Killer cocktail: methanol poisoning

Approx read: 3 mins

As the peak dry season wraps up in Indonesia budget travellers will start pouring into the country, looking for waves, cheap eats, and even cheaper drinks.

Travellers beware: the most dangerous thing in Bali isn’t a kamikaze motorist or a sharp reef.

It comes with a little umbrella.

Cheap cocktails can get you killed in Indonesia. As taxes on liquor continue to rise, shopkeepers have started cutting spirits with locally-brewed arak, which can contain toxic methanol. The taste of methanol is similar to ethanol, the alcohol in beer and wine.

Symptoms

But unlike the ethanol in booze that produces light euphoria, and perhaps a thumping hangover the next day, methanol produces formaldehyde and formic acid, destroying soft tissues along the way.  Blue lips and fingernails, blindness, seizures, liver and renal failure, pancreatitis, coma and death follow. According to Bali physician Dr Lanang Suartana Patra, ‘It’s like your body is being embalmed from the inside out.’

It doesn’t take much: permanent blindness can occur after ingesting as little as 30cc of methyl alcohol, an amount that’ll barely fill a shot glass.

Treatment

Treatment is available: it usually begins with booze. By dosing a methanol-poisoned person with ethanol, the ethanol zips to the liver faster, and keeps it ‘occupied’ from processing the fermaldehyde-producing methanol. Secondary steps may include dialysis and more drugs to eliminate methanol from the body.  But treatment has to happen fast. And the earliest signs of poisoning resemble regular drunkenness, which can lead to time-consuming misdiagnoses as the clock ticks.

A private group, Lifesaving Initiatives About Methanol, (LIAM), dedicated to educating people of methanol’s dangers, was started in 2012, after 19-year-old Liam Davies died of poisoning in Bali. Despite growing awareness, arak continues to make its way into cocktails.

Why serve poison?

Bali distillers and bartenders aren’t serial killers. Making alcohol is a complicated process. When arak is distilled at the wrong temperature, it produces methanol as a by-product. Why arak? Imported alcohol is so highly taxed that up to 50% of it is counterfeit, according to the International Federation of Spirit Producers. This not only includes fake labels, but also cutting the good stuff with arak to stretch profits. Even if the label on the bottle is real, the contents could be deadly.

Liam Davies asked the bartender if the alcohol was the real thing. The bartenders was assured him that the vodka was imported. He asked the bartender to make him  a drink from an unopened bottle; the bartender complied. Sadly, the imported vodka turned out to be cut with local arak, poured into an imported bottle and resealed.

Duty-free or death?

The only way to be sure you’re not drinking poison is not to drink it. Drink the duty-free you brought from home (travellers can bring up to 1 litre per person into the country) or stick to beer.

These days, you don’t have to go to Bali to go blind.

Methanol poisonings have occurred in Turkey, Nigeria, the Czech Republic and the UK. Over 90 people from Mumbai died from a single bad batch of homemade alcohol in 2015. Kentucky rednecks, despite over a century in the backyard booze business, regularly succumb to moonshine poisoning.

Methanol poisoning checklist

Difficulty breathing

Blurred vision

Agitation

Dizziness

Stomach pain

No matter where you are, if you think you have methanol poisoning, get to a hospital immediately. Let somebody know what the problem is. By the time you arrive, you may not be in any shape to communicate with medical staff.

Until countries with unregulated alcohol industries raise awareness and enforce regulation, travellers have to decide what risks they’ll take for a taste of culture.

Sarah is a blogger, writer and amateur palaeontologist from New Orleans. When not writing or digging dinosaurs, she teaches English.