Question

In 2012, a fraternity at the University of Tennessee was suspended
because a member of the fraternity, student A, was admitted to the
hospital with alcohol poisoning. Student A had a blood alcohol
level of 0.4, which is in the “death zone” for alcohol poisoning.
After questioning, it was revealed that two students were having a
drinking competition, Student A consumed vodka via an enema,
rectally, and Student B consumed vodka orally (P.O.). Student A and
B consumed the same amount of alcohol however, Student B did not
get alcohol poisoning. Provide a rational for why Student A
experienced alcohol poisoning and Student B did not. Be sure to
describe in detail the different routes of administration and the
expected alcohol plasma concentrations.

Answer 1

Normaly when you ingest alcohol, alcohol is broken down, or metabolised, by an enzyme in your liver cells known as alcohol dehydrogenase (ADH), our stomach has also these enzyme. ADH breaks down alcohol into acetaldehyde, and then another enzyme, aldehyde dehydrogenase (ALDH), rapidly breaks down acetaldehyde into acetate, this acetate is used by the body in the ciric acid cycle, so alcohol does not remain as alcohol when you consume it.

Alcohol poisoning is caused by drinking large quantities of alcohol in a short period of time. Very high levels of alcohol in the body can shutdown critical areas of the brain that control breathing, heart rate, and body temperature, resulting in death.  Alcohol is broken down in human body at a rate of about 3.3 mmol/L (15 mg/dL) per hour. Levels of alcohol in body is measured by term known as  blood alcohol concentration (BAC), which is a measurement of alcohol intoxication, A, BAC of 0.10 means that there are 0.10 g of alcohol for every 100 ml of blood, so BAC of 0 means there is no alcohol present in our body, a reading of 0.001–0.029, may appear normal, but a reading of 400–0.500, may indicate alcohol poisoning, which can result in death or coma.

Using an alcohol enema involves placing a small tube into someone's rectum and pouring alcohol into the colon. Because the alcohol is absorbed directly into the bloodstream, the recipient gets drunk faster., when you consume alcohol rectum, alcohol does not get into liver or stomach and moreover  the lower gastrointestinal tract doesn't have that enzyme, so alcohol molecules are absorbed into the bloodstream through the lining of the colon, because of these reasons levels of alcohol go up resulting in alcohol poisoning.This is the reason, Student A
experienced alcohol poisoning and Student B did not.