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Updated: Oct 5, 2025

Chronic Intermittent Ethanol Vapor Exposure Paired with Two-Bottle Choice to Model Alcohol Use Disorder
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Acute alcohol intoxication and lethal neck flexion.

Roger W Byard1,2

  • 1Forensic Science SA, Adelaide, South Australia, Australia. roger.byard@sa.gov.au.

Forensic Science, Medicine, and Pathology
|January 27, 2022
PubMed
Summary

Positional asphyxia, often linked to alcohol intoxication, can be fatal when neck hyperflexion impairs breathing. This study highlights neck flexion as a specific cause of death in intoxicated individuals, emphasizing scene documentation.

Keywords:
AlcoholIntoxicationNeck hyperflexionPositional asphyxia

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Area of Science:

  • Forensic Pathology
  • Toxicology
  • Public Health

Background:

  • Positional asphyxia is a known risk in drug and alcohol intoxication.
  • Neck hyperflexion's role as a specific cause of death in alcohol intoxication is underappreciated.

Observation:

  • Two cases illustrate positional asphyxia due to neck hyperflexion in acutely intoxicated individuals.
  • Case 1: A woman with a blood alcohol content of 0.24% died from neck hyperflexion caused by vehicle bumper pressure.
  • Case 2: A man with a blood alcohol content of 0.4% died from neck hyperflexion while lying on his back.

Findings:

  • Deaths were attributed to positional asphyxia from neck hyperflexion, exacerbated by alcohol intoxication.
  • Concussion and combined alcohol/drug effects may worsen outcomes.

Implications:

  • Meticulous scene description and documentation are crucial in alcohol toxicity cases.
  • Further investigation into the incidence of neck hyperflexion in alcohol-related deaths is warranted.