiest is to induce vomiting. After this, you are allowed to drink a glass of strong sweet tea. If a person has lost consciousness, only doctors in the hospital can wash him.

If a person is poisoned by methanol, then he needs to be given one hundred grams to drink quality vodka or cognac to kill the poisons of the destructive effects of methanol. After this, immediately call an ambulance, as this could cost a person’s life.

The most reliable way to avoid poisoning from surrogate alcoholic drinks is to completely abstain from alcohol. Products and household chemicals should be stored separately from each other, and the purchase of alcoholic beverages should only be made in reliable stores with a good reputation.

You need to watch the news about surrogate poisonings and draw appropriate conclusions. After all, human life is much more valuable than a drink.

Poisoning with surrogate alcohol belongs to the category, which contains various impurities. This also includes poisoning with an alcohol surrogate based on other polyhydric or monohydric alcohols.

An alcohol surrogate is an alcohol-containing liquid not intended for oral consumption. Therefore, this substance provokes reactions and changes in the body that pose a threat not only to health, but also to life.

Intoxication with surrogate alcohol is most often observed:

• in people suffering from alcoholism who do not particularly care about the quality of the alcohol they drink,
• among teenagers who, for obvious reasons, cannot purchase quality alcoholic drinks,
• Quite rarely, this happens to normal adults due to the fact that they bought low-quality products by mistake or ignorance.

Poisoning is usually accompanied by symptoms such as nausea, vomiting, cramps, diarrhea, flushing (redness of the skin), loss of vision and others. Sometimes psychosis and acute liver failure develop, and this can end in death.

To accurately make a diagnosis, external symptoms are not enough. It is necessary to take special clinical samples, after which treatment is prescribed in the form of detoxification and restoration of normal functioning of the affected organs.

Among other types of intoxication, poisoning with surrogate alcohol occupies a leading position both in prevalence and in the number of deaths. Moreover, often the person does not even have time to be hospitalized. Also, in most cases it ends in serious health problems.

Classification and toxicity of alcohol surrogates

There are two types of alcohol surrogates:

• True, which includes ethanol with various impurities. The latter are what cause poisoning.
• False, containing other alcohols that lead to intoxication. They themselves are toxic to the body.

The ethanol-containing group includes:

• denatured alcohol,
• cologne,
• butyl alcohol,
• wood alcohols,
• stain,
• varnish.

The surrogate is much more toxic than ordinary alcohol, for example, denatured alcohol contains aldehyde, wood alcohol contains methanol, polish contains a whole “bouquet” of toxic alcohols, and stain contains dyes.

The group of false surrogates includes:

• BF glue,
• methanol,
• dichloroethane.

Toxicity alcohol surrogates due to the presence of technical alcohols in their composition. Although ethanol is a drinkable liquid, when combined with other chemicals it becomes deadly to humans.

When a regular, acceptable drink containing alcohol enters the body, the latter goes through a series of breakdowns, eventually turning into carbon dioxide and water. They are safely excreted by the lungs and liver, which this process uses its carbohydrate reserves.

With industrial alcohols, everything is not so simple, because they break down much longer than their “edible” colleagues, circulating in the blood and destroying internal organs. For example, amyl alcohol is not excreted for about two days, significantly impairing the functioning of the heart muscle, from which a person can die.

When alcohol substitutes are consumed regularly, vascular tone decreases, microthrombi form, which in turn provokes hypertension. Kidney and liver failure also occurs because these organs remove toxins that cause their tissues to gradually die.

Toxic doses of false surrogates

The danger of a false surrogate for the body is that even a small amount of it can lead to death. The toxic dose of a substance depends on its composition:

• isopropanol – 0.5-2 ml/kg body weight,
• dichloroethane – 5 ml,
• methanol (methyl hydrate) – 7-8 ml,
• butyral-phenolic glue (BF) – 20-50 ml,
• acetone – 30 ml,
• polyura – 50 ml,
• ethylene glycol – 50 ml.

Severe intoxication occurs when 0.5 ml/kg body weight of isopropanol enters the body. The person falls into a coma or experiences a severe decrease in blood pressure and serious disturbances in the gastrointestinal tract. If 240 ml of this substance is drunk, death occurs.

Dichloroethane is the most toxic of these substances. 5 ml or even less is enough for it to affect all internal organs, leading to convulsions and loss of consciousness. A dose of 20 ml is lethal.

As a result of the breakdown of methanol in the body, formaldehyde and formic acid are obtained, which are highly toxic and cause irreversible damage to the central nervous system. For an adult, 7 ml is enough to lose vision and lose consciousness, and 50 g of this substance causes instant death.

BF glue contains acetone, ethanol and chloroform. However, these are not permanent ingredients in its composition, but the toxic dose of liquid depends on them. Usually 20 ml is enough for a person to feel a serious deterioration in health.

If acetone enters the body, it greatly irritates the mucous membrane of the digestive tract, causing inflammation. To get poisoned, it is enough to drink 30 ml of this liquid. Exceeding this “limit” leads to death.

The polish contains acetone, ethanol, other impurities and alcohols, and sometimes there are aniline dyes. 50 ml of this substance, entering the body, affects all systems and organs, leading to coma. Instant death is caused by drinking 150 ml of polish.

Ethylene glycol is broken down in the body into highly toxic oxalic and glycolic acids. 50 g of this liquid, taken orally, causes convulsions, impaired consciousness, and difficulty breathing. If you drink 100 g, it is guaranteed death.

Symptoms of intoxication with true surrogates

Quite often, the symptoms of alcohol poisoning and its true surrogates are similar. However, depending on what components were included in the alcohol-containing drink, the signs may be supplemented by new factors or the degree of severity.

When hydrolytic alcohol is present in alcohol, it, like ethyl alcohol, provokes:

• nausea,
• vomiting
• dry mouth,
• headache,
• dizziness.

If a person abuses alcohol-containing cardiac drugs, he develops bradycardia, since these drugs contain cardiac glycosides. When taken systematically and in large doses, it can lead to the development of acute heart failure.

When an alcohol-containing product for external use is taken internally, it causes oxygen starvation of the tissues of the internal organs. Since anesthesin is often added to such substances, which prevents the delivery of oxygen to tissues and organs.

Signs of poisoning with surrogate alcohol can be supplemented by:

• rapid heartbeat,
• blue mucous membranes,
• development of hepatitis,
• gastritis.

When moonshine is abused, its fusel oils have a strong destructive effect on the liver, causing liver failure and cirrhosis.

Symptoms of intoxication with false surrogates

The composition of surrogate alcohol may include alcohol, which does not differ from ethyl alcohol either in taste or smell. However, just 100 ml of this liquid is enough to cause death. Depending on individual sensitivity, this dose may vary downward. And if a person also took ethanol, which is an antidote to methanol, the picture of intoxication may generally be blurred.

For this reason, alcoholics often mix these two types of alcohol. However, such “chemistry” is dangerous to health because, when broken down in the body, methanol forms formic acid and formaldehyde. If too many of them accumulate, it causes inevitable death.

How does it feel to replace ethyl alcohol with some technical alcohol:

• pain in the stomach area,
• nausea,
• prolonged vomiting,
• headache,
• visual disturbances (“floaters”, “fog”).

This light form intoxication. Symptoms can persist for up to several days, gradually disappearing if the person no longer drinks substitute alcohol.

Average severity of poisoning with surrogate alcohol is accompanied by the same symptoms, but in a more pronounced form, and on the second day the person loses vision. After some time it may partially recover, and then disappear again. An average degree of intoxication does not pose a threat to life, but it is quite possible to become visually disabled.

A severe form of poisoning is accompanied by the following symptoms:

• stupefaction,
• drowsiness,
• strong thirst
• temperature increase,
• dryness, blueness of mucous membranes,
• skin hyperemia,
• leg pain,
• tachycardia alternating with bradycardia,
• shortness of breath,
• sharp rise and fall in blood pressure,
• confusion,
• psychomotor agitation,
• convulsions.

In case of very severe intoxication with surrogate alcohol, a person has literally 2-3 hours between the appearance of the first signs of poisoning and irreversible damage to internal organs. If proper assistance is not provided during this time, the functioning of the heart and lungs is disrupted, the patient falls into a coma and dies.

How to help someone who has been poisoned with alcohol substitute

First aid for someone poisoned with surrogate alcohol depends on his condition. If he loses consciousness, you must:

• lay the victim on a hard, flat surface,
• turn his head to the side so that he does not choke if he vomits,
• call the doctors.

If a person stops breathing, you must first call an ambulance, and then carry out resuscitation procedures.

When the patient is conscious before the doctors arrive, he should be given:

• sorbent,
• saline laxative,
• jelly or other enveloping decoction.

After this, it is necessary to take care of urgent hospitalization.

The hospital will take the following actions:

• The stomach will be rinsed using a probe. If it turns out that the intoxication was due to methanol, this washing will be repeated for three days.
• They will give sorbents and an antidote, for example, a liquid with a strictly defined concentration of ethyl alcohol (intravenously or orally).
• When poisoning was due to false surrogates, calcium gluconate will be administered to neutralize the breakdown products.
• Forced diuresis will be performed if renal dysfunction is not observed.
• At severe intoxication a false surrogate may require a kidney transplant.
• If necessary, toxins will be removed from the blood using hemodialysis.
• To maintain the functioning of the body, various drugs and vitamins are administered intravenously.
• When intoxication was due to methanol, a spinal puncture is taken for testing.

Consequences of poisoning with surrogate alcohol

Even if the surrogate alcohol contains ethyl alcohol, to which the human body does not react so acutely, the consequences of intoxication even from this substance are often quite serious. What can we say about when people drink technical alcohol intentionally or by mistake?

The consequences in most cases are determined not by the amount of alcohol consumed, but by the timeliness and competence of the assistance provided. There are more deaths among alcoholics because their poisoning is much more severe than among those who do not suffer from such addiction.

When intoxicated with methanol, a person can become completely blind. Even after the poison is removed, vision will not be restored. False surrogates also cause kidney failure. Those who are poisoned often die.

It is not difficult to protect yourself from poisoning with surrogate alcohol. It is enough to buy certified products in trusted stores. Under no circumstances should you consume non-edible liquids, drink anything bought second-hand, or moonshine brewed at the nearest “spot.” There is a high probability that in order to reduce the cost of the product or give it special properties, they added something that should not be taken orally.