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Alcohol Effects
15 questions1. Approximately what percentage of consumed alcohol is absorbed into the bloodstream through the small intestine, rather than the stomach?
Alcohol does not require digestion; it is absorbed directly through mucous membranes. Roughly 20% is absorbed across the stomach lining and about 80% across the small intestine, where the surface area is much greater. This is why food in the stomach (which slows gastric emptying into the intestine) slows absorption and lowers peak BAC, while drinking on an empty stomach speeds absorption. The stomach does absorb some alcohol (d is wrong); the intestine is the dominant site.
RBS Training Curriculum; ABC Server Education2. Which of the following will tend to INCREASE the speed at which alcohol is absorbed and raise a customer's BAC fastest?
Carbonation accelerates gastric emptying, pushing alcohol into the small intestine faster, which speeds absorption and produces a higher and earlier peak BAC. Mixed drinks with soda, champagne, and beer in volume can therefore impair faster than a still drink of equal alcohol content. Fatty food (a) slows absorption, water (c) dilutes and slows it, and slow pacing (d) allows time for the liver to eliminate alcohol between drinks.
RBS Training Curriculum3. Which of the following represents one 'standard drink' under U.S. dietary guidelines?
A U.S. 'standard drink' contains about 0.6 fl oz (14 grams) of pure ethanol, which equates to 12 oz of 5% beer, 5 oz of 12% wine, or 1.5 oz of 40% (80-proof) spirits. Servers use this rule to roughly equate drinks when monitoring patrons. Options b, c, and d each contain significantly more than one standard drink, which is why a 16-oz craft IPA or a generous 8-oz pour of wine impairs faster than the customer may expect.
NIAAA; USDA Dietary Guidelines4. Under California Vehicle Code §23152(b), a person 21 or older driving a non-commercial passenger vehicle is guilty of DUI if their blood-alcohol concentration is:
Vehicle Code §23152(b) makes it unlawful for a person to drive a vehicle with a BAC of 0.08% or higher. §23152(d) sets a lower 0.04% limit for commercial drivers, and Vehicle Code §23136 imposes a 0.01% 'zero tolerance' rule for drivers under 21. A driver can also be convicted under §23152(a) for driving 'under the influence' at any BAC if impairment is shown. Servers should be aware that an average 160-lb adult reaches 0.08% with about 4 standard drinks in one hour.
Cal. Vehicle Code §23152(b)5. Under Vehicle Code §23136, what BAC limit applies to a driver under 21 years of age in California?
Vehicle Code §23136 sets a 'zero tolerance' limit of 0.01% BAC for drivers under 21, enforced by a one-year license suspension on first offense. This is effectively any detectable alcohol — even residual mouthwash. §23140 separately makes any under-21 driver with 0.05% or higher subject to criminal penalties, and §23152 still applies at 0.08%. The under-21 driver who has 'just one beer' before driving home is committing a violation regardless of impairment.
Cal. Vehicle Code §231366. The healthy human liver eliminates alcohol at a roughly constant average rate of approximately:
The liver oxidizes alcohol via alcohol dehydrogenase at a roughly fixed rate of about 0.015% BAC per hour for the average adult, equivalent to about one standard drink per hour. Body size, sex, food, and genetics cause some variation, but nothing the customer does — coffee, cold shower, fresh air, exercise, food after drinking — speeds liver metabolism. A patron at 0.10% BAC who stops drinking will need roughly 6-7 hours to fall to zero.
RBS Training Curriculum; NHTSA7. A customer at 0.10% BAC drinks two large cups of black coffee. What is the effect on their BAC?
Caffeine is a stimulant that may briefly mask drowsiness, but it does not increase the liver's rate of alcohol metabolism. The patron remains as impaired as before, only now more alert — sometimes called a 'wide-awake drunk' — which can actually increase risk-taking. Only time eliminates alcohol. The same myth-busting applies to cold showers, exercise, vomiting, and 'sleeping it off' for a short period. Servers must never tell a customer coffee will 'sober them up' enough to drive.
RBS Training Curriculum; NIAAA8. Two adults of the same height and weight, one male and one female, drink the same number of drinks over the same period. Which statement is generally TRUE?
Women, on average, produce less alcohol dehydrogenase (the stomach enzyme that begins breaking down ethanol) and have a higher percentage of body fat / lower percentage of body water than men of identical weight. Alcohol distributes through body water, so less water means a higher concentration. The net result is that the same drink raises a woman's BAC roughly 20-30% more than a man's. Servers should adjust pacing recommendations accordingly.
RBS Training Curriculum9. A patron tells the server, 'I can hold my liquor — five drinks doesn't even affect me.' What does high alcohol tolerance actually mean for the server's duty?
Tolerance is the brain's adaptation that masks behavioral signs (slurred speech, stumbling) at a given BAC. The drinker's reaction time, judgment, vision, and motor coordination are still impaired at the same BAC as a non-tolerant person, and their BAC is identical for DUI purposes. In fact, tolerant drinkers are MORE dangerous because they appear sober while being legally too drunk to drive. Servers should not be reassured by 'I can handle it' statements.
RBS Training Curriculum10. A customer mentions they took a prescription pain medication or antihistamine earlier today. The most appropriate server response is to:
Many common medications — opioid painkillers, benzodiazepines, antihistamines, sleep aids, antidepressants, muscle relaxants — produce additive or synergistic CNS depression with alcohol. A patron may become severely impaired after one or two drinks. The server cannot diagnose interactions but can observe and respond: pace slowly, suggest food and water, and refuse early if impairment signs appear. Demanding to see prescriptions is intrusive and inappropriate; ignoring the disclosure is risky.
FDA; RBS Training Curriculum11. Compared to a younger adult, an older adult (age 65+) of the same body weight will generally:
Aging reduces total body water, lean muscle mass, and (often) liver enzyme efficiency, all of which raise the BAC produced by a standard drink. Older adults are also more likely to be on medications that interact with alcohol and to have slower reflexes baseline. The server should pace conservatively for clearly older patrons and watch for impairment signs that may appear after fewer drinks than expected.
RBS Training Curriculum12. Which cognitive or physical ability is impaired EARLIEST as BAC begins to rise, even at 0.02-0.04%?
Even low BACs (0.02-0.04%) impair the brain's executive functions: judgment, risk assessment, social inhibition, and divided attention. This is why patrons become louder, more talkative, and willing to order another round long before they slur or stumble. By the time gross motor coordination (a) and clear slurring (b) appear, BAC is typically 0.10% or higher. Server intervention is most effective in the early stages, before judgment is fully compromised.
RBS Training Curriculum; NHTSA13. A 'blackout' from alcohol consumption refers to:
An alcohol-induced blackout is a memory-encoding failure of the hippocampus that occurs typically above 0.16% BAC. The drinker may walk, talk, and even drive home with no memory the next day. Blackout drinkers are extremely high risk: still legally drunk, often disinhibited, and prone to victimization or violence. Loss of consciousness (passing out) is a separate, even more severe stage. A patron showing blackout behavior (repeating themselves, not recognizing companions) requires immediate cut-off and safe transport.
RBS Training Curriculum14. A patron orders a 'double' 3-oz pour of 40% ABV bourbon. How many U.S. standard drinks does this contain?
A U.S. standard drink is 0.6 fl oz of pure ethanol, equal to 1.5 oz of 40% spirits. A 3-oz double pour therefore contains exactly 2.0 standard drinks. Many craft cocktails contain 2-3 oz of spirits plus liqueurs, easily reaching 2-3 standard drinks per glass. Servers must track actual alcohol content, not just the number of glasses, when pacing patrons. A patron ordering 'three doubles' has had six standard drinks.
RBS Training Curriculum15. Under Vehicle Code §23152(d), a person driving a commercial motor vehicle is guilty of DUI at a BAC of:
Vehicle Code §23152(d) sets a 0.04% BAC limit for any person driving a commercial motor vehicle (CDL required), matching federal Department of Transportation rules. The lower limit reflects the heightened public safety risk of large vehicles. Servers should treat patrons who mention they 'drive a truck for a living' or who arrive in a commercial vehicle with extra caution, especially when offering 'one for the road.'
Cal. Vehicle Code §23152(d)