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Palcohol: Powdered Alcohol Dangers that Emergency Physicians Should Know

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August 13, 2015

Powdered alcohol could soon be sold in stores throughout the United States, but some say the product, marketed under the name Palcohol, could also bring with it unique health risks.

“People argue there is not enough evidence indicating any more concern than there is for liquid alcohol,” said Robert Glatter, MD, FACEP, an emergency physician at Lenox Hill Hospital in New York. “But there are certainly other hazards. I think the powdered form is appealing, the flavoring is appealing, and it creates a situation where there’s potential for abuse.”By

In early April, the Alcohol and Tobacco and Trade Bureau approved the product for sale in the United States but then revoked that approval, calling it an “error,” according to the Associated Press. The product’s maker, Lipsmark, told the Associated Press it would resubmit after making changes to the volume labeling on its packaging. Initial reports indicated Palcohol could be sold as soon as this summer.

When the powder is used as intended, Lipsmark indicates it should be mixed with six ounces of liquid and contains as much alcohol as a glass of wine. The company plans to sell five versions: rum, vodka, Cosmopolitan, Lemon Drop, and Powderita.

Concern stems from the potential for the powder to be snorted by risk-taking teens, accidentally ingested by children, mixed with other substances, and easily concealed and abused.

Dr. Glatter cited a recent case he saw in which a hungry teen babysitter accidentally ingested a brownie infused with marijuana after it had been stored out of sight and forgotten by the adults in the home. Similar unintended incidents may arise with Palcohol, he said.

As of mid June, the National Conference of State Legislatures reported that a dozen states, including Vermont, Tennessee, and Washington, have banned the sale of powdered alcohol, and three additional states have banned it temporarily. There are more than 80 bills in 39 states related to powdered alcohol, and according to Wired, Sen. Chuck Schumer (D-New York) has introduced legislation to ban it nationwide, calling it the “Kool-Aid of teenage binge drinking.”

If, or when, Palcohol enters the market, Dr. Glatter said emergency physicians should be aware of the potential for intoxication resulting from the powder and should work with parents and teens to educate them about the risks. Children presenting with oral burns or a gel-like substance in the mouth and airways may have consumed the powder, which can turn gummy when mixed with saliva, he said.

Snorting the powder may also cause burns, sinus infections, and fungal infection with bacterial overgrowth, said Dr. Glatter.

When used properly, Palcohol should not be any more problematic than liquid alcohol, and Dr. Glatter noted that banning it could create a black market similar to those that have popped up when other substances, like “bath salts,” have been prohibited. He noted that physicians have expressed their concerns about the product.

“I think this is a disaster in the making, especially for kids,” he said. “We really need to have our guard up and really educate children, teens, and schools about this.”