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Dubowski’s Seven Stages of Alcohol Influence

Written by: Alan Baker 15th February, 2024

In the fields of forensic science and legal medicine, one of the most widely utilised tables was developed by Professor Kurt M. Dubowski at the University of Oklahoma.

An article explores the origins of various charts and tables that outline the progression of alcohol influence. These regard clinical indicators of intoxication and an individual’s blood-alcohol concentration (BAC).

Professor Kurt M. Dubowski introduced the initial version of the alcohol table in 1957, with minor adjustments documented until 2012.

Dubowski’s table identifies seven stages of alcohol influence:

  1. Encompassing subclinical (sobriety),
  2. Euphoria,
  3. Excitement,
  4. Confusion,
  5. Stupor,
  6. Alcoholic coma, and
  7. Fatality.

Initially, the BAC associated with fatality was reported as 0.45+ g%, though the latest edition indicates a mean and median BAC of 0.36 g%, with a 90% range from 0.21 g% to 0.50 g%.

The Dubowski alcohol table features overlapping BAC ranges for each stage, reflecting individual differences in alcohol’s nervous system effects.

It’s crucial to note that information derived from the Dubowski table is not intended for application to specific individuals but rather for general reference among social drinkers, excluding regular heavy drinkers or individuals with alcohol use disorders.

Real-world scenarios introduce variables such as age, race, gender, drinking patterns, alcohol tolerance, and central nervous system adaptation, all of which influence the effects of ethanol impairment.

Ethanol’s effects vary based on observing during the ascending or descending phase of the blood-alcohol curve (Mellanby effect). The Mellanby effect is the phenomenon where an individual’s perceived level of impairment at identical blood alcohol concentration (BAC) levels is greater when the BAC was rising than when it was falling.

Some individuals, like heavy drinkers or those with alcohol use disorders, may not show expected ethanol-induced behavioural impairments.