Judging intoxication

Abstract

Judgments of whether a person is intoxicated by alcohol are important in a number of civil and law enforcement settings. This paper reviews how well people are able to make such judgments, the evidence for individual signs of intoxication, several structured rating techniques, and the use of sobriety tests. It is concluded that observers relying on common-sense clues of intoxication have limited ability to assess the blood alcohol concentration (BAC) levels of strangers, particularly below .10%. This generalization holds across professions that might be expected to show greater accuracy. Structured assessment instruments based on observable signs have shown promise but are confounded by the wide variations between casual social drinkers and those that have obtained a high level of tolerance. Among sobriety tests, only NHTSA's Standardized Field Sobriety Tests (SFSTs) have substantial, but seriously flawed, research support. Assessing the sobriety of strangers in the low to moderate BAC ranges without resort to chemical tests remains a daunting task.

Spatial relationships between alcohol-related road crashes and retail alcohol availability

“…First, despite paramedics' clinical training and the extended time spent with patients, assessments of alcohol intoxication may be subject to error (Rubenzer, 2011). Provided this error was not spatially structured, any misclassification would have attenuated results towards null.…”

Relating off‐premises alcohol outlet density to intentional and unintentional injuries

“…Within each SA1 unit we calculated counts of intentional injuries (assaults, stabbings, or shootings) and unintentional injuries (falls, crush injuries, or where patients were accidentally struck by an object). Although indicators of recent alcohol use were available in the ambulance data, we included all intentional and unintentional injury cases because unstructured field assessments of intoxication are known to be inaccurate (48). …”

Comparing levels of blood alcohol concentration and indicators of impairment in nightlife patrons

“…There are a number of standardised field screening tools for identifying alcohol intoxication, such as the one leg stand test or measurement of horizontal gaze nystagmus . However, controlled assessments of field sobriety tests have found they are neither sensitive nor specific enough, subject to operator error and vulnerable to confounding by levels of alcohol tolerance .…”

“…There are a number of standardised field screening tools for identifying alcohol intoxication, such as the one leg stand test or measurement of horizontal gaze nystagmus . However, controlled assessments of field sobriety tests have found they are neither sensitive nor specific enough, subject to operator error and vulnerable to confounding by levels of alcohol tolerance . As a result, many jurisdictions have replaced field sobriety testing with estimates of blood alcohol concentration (BAC) via breathalyser testing, which is a more objective and reliable assessment of alcohol intoxication .…”