Consumption of alcohol has played a major role in the evolution of society, from our very first agrarian days of 10,000 years ago this magic product of yeast, grain and time has provided comfort.
Later we learned the other benefits of this miracle brew - potable beverage. As men crowded ever closer in our first villages and towns, fecal contamination of water supplies was more or less inevitable and beer and wine became the only beverage that would not spread dreaded cholera and dysentery and hepatitis.
The custom of alcohol drinking persists throughout our society today in all matter of variation from social tippling to "good old boy" 6-pack a day, more on weekends. Few remain untouched by the reality of alcohol consumption in our society.Naturally alcohol drinking alone can induce a wide range of cognitive effects from forgetfulness to near unconsciousness, depending upon a number of factors such as dose and tolerance. Because these effects frequently become legal issues in our society we need objective indicators of alcohol consumption resulting in our various breath and blood tests. For many years now most states have used a blood test result of 0.08 as the definition of "under the influence". This is a guide only not an absolute indicator of impairment for habitual drinkers almost always have greater tolerance and therefore less impairment at that level.
Possible contribution from medications in an over-medicated society has always been a consideration when the issue of alcohol impairment has come up in the courts. In the past decade a powerful new factor has emerged, relating to the potential of the statin drugs to cause abrupt amnesic reactions. Tens of millions of people will be taking statin drugs this year alone just in the United States.
Each of these statin users will carry a risk of the condition known as transient global amnesia in addition to the more common impairment of memory, confusion and disorientation associated with statin drug use. With numbers of this magnitude many of the victims of these amnesic cases will also have imbibed alcohol at or immediately before the time of the problem.
Transient global amnesia is the abrupt and unheralded loss of ability to formulate new memory combined with varying degrees of retrograde memory loss for events, months, years and even decades into the victim's past. Imagine a police officer trying to deal with a situation in which the person can walk and talk and drive but cannot remember the last word spoken.
"May I see your driver's license, insurance and proof of registration, Mam?" goes unheeded by the confused soul for they only recall possibly the last syllable of the query and that also blinks out completely after a few seconds. "Get out of the car, please." Results in the same non-responsiveness for the victim cannot remember the order!
Many of these cases have been reported. All have become immediately suspect for acute alcoholism and indeed many had been drinking but the problem was transient global amnesia. And many variations exist with respect to how the victim handles his or her strange new world. Some are hostile, many are strangely receptive, others are anxious and fearful - in near panic attacks, depending on their basic personality.
The one consistent feature is inability to respond to any request, order or command for they cannot remember any input while having one of these episodes. A victim of a TGA can talk but not converse. The usual duration of action is 6-10 hours but they may last up to 24 hours. Or they may be of short duration measured in minutes so the victim can say with assurance, "I don't know what happened."
This is the world of the cognitive side effects of the statin drugs. Sometimes years have elapsed from the time the drug was first started. Another feature that has emerged is the fact that some of these attacks can occur up to 6 months after the offending statin drug has been stopped.
A blood alcohol test at the time the incoherent and confused individual is first seen by the police will tell only what it would tell in anyone - whether they have been drinking and if so roughly how much. It, by itself, would not be sufficient to dismiss statin associated TGA as an explanation for strange non-compliance to direct orders.
The following are some of the reports I have received from readers of my books and website articles regarding alcohol use along with statin drugs.
1) My husband has been on Lipitor for about 5-6 years. I have noticed lately that his personality has changed. He works very long hours in the car sale industry and enjoys a day off and having a glass or two of wine, sometimes a vodka with 7-UP. As of late he becomes very verbally aggressive and abusive and argumentative. Anything I say seems to aggravate him more. I try to avoid him when he is in this mood but sometimes it is unavoidable. He will ask me a question, I will answer and he will become very angry with me. I work for a podiatrist who is quite knowledgeable and he suggested that Lipitor can cause these mood swings and aggressiveness
2) I recently pulled myself off Lipitor because of the constant tiredness and aching that occurs if I work out. I use to think the tiredness was due to extra weight I had put on. I have always had a lot of energy and working out never bothered me. Now however I have no energy and if I just do some yard work I might suffer for a day or more. I also have had to quit drinking alcohol. I'm not sure Lipitor has any effect on the body when you drink, as I have seen no chat input on this, however when I would drink I would totally black out and not remember the evenings events. I was not physically incapacitated when drinking I just could not remember what I did. That being said I do not have a drinking problem. I don't drink all week and only would drink on the weekends. Sometimes just 4 to 6 drinks would give me this effect. In the past I never had this experience.3) Just last Saturday, an hour or so into hosting a Martini Party that we donated to a benefit Auction, I pulled my friend aside (and I remember none of this part) and asked her why all these people were at my house. Of course, she thought I was kidding. I kept asking her and she kept asking if I was okay. I was saying, "Yes, I'm fine, just tell me why these people are at my house." Minutes earlier I was fine, mingling with my guests (most of whom I had just met that night, but I knew who they were by this point and why they were there - I'd spent all day preparing for the event) and all of a sudden I couldn't remember.
A few minutes later I went back into the party, was fine, and remembered everybody! So I not only had the momentary (about 5 minutes) amnesia, I have absolutely no recollection of that conversation with my friend. Yes I had had several Martinis. I had stopped taking Lipitor for my short-term memory loss about 3 months ago but am not noticing any improvement.
One of the first statin TGA cases I saw, several years ago, was someone stopped by the side of the road in unfamiliar territory, far from home. He remembered having had a couple of drinks, which was not an unusual thing for him when returning from work. The police drove up, he seemed confused, refused the breath test, was arrested, and woke up at the police station demanding to know what was going on.
Only a subsequent episode of statin associated TGA and his identification of a growing number of TGA cases in the then new USCD Statin Study finally enabled him to prove the truth of his statement to the police department. Incidentally this scenario has been repeated many times by others.
A woman related to me her story after having been arrested one evening in the downtown of a major city, driving erratically and having run a red light. The police found her uncooperative, confused, irate and extra-ordinarily difficult to deal with. She refused a sobriety test and because of a strange smell in her car (Chinese take-out) the police were certain she was drunk but she refused to do anything they asked.
After spending several hours in the local lock-up during which time she was verbally and physically assaultive to the officers, she abruptly became calm and cooperative and performed the sobriety test. She said she remembered nothing of the previous several hours.
Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor