If you're not a regular drinker, you've probably never seen this medicine:
(Source: Qilu Evening News, a social shopping platform)
But for those who often go out to socialize and drink, "decanting candy and antidote" is very popular in the circle, and even a life-saving straw that they carry with them.
There is also such a plot in the hit drama "Thirty Only": Wang Manni went to the sales department to do a collection, and the dinner was drunk by colleagues. The next day, a well-meaning female colleague took out a bottle of medicine and put it on the table, reminding her to "eat this before drinking later."
(Source: TV series "Thirty Only")
But is there really a drug in the world that "drinks the first 2 sake breweries without fear" and "turns wine into water in 10 minutes after drinking"? Is the antidote reliable?
It all starts with the detoxification process of alcohol.
After alcohol enters the digestive tract, about 10% is metabolized in the stomach, and the remaining 90% quickly enters the bloodstream. In addition to a small amount that can be excreted from urine, sweat, and exhalation, more than 90% of the remaining alcohol needs to be metabolized in the liver [2].
There are three main steps for liver metabolism of alcohol:
Under the action of ethanol dehydrogenase, alcohol is converted into acetaldehyde;
Under the action of acetaldehyde dehydrogenase, acetaldehyde is converted to acetic acid;
Through the biochemical reaction of the tricarboxylic acid cycle, acetic acid is converted into carbon dioxide and water, which is excreted out of the body.
For us, if we don't drink too much, the first step above can be completed quickly, and many people are actually stuck in the first step [3].
Because, in different human bodies, the content of acetaldehyde dehydrogenase is different.
People who are relatively dehydrogenated in acetaldehyde dehydrogenase cannot continue to completely convert acetaldehyde into acetic acid, and acetaldehyde will accumulate in the body.
This thing is much more toxic than alcohol and is a first-degree carcinogen[4] that can cause telangiectasia and cause discomfort such as blushing, palpitations, and nausea.
(Drinking and blushing or gaffe depends on the appearance.) Source: TV series "Dear Myself")
In our Chinese, about 40 to 50% of people are born deficient in acetaldehyde dehydrogenase [5]!
So those who "drink and blush" are not drunk, on the contrary, their acetaldehyde dehydrogenase may be relatively deficient and more likely to get drunk.
People who are relatively rich in acetaldehyde dehydrogenase can quickly metabolize acetaldehyde into non-toxic acetic acid, decompose it into carbon dioxide and water and excrete it from the body. This kind of talent is really "drunk" and not easy to get drunk.
(Source: soogif)
However, if the intake of alcohol exceeds the metabolic capacity of the liver, even if the amount of alcohol is large, the alcohol concentration in the body will rise sharply, or it will be drunk!
In this way, if you want to prevent drunkenness, there are only two ways:
1. Reduce or delay the absorption of alcohol in the human body
Alcohol molecules are small, easily pass through the intestinal wall and enter blood vessels, are relatively chemically stable, and are unlikely to "bind to precipitation with other substances" to reduce absorption.
"Delayed absorption" can be done, such as eating some staple foods before drinking alcohol and letting alcohol stay in the stomach for a while. This is why it is often said that "it is not easy to get drunk after a pad of the stomach". But this is still a palliative effect.
(Source: soogif)
2. Increase the amount or activity of acetaldehyde dehydrogenase and accelerate the process of alcohol metabolism
How much acetaldehyde dehydrogenase there is in the human body is only related to genes, and theoretically, after everyone is born, the amount of enzymes in the body has been fixed. Therefore, the "amount of alcohol" is basically innate, and it is impossible to change the amount of acetaldehyde dehydrogenase by drinking a small amount of alcohol every day.
So if a drug is invented to supplement the liver acetaldehyde dehydrogenase, will it be able to dissolve alcohol?
So naïve! The essence of enzymes is protein, which loses activity and breaks down into amino acids after entering the stomach acid. Oral enzymes do not enter the liver at all.
But some people say that "drinking a little wine every day" may be able to partially increase the amount of alcohol.
Because long-term alcohol consumption enhances the activity of another "anti-alcohol" pathway of the liver, the microsomal ethanol oxidation system, which plays a key role in cytochrome P-450 (CYP) 2E1 [6].
This enzyme, which we often call "liver drug metabolism enzyme (liver drug enzyme)", can metabolize ethanol to acetaldehyde, similar to the ethanol dehydrogenase mentioned earlier.
However, liver drug enzymes are still unable to transfer acetaldehyde into acetic acid, so toxic acetaldehyde will continue to accumulate in the liver, and can only wait for acetaldehyde dehydrogenase to clean up.
It's like cleaning in a class, you just help the labor commissioner "sweep the floor" but don't take out the garbage.
(Source: Network, Tencent Medical Code)
Moreover, after all, the metabolism of alcohol is not the "full job" of liver drug enzymes, only occasional cameos, and the ability to dissolve alcohol is very limited. Therefore, the amount of alcohol that can be "practiced" by long-term drinking is also very limited.
In addition, the increase in liver drug enzymes and its metabolites will bring many harms, and over time, it will cause serious damage to the liver [6].
Since the amount of acetaldehyde dehydrogenase is innately determined, can it improve its activity to dissolve alcohol?
There is really such a drug, which can relatively improve the activity of acetaldehyde dehydrogenase.
Metadoxine has been found to be acetaldehyde dehydrogenase activator, which antagonizes the decline in ethanol dehydrogenase activity caused by acute and chronic alcoholism, and accelerates the excretion of ethanol and its metabolites, acetaldehyde and ketones in the urine [7].
In healthy volunteers, metadoxine can reduce the half-life of ethanol metabolism from 7 hours and 15 minutes to 5 hours and 50 minutes [10].
But don't be too happy too soon, this medicine can not be used casually!
Metadoxine is a prescription drug that is only used for the treatment of alcoholic liver disease and needs to be purchased and used with a prescription under the guidance of a doctor.
(Source: Network, Tencent Medical Code)
It is important to note that metadoxine may cause peripheral nerve disease! Also, it should not be used by people with bronchial asthma and in children.
So there are so many antidotes on the market, there is no use?
Most of the so-called "antidotes" claimed on the market are some plant extracts or medicinal and food raw materials, such as turmeric, oyster extract, gardenia, goji berries, salvia, poria, barley seedlings, chitin, etc.:
(Source: A shopping platform)
There are also some containing protein, vitamins, certain minerals and other nutrients, mainly imported dietary supplements, domestic if it is a regular health food, there will be a "blue hat" logo. But these are all food, not real "medicine".
(Ingredient list of imported anti-alcohol liver protection capsules.) Source: A shopping platform)
There is also a category of drugs that are indeed certain chemical components such as naloxone, diuretics, etc., which are printed with the national medicine standard.
(Source: A shopping website)
Naloxone is an antidote to opioid excesses (including drugs such as heroin) that also relieves central inhibition of alcohol and shortens coma [11].
To put it bluntly, it only makes you sober, but it cannot accelerate the "detoxification" process of acetaldehyde.
Moreover, this medicine is a prescription drug, cannot be used casually, and may cause mania [12]. In hospital emergencies, it is usually a direct intravenous infusion, rather than sublingual.
In short, no matter which of the above ingredients of the "antidote", there is no clear study to prove that it can increase the amount or activity of acetaldehyde dehydrogenase, so it can not play a real antidote!
The advertisement of "greatly increasing the amount of alcohol, a thousand cups are not drunk" is only psychological comfort, and eating antidotes may increase the burden on the liver.
The terrible thing is that some people are misled by the advertisement of "a thousand cups are not drunk", thinking that they can "let go and drink" by buying liquor and medicine, and as a result, they are drunk and go to the hospital...
(Source: Nanfang Daily)
There are also people who try to rely on "antidotes" to evade traffic police to check drunk driving, and the result is a "one-day trip to the traffic police team"...
(Source: Minbei Daily)
The price is so big, can't you take the money to buy medicine to ask for a substitute driver?
Serious reminder: the only way to prevent getting drunk is to drink less or no alcohol.
(Source: Network)
Of course, professional wine saucers also have to practice a unique skill, which is the real thousand cups not drunk:
(Source: Southern Metropolis Daily N video)
Unfortunately, in addition to learning about alcohol and medicine, the folk "anti-alcohol food" is not helpful for drunkenness.
The fructose in honey can slightly increase the efficiency of ethanol dehydrogenase [8,9], but is powerless against the more toxic acetaldehyde. Strong tea coffee diuresis may worsen symptoms of dehydration, but in turn increase the concentration of alcohol in the body.
If drunk people can still move, it is better to drink some warm water and eat some fruit (not because of fructose, mainly to supplement sodium, potassium and magnesium ions to alleviate the symptoms of dehydration). If the symptoms improve after vomiting, you can rest on your side, but you must be accompanied.
(Source: soogif)
If your friend or loved one is too drunk to wake up (coma), be sure to let him lie on his side to prevent vomit from being inhaled into the airway and causing choking! Then dial 120 as soon as possible to take it to the hospital.
Finally, the class representatives gave you the key points:
● The human body's "liquor" mainly relies on acetaldehyde dehydrogenase, but the amount of enzyme is innate, and it cannot be supplemented by taking medicine. Only metadoxine can increase the activity of the enzyme, but this is a prescription drug and cannot be used casually.
● Most of the "antidotes" on the market are plant extracts or vitamins, or diuretics, awakening agents, etc., but they cannot increase the amount or activity of acetaldehyde dehydrogenase, and cannot really dissolve alcohol.
● If you are already drunk, honey, strong tea and coffee are not helpful for the antidote, it is better to drink some warm water to replenish water and sober up naturally.
Review expert: Zhao Ning | deputy chief pharmacist of Peking University First Hospital
bibliography
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[3] Yokoyama A， Muramatsu T， Ohmori T， et al． Alcohol and aldehyde dehydrogenase gene polymorphisms and oro-pharyngolaryngeal esophageal and stomach cancers in Japanese alcoholics[J]．Carcinogenesis，2001，22:433-439．
[4]http://samr.cfda.gov.cn/WS01/CL1991/215896.html
[5] Cao Y, Li L, Xu M, et al. The ChinaMAP analytics of deep whole genome sequences in 10,588 individuals[J]. Cell Research, 2020: 1-15.
[6] Prakash O,Nelson S.Alcohol and liver disease[J]. Ochsner J,2002,4(4):241-4.
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[8] Tygstrup N,Winkler K,Lundquist F.The Mechanism of the Fructose Effect on the Ethanol Metabolism of the Human Liver*[J]. Journal of Clinical Investigation,1965, 44(5):817-830.
[9] Handler J A ,Bradford B U ,Glassman E B ,et al. Inhibition of catalase-dependent ethanol metabolism in alcohol dehydrogenase-deficient deermice by fructose[J]. Biochemical Journal,1987,248(2):415-21.
[10] Pellegrini-Giampietro DE, Moroni F,Pistelli A,et al. Pyrrolidone carboxylic acid in acute and chronic alcoholism. Preclinical and clinical studies[J]. Recenti Prog M, 1989 ,80(3):160-4
Tian Yingping,Shi Hanwen. Consensus on diagnosis and treatment of acute alcoholism[J]. Chinese Journal of Emergency Medicine,2014,23(2): 135-138.
[12] Chen B, Liu Y S. Randomized double-blind clinical trial of moderate dosage naloxone in acute moderate and severe traumatic brain injury[J]. Bulletin of Hunan Medical University, 2002, 27(1): 58-60.
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
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