{"id":57846,"date":"2020-02-06T20:41:07","date_gmt":"2020-02-07T04:41:07","guid":{"rendered":"http:\/\/www.todayifoundout.com\/?p=57846"},"modified":"2020-02-06T20:41:07","modified_gmt":"2020-02-07T04:41:07","slug":"do-drunk-people-really-survive-car-crashes-more","status":"publish","type":"post","link":"https:\/\/www.todayifoundout.com\/index.php\/2020\/02\/do-drunk-people-really-survive-car-crashes-more\/","title":{"rendered":"Do Drunk People Really Survive Car Crashes More?"},"content":{"rendered":"
Brexstacular asks: Why don\u2019t drunk drivers get injured very often in wrecks?<\/div>\n

\"\"There are seemingly never ending news stories involving the mug shot of a drunk driver mostly unharmed after getting in an accident. Meanwhile, their victims are left fighting for their lives, or worse, already dead.\u00a0 The perception from this is that somehow being drunk will protect you from sustaining injuries in the event of a car crash or some other trauma.\u00a0 As to why, the commonly held idea is that the more relaxed you are in your drunken stupor, the less likely you will be to get injured.\u00a0 As to why, the general idea often put forth is that you\u2019ll bend and contort into whatever shape the accident puts you in without fighting it.\u00a0 Stiffening up prevents your ability to fold like a pretzel and makes all your inner bits tense. Thus, you snap like a twig, injuring yourself more readily and severely.\u00a0 But is any of this actually true? Are drunk drivers actually less likely to be injured than their vastly more responsible compatriots?<\/p>\n

It turns out there are indeed many studies on the topic that show you have a greater chance of survival from trauma should alcohol be in your system.\u00a0 That said, other studies show overall mortality can be as much as 2-fold higher if you have alcohol on board.\u00a0 So, which is correct and is the whole floppy drunk thing actually protecting you?<\/p>\n

To begin with, let us look at the whole Floppsy the drunk thing.\u00a0 All the nerve cells in your central nervous system can be either excited or inhibited by neurotransmitters. \u00a0The more excited, the quicker and stronger your muscles will react. \u00a0Glutamate is an excitatory neurotransmitter.\u00a0 Thus, it gives your brain and spinal cord the ability to send electrical signals at high rates of speed.\u00a0 Alcohol inhibits glutamates’ ability to do this by reducing ion flow through glutamate receptors.\u00a0 It can do this with blood alcohol levels as low as 0.03. The more alcohol you consume, the harder it is for you to control those muscles because glutamate can no longer transmit as readily. \u00a0The result makes you walk like Gumby in an earthquake.<\/p>\n

So now let’s look at Floppsy in a car wreck. When you get into such an accident, there are three collisions- the car hitting something; you hitting the inside of the car; and your organs hitting the inside of your body. \u00a0So as the floppy-drunk hypothesis goes, if you\u2019re sober as a catholic priest on Sunday, you\u2019ll tense up, reducing the absorption capacity of your body to take the punch and making your rubber band like tendons and the like tighter and more likely to snap as a result; compare that to your inebriated counterpart who takes the path of least resistance, turning their arms and legs into a newly acquired air-bag and fully taking advantage of your stretchy inner bits doing their thing.\u00a0 On the surface, this all seems reasonable enough.<\/p>\n

Unfortunately, due to the decrease in your muscles tension, the argument can be made the impact of your body with the car will be a greater force than if your arms or legs were tensed and able to direct that force in a more controlled way.\u00a0 On that note, in the journal article Does alcohol intoxication protect patients from severe injury and reduce hospital mortality? p<\/em>ublished in \u2018The American Surgeon\u2019 in Dec. of 2013, researchers found those with positive blood alcohol levels actually had an increased risk of sustaining head, facial, chest and abdominal injuries.\u00a0 Those injuries are obviously much more prone to killing you then the arm or leg fractures, torn tendons, and the like sustained from stiffened limbs.<\/p>\n

From this and other such studies, while the research to date is unfortunately far from definitive, the idea that you\u2019re more likely to survive a car accident because you become as floppy as your grandpa before Viagra is generally considered somewhat suspect- or at the least currently falling solidly under the category of “more research needed”.<\/p>\n

That said, there really is a growing body of evidence showing a large amount of alcohol in your system will give you a better chance of survival in a traumatic event. (Though, also drastically increases your chances of getting in that traumatic event in the first place, not just in cars, but doing anything- \u201cHold my beer\u201d being a meme for a reason.)<\/p>\n

Further indicating that being flopsy isn\u2019t the root cause is that it turns out the benefit here does require you make it through your alcohol-fueled traumatic event and reach medical aid.<\/p>\n

Whether drunk or not, unsurprisingly, should you remain alive long enough to see the hospital, chances are, you\u2019ll survive the initial assault on your system. For everyone, the complications after, from how the body reacts to your injury, will now be your greatest enemy to whether you survive beyond.\u00a0 And it is this that is thought to be where the real benefit comes from- how alcohol affects these bodily reactions.<\/p>\n

On that note, in Jan. of 2010, researches publishing in the Journal of American Medical Association, \u2018Motor Vehicle Crashes: The Association of Alcohol Consumption with the Type and Severity of Injuries and Outcomes\u2019<\/em>, found that those whose injuries were the most severe had a significantly better survival rate compared to those who didn\u2019t if they had high levels of alcohol in their system. On top of that, even though drunk people were more likely to get severe head trauma and septic complications (infections), they nevertheless had better survival rates despite this.<\/p>\n

Backing up this idea, in 2012 at The University of Illinois at Chicago, researcher and injury epidemiologist Lee Friedman found alcohol decreased mortality for all types of traumatic injuries-\u00a0 fractures, open wounds, and internal injuries to name a few.\u00a0 The only type of trauma not seeing a benefit was burn patients.\u00a0 This makes sense given the immunosuppressant effects of alcohol and the known, deadly complication of infection in burn patients.<\/p>\n

Dr. Friedman also showed the benefits increased the higher the blood alcohol concentration was, reducing mortality up to 50% in some cases.\u00a0 Unfortunately, as he points out, no one definitively knows why this is the case. There just aren\u2019t currently many studies looking at the physiologic mechanisms involved in alcohol’s protective effects once the body is injured.<\/p>\n

Nonetheless, in an attempt to solve the mystery, Dr. Friedman took a stab at explaining why alcohol might help in these cases.\u00a0 In his 2014 study, \u2018Complications Associated with Blood Alcohol Concentration Following Injury\u2019<\/em>, he hypothesized the protective benefits came from how alcohol affects the many types of complications following injury, specifically reducing the chances of having said complications in the first place.<\/p>\n

Looking at the data, of those who were covered in the study who died, 43.2% had at least one complication.\u00a0 However, among the inebriated, instances of complications were indeed decreased. For example, the tipsy individuals saw a decrease in cardiac complications by 23.5%, and renal function complications by 30%. Friedman states \u201cThe current analysis shows there were reductions in medical complications dominating the cardiovascular system and kidneys, which provides clues to solving this interesting and potentially life-saving puzzle\u201d.<\/p>\n

Throwing a wrench in things, however, is a 2011 study \u2018Alcohol Exposure and Outcomes in Trauma Patients\u2019<\/em>.\u00a0 Published in the European Journal of Trauma and Emergency Surgery, these researchers found mortality was almost two-fold higher in trauma patients who had alcohol in their system.\u00a0 Further, victims of penetrating trauma were more likely to be admitted with no vital signs if they had alcohol in their system compared to those who didn\u2019t.\u00a0 They also found those who were alcohol positive were more likely to be admitted with low blood pressure (hypotension) and a lower GCS, (a measure of mentation known as the Glascow Coma Scale). They surmised this may increase mortality.<\/p>\n

As to why, they point out \u201cAlcohol alters hemodynamic, metabolic, and inflammatory homeostasis after hemorrhage, blunts the catecholamine surge after injury, and reduces the electrical threshold for ventricular arrhythmias…immunosuppressive effects from alcohol increase the risk of secondary infections\u2026.\u201d\u00a0 In English, basically you\u2019ll bleed more if you get cut when tipsy because the body\u2019s ability to constrict its blood vessels and clot off is reduced.\u00a0 The chance of your heart going into deadly rhythms is increased.\u00a0 Should you get an infection, your body\u2019s ability to fight it will be diminished.<\/p>\n

The authors do point out, however, there\u2019s a discordance in the studies resulting in inconsistent findings in the literature.\u00a0 They also state their study greatly contributes to the continued controversy over the issue and will of course mandate further study to reach any level of definitiveness.<\/p>\n

Very important to point out here is that when looking at these various studies, part of the controversy and seemingly inconsistent data is that wildly different results often depend on what type of trauma the researchers are studying- burns vs gun shots vs motor vehicle accidents, etc. \u00a0This, of course, shouldn\u2019t come as a big surprise as there\u2019s no such thing as a cure-all, and thus it\u2019s not surprising alcohol might be beneficial in some types of injuries, while not in others. It\u2019s just the question of whether you\u2019ll be safer in, say, a car accident, or not if drunk isn\u2019t yet fully clear when all factors are considered including deaths directly after the initial impact.<\/p>\n

That said, while not for every traumatic situation, there is convincing evidence mortality in certain types of patients can be reduced with the addition of some good old-fashioned moonshine.<\/p>\n

Take traumatic brain injuries (TBI) for example. There are quite a few studies, and reviews, showing alcohol will have a protective affect should you have one. When you get a TBI your body\u2019s fight or flight nervous system (sympathetic) releases a surge of neurotransmitters like norepinephrine and epinephrine. It also ends up with high levels of excitatory neurotransmitters like glutamate and aspirate.\u00a0 The release of these cause a cascade of chemistry leading to neuron cell death. \u00a0Calcium influx causes mitochondrial death. Mitochondria produces adenosine triphosphate, which is needed to give cells their ability to function.\u00a0 Sodium influx is also increased causing the cell to swell and die.<\/p>\n

To prevent this, if you just blocked the receptor sites allowing these chemicals to weave their web of woe, you can help in the complications from them and your neurons live to fight another day.\u00a0 One pathway is to block a receptor known as N-methyl-D-aspartate (NMDA).\u00a0 Remember blocking glutamate makes you all floppy when your drunk?\u00a0 NMDA is a type of glutamate receptor. \u00a0Block it and you\u2019re floppy, and you get to save some brain cells from a TBI.<\/p>\n

Alcohol is also associated with marked decreases in epinephrine and norepinephrine release.\u00a0 So, alcohol will decrease the surge of sympathetic neurotransmitters while not allowing the ones that are there, like glutamate, to work, giving you a greater chance of saving those precious brain cells should you have a TBI.<\/p>\n

For what it\u2019s worth, animal studies on rats in 2013 also seem to confirm this data, showing that neuron cell death was decreased after a TBI if alcohol was present in the rats’ bloodstream. Thus, while your chances of getting a TBI are greatly increased when you\u2019re drunk, funny enough, you\u2019ll have a better chance of survival when you get one.<\/p>\n

In the end, while we can\u2019t say for sure if alcohol will protect you from injury or death in an accident, contrary to popular belief, while more data is definitely needed to be definitive about it, it does not appear that being floppy is the reason for the protection. There is, however, a growing body of evidence it will help in certain types of injuries that may occur in such an accident, potentially paving the way for a new and effective way to help treat certain traumatic injuries once things are a bit more definitive. Of course, the more you drink, the more likely you are to be injured in the first place. So maybe don’t drink and drive.<\/p>\n

If you liked this article, you might also enjoy our new popular podcast, The BrainFood Show (iTunes<\/a>, Spotify<\/a>, Google Play Music<\/a>, Feed<\/a>), as well as:<\/p>\n