Ethanol is often combined with hypnotics in an effort to improve sleep. Guilleminault, Spiegel, and Dement (1977), for instance, found that among 549 insomniacs in the Los Angeles area, 21% took ethanol plus a hypnotic “frequently.” The two are also inadvertently combined whenever a person who has residual blood concentrations of a hypnotic from nightly use takes a drink during the day. This raises the possibility that their interaction may carry an increased risk either of toxicity or of injuries due to impaired coordination or judgment, for instance when driving (see Chapter 6). Ethanol is often taken in combination with hypnotics and other drugs in suicide attempts. (A combination of ethanol and a drug represents the second most common emergency room problem in the DAWN* program.) There is some reason to believe that concurrent ethanol use is often overlooked in patients who appear to be suffering from a drug toxicity. In one study, a pathology service looked for ethanol in blood samples which had been sent by physicians only for drug determinations (due to suspected toxic drug reactions). It was found that 19% of such samples were positive for ethanol as well (Hirsch, Valentour, Adelson, & Sunshine, 1973). Thus an examination of toxicity of hypnotics would be incomplete unless it also examined the interaction of these agents with ethanol.
KeywordsChloral Hydrate Severe Liver Damage Acute Intermittent Porphyria Critical Flicker Fusion Frequency Impaired Coordination
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