ETHANOL’S EFFECTS ON DRIVING ABILITY

 Slow reaction time

 Poor judgement
 Impaired vision and hearing
 Poor coordination
 False sense of confidence

How does ethanol affect driving ability adversely?

Ethanol is a central nervous system (CNS) depressant. The CNS, in

conjunction with the peripheral nervous system (PNS), works to integrate the
somatosensory responses necessary to drive safely. As ethanol works to
depress the CNS, driving ability consequently suffers.

There are two main theories about how ethanol achieves this. Firstly, for
neurons to communicate they must have a working connection, otherwise
known as a synapse. A synapse is an electrochemical junction between two
neurons. The electrical impulse transmitted via the axon of the presynaptic
neuron initiates the release of neurotransmitters into the synaptic cleft. These
diffuse across the synaptic cleft and bind to their receptors on the
postsynaptic membrane. Ethanol is thought to interfere with these
neurotransmitters but the exact mechanism of action is unknown.

The second theory is based on the finding that ethanol inhibits calcium entry
into neurons, possibly by increased GABA-mediated neuronal inhibition or by
preventing the binding of excitatory neurotransmitters such as glutamate. As
calcium is a positively-charged ion that could potentially lead to the
depolarisation of a neuron in the CNS (i.e. an excitatory event), its inability to
enter the neuron may contribute to ethanol-mediated CNS depression.

What does driving demand from the CNS?

Driving involves using a collection of motor and sensory skills, situational

awareness, execution of learned responses, an ability to anticipate and avoid
risk, and to sense the changing nature of the external traffic environment.

Different sections of the CNS are required to function in tandem to this.

CNS region Function

Primary motor cortex
Supplementary motor area
Somatosensory cortex
Prefrontal association cortex
Posterior parietal cortex
Voluntary movement
Programming of complex movements
Somesthetic sensation &
proprioception
Decision making, planning
Integration of somatosensory and
visual input
As driving requires many brain regions to cooperate with each other,
introducing a drug (ethanol) that depresses their activity and thus the
communication between them, is likely to result in reduced CNS output and
consequently poorer driving.

BRIEF FACTS ON ETHANOL

 Very small chemical compound, molecular weight = 46

 Water-soluble and because of size, passes easily through lipid
membranes and into cells e.g. neurons
 Following absorption, ethanol is distributed in every tissue of the body in
the same ratio as the tissue’s water content.
 90% of absorbed ethanol is metabolised in the liver by alcohol
dehydrogenase (acetaldehyde -> acetic acid -> CO2 and water)
 As BAC rises, the hepatic pathway (utilising alcohol dehydrogenase)
becomes saturated, resulting in an increase in the unmetabolised form of
the drug.
 BAC tend to be higher in women because they have less of the enzymes
necessary to metabolise the drug and have a higher proportion of fat to
lean tissue which means a smaller volume of distribution for water-soluble
drugs.

References

Bryant & Knights (2007) Pharmacology for Health Professionals

Sherwood (2004) Human Physiology: from Cells to Systems

Government of South Australia, Drug and Alcohol Services

(www.dassa.sa.gov.au)