Methanol metabolism in chronic alcoholism

Serum methanol concentrations (SMC) exceeding 10 mg/l are highly suggestive of long-term alcohol intoxication and can be considered as marker for chronic alcohol abuse. Endogenously formed or consumed methanol is almost exclusively metabolized by alcohol dehydrogenase. As long as blood alcohol concentrations exceed 0.2-0.5 g/l methanol cannot be metabolized and accumulates. In a prospective study on 78 patients admitted for alcohol detoxification, elevated SMC up to 78 mg/l were found, with a mean SMC of 29.4 mg/l. No correlation was demonstrated between SMC and severity of the alcohol withdrawal syndrome. Further clinical, forensic and biochemical aspects of methanol metabolism are discussed.