Liver Disease and Alcohol Metabolism

[mizzzfrizzz]

Male. Age 55. Weight 257 lbs. The questions are directed to Dr. Pho.

Moderate drinking in Airforce. Lasted through mid-thirties. More heavily in 40's. Two inpatient treatment programs. Relapsed in early 50's but not heavy drinking although drinking about 4 beers daily after work, hit the sack early, and would go to work the next day. Then, back surgery in 2004 for spinal stenosis but bled too much so surgery was not complete. Changed everything. The pain was so severe, I was having trouble with pain medications, anxiety, depression. I was told by my supervisor that I had to stop taking prescription medication for pain control that contained narcotics. Couldn't tolerate pain and normal meds didn't work.  Recently, I drank on my day off in the morning - 4 drinks - and had beers in the afternoon and evening until I went to bed at 8pm. Developed flu and a cold and cough.  Ttook some Nyquil at bedtime. Went to work the next day (5:30am). Took Vicks formula 44 in the morning about 6am. I worked until 10am and started coughing again. Took some Robitussin. The supervisor said he could smell alcohol on my breath (my wife and car pool people could not). Had company breathalyzer. Registered a .048. I was terminated.

How could I have registered on the breathalyzer? I have the liver damage. Haven't had a phlebotomy for quite some time.  Don't know what my hematocrit level is. I used several BAC calculators on the internet, although I know they are not exactly accurate, my BAC was consistently .017. Why would my breathalyzer reading be so high at work? The company allows a .02 reading. Could it have been cough medicine in my mouth? I hadn't eaten and didn't drink anything before the test.

Thank you for your input.... M

[mizzzfrizzz]

There is so much information on the internet today about the prescription medications and over the counter medications that will cause false positives in drug and alcohol tests. I am curious about what the medical community thinks of this information. Some people swear that they had a false positive test. Is there any reliable study being done? It is sad to see people get terminated if a false positive reading is the culprit. Thanks again.

[Kevin Pho, MD]

Difficult to say.  In those with liver damage, there is a delay in metabolizing the alcohol.  

Obtaining liver function tests and imaging the liver with an ultrasound should be done to evaluate the possibility and extent of liver damage.  

Although possible, I am not aware of the cough syrup affecting the breathalyzer test.  

These questions can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com