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Humans have been drinking alcohol for its intoxicating effects. For intoxication a small amount of alcohol is sufficient, but because the liver is very efficient in filtering it, we need more of it to get intoxicated.

This seems to be the main problem. This is what causes us to drink a lot to get high. This is also what causes liver damage over a long period of time and in short term this is what causes hangover.

This metabolic pathway changes if we co-administer lesser amount of alcohol with alcohol dehydrogenase (ADH) inhibitor like 4-methylpyrazole (4-MP) which slows down breaking of alcohol and one could achieve same amounts of intoxication with comparatively very less alcohol.

Apparently Wikipedia agrees with this, but warns that if the alcohol dose is not reduced then it may cause severe intoxication and overdose.

Concurrent use with ethanol is contraindicated because fomepizole is known to prolong the half-life of ethanol via inhibiting its metabolism. Extending the half-life of ethanol may increase and extend the intoxicating effects of ethanol, allowing for greater (potentially dangerous) levels of intoxication at lower doses. Fomepizole slows the production of acetaldehyde by inhibiting alcohol dehydrogenase, which in turn allows more time to further convert acetaldehyde into acetic acid by acetaldehyde dehydrogenase. The result is a patient with a prolonged and deeper level of intoxication for any given dose of ethanol, and reduced "hangover" symptoms (since these adverse symptoms are largely mediated by acetaldehyde build up

But also agrees that if the dose is adjusted and lowered it can have a positive effect.

If alcoholics instead very carefully reduce their doses to reflect the now slower metabolism, they may get the "rewarding" stimulus of intoxication at lower doses with less adverse "hangover" effects - leading potentially to increased psychological dependency. However, these lower doses may therefore produce less chronic toxicity and provide a harm minimization approach to chronic alcoholism

Now assuming that alcoholics are placed under strict supervision and two groups are given with just alcohol and alcohol with 4-MP, to achieve comparable intoxication.

So if group A receives, say 15ml of pure alcohol containing beverage, then B receives 3ml or so, of alcohol along with 4-MP.

  1. Can this help in the prevention of alcohol related liver complications?
  2. Is 4-MP, despite its short-term safety, is safe for long term use?

Is there any data is medical literature on this?

Edit: Regarding the concerns about toxicity.

According to Dr. Dasgupta's research, the perfect BAC in accordance with these moderate drinking guidelines is 0.04 - 0.05%. When your BAC is in this range, you feel good, you gain all the health benefits from the alcohol, and you should not appear overly impaired

So even if we assume none of the alcohol breaks down, average human has around 5000 ml of blood. Reverse calculating it 2.5g of alcohol will cause a BAC of 0.05% which is ideal and non-toxic. So if we give someone 3ml of ethanol with 4-MP, then it is, at least theoretically, it's completely safe.

Xander
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    Can you clarify that, please? At least precis it? Does "For intoxication a small amount of alcohol is sufficient, but… we need more of it to get intoxicated" really work for you? – Robbie Goodwin Jan 08 '22 at 23:02
  • @RobbieGoodwin I mean while taken along with 4-MP, a little amount is enough as the process of breaking down alcohol is paused. This is not for normal circumstances. –  Jan 09 '22 at 07:45
  • @RobbieGoodwin theoretically BAC level of 0.05 should be enough to get you drunk, for this you only need approx 3ml to 4ml of alcohol, but it is not sufficient because the liver simply breaks down the alcohol so you need adound 15 to 20 ml of pure alcohol. –  Jan 09 '22 at 07:48
  • Thanks and could you collate those two Comments and the rest to make a coherent statement clarifying "For intoxication a small amount of alcohol is sufficient, but… we need more of it to get intoxicated"? – Robbie Goodwin Jan 10 '22 at 18:40
  • @RobbieGoodwin plz feel free to edit, I'm deleting all my accounts here on stackexchange. –  Jan 10 '22 at 18:43
  • So long and thanks for the fishies – Robbie Goodwin Jan 10 '22 at 18:44
  • @RobbieGoodwin fishies? What fishies? – Profile name Jan 12 '22 at 15:41
  • @Dnrhbfbfbrhrbf You prolly had to be there, and did you see how in Douglas Adams' Hitchhiker's tales, the dolphins left Earth with the comment "so long and thanks for all the fish…"? Here, user14203 said "Goodbye" rather than explain some Comments. Questionable Comments, unexplained, can reasonably be termed "fishy." The plural of ""fish" is "fish" but the plural of "fishy" would be "fishies…" Is that enough to explain "so long and thanks for all the fishies"? – Robbie Goodwin Jan 15 '22 at 01:47
  • @RobbieGoodwin I am user14203. What question is unanswered. – Profile name Jan 15 '22 at 07:01
  • @Dnrhbfbfbrhrbf Are you saying you see no contradiction in "For intoxication a small amount of alcohol is sufficient, but… we need more of it to get intoxicated"? – Robbie Goodwin Jan 15 '22 at 23:57
  • @RobbieGoodwin dude I think you missed the whole point of the post. Read it again carefully with context. See, to get you drunk very small levels of alcohol is sufficient, **if** the liver didn't break down alcohol, But as you drink, the liver keeps on breaking alcohol, you'll need more and more alochol. So switching off the liver's ability to break alcohol will let us het drunk on as little as 3ml of alcohol. That's what 4-MP does. It switches off the liver's ability to breakdown alcohol. – Profile name Jan 16 '22 at 04:26
  • @RobbieGoodwin this is the full sentence, For intoxication a small amount of alcohol is sufficient, but because the liver is very efficient in filtering it, soooo we need more of it to get intoxicated. – Profile name Jan 16 '22 at 04:28
  • @Dnrhbfbfbrhrbf Why is it hard for you see that if that's the full sentence, it negates itself… even after these several iterations? Do you truly not see how that does boil down to "For intoxication a small amount of alcohol is sufficient, but we need more to get intoxicated"? Is English not your language of choice? – Robbie Goodwin Jan 20 '22 at 21:29
  • @RobbieGoodwin that's cause that is not the sentence, quote the sentence as it is. Why are you changing it? What is the exact sentence? The exact sentence is "For intoxication a small amount of alcohol is sufficient, but because the liver is very efficient in filtering it, we need more of it to get intoxicated". This is the sentence. Why are chaning it and then saying its wrong?? – Profile name Jan 21 '22 at 05:51
  • @Mr.GreenGold Are you not familiar with literary discussion? Taking the time to write or the space to read the full version, "For intoxication a small amount of alcohol is sufficient, but because the liver is very efficient in filtering it, we need more of it to get intoxicated" doesn't change the meaning in English. Would you rather use another language? Dropping the middle part "because the liver is very efficient in filtering it" makes no difference in English. The point remains, what difference but grammar is there between "intoxication" and "getting intoxicated" in any language? – Robbie Goodwin Jan 30 '22 at 22:26
  • @RobbieGoodwin it's not the language issue, it's your basic incomprehension of a basic concept. That is why the word but is used. Dropping the middle part makes no difference? What? It's the middle part that makes it all different. Its like saying I can hit someone if I wish, but because there is a law I can't hit another person. This is legitimate sentence, the first scenario is in the absence of law, then the word but and because are used to convey a reason why the hypothetical is not possible. Why can't you comprehend this basic logic? And I told you that you are free to edit. – Profile name Jan 31 '22 at 02:37
  • @RobbieGoodwin instead you seem to be obsessively stuck on a semantic issue, ignoring the content of the question. As of now I can't edit it because this is a different account. – Profile name Jan 31 '22 at 02:38
  • @Mr.GreenGold Could you even now just read what you wrote? It still doesn't work. Before you get us thrown to Chat, look at what you're saying. One: There is a difference between "For intoxication a small amount of alcohol is sufficient…" and "… we need more of it to get intoxicated". Sorry; not without re-phrasing, there isn't. Two: Dropping the middle part "because the liver is very efficient in filtering it" makes a difference in English. Sorry; it doesn't. Edit the Post to say what you meant but please, stop denying the problem is that you slipped up in the first place. – Robbie Goodwin Jan 31 '22 at 23:13
  • @RobbieGoodwin as I have said multiple times feel free to edit this. I can't edit this as it is my old account. It's deleted.I don't have edit privileges. – Profile name Feb 01 '22 at 03:48
  • @MrGreenGold Thanks and what excuse is that? I'm still sorry to have noticed that what you Posted would in no way have been helpful, even had it been true. Why not now Post a useful a Comment? – Robbie Goodwin Feb 05 '22 at 22:42
  • @MrGreenGold Thanks and that's not up to me… If you believe no editing is needed, why not say so? If you accept any editing is needed, why not make those edits? Either way, how could I be positive - more, less or how? If your Edit privileges come into this, why not just Post your revised views here? If that's a simple Post, Commenting on something earlier, fine. If you'd like to Edit the original, I'll try to accommodate you… – Robbie Goodwin Feb 06 '22 at 00:00

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