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Health officials sound warning over potential risks of powdered alcohol

Clinicians should be aware of the potential risks of powdered alcohol, including the possibility of increased binge drinking, according to health officials in Baltimore.

In an editorial published in the Annals of Internal Medicine, the city health officials warned of a series of risks posed by the product Palcohol (Lipsmark), a powdered alcohol that in March 2015 gained federal approval for commercial sale in the United States.

According to the editorial’s authors, there is currently little evidence of how the product’s pharmacologic effects differ from those of liquid alcohol. However, they noted that critics have warned that powdered alcohol may increase the potential for abuse, through its ease of portability and combination with other alcoholic drinks. This in turn, they argue, can lead to underage use, increased binge drinking and dangerous “spiking” of others’ beverages.

“With the dearth of evidence on its clinical and public health effects, powdered alcohol poses a substantial threat to ongoing efforts to decrease alcohol consumption, particularly among young persons,” Katherine E. Warren, BA, of the Baltimore City Health Department, in Maryland, and colleagues wrote. “Citywide campaigns with strong clinician leadership and robust mayoral support in such cities as Baltimore, Chicago and New York, strong affected statewide legislation.”

The citywide campaign championed by Baltimore health officials included a meeting of physicians and public health leaders, in which the participants endorsed a statement on the potential dangers of powdered alcohol. In addition, they called for the Maryland comptroller to take preemptive action to restrict the product. The comptroller later announced an agreement with the state’s three major beverage associations to ban the distribution and sale of powdered alcohol. The group also successfully lobbied the state legislature to approve a temporary ban on the product in May 2015.

As of November 2015, 27 states have banned powdered alcohol, and 40 have either approved, or are debating, bills to restrict its sale.

“Clinicians in local jurisdictions can leverage strong provider coalitions to make public health change at the state and federal levels,” Warren and colleagues wrote. “Given the inconsistency of federal oversight, provider advocacy at the local level can identify and prevent potential threats to effective drug and alcohol regulation.”

Palcohol is the first powdered alcohol product to be approved for regular consumption in the United States. It had initially been scheduled for summer 2015 debut, but has yet to be released, according to the editorial’s authors.

The product contains about 55% alcohol by weight, and is reconstituted by adding water. There are five planned flavors, including vodka, rum, cosmopolitan, “powderita” and lemon drop.

Its stated applications include usefulness in outdoor activities and travel, such as reducing airline fuel costs as companies would no longer have to stock heavier liquid alcohol. According to the editorial, the manufacturer has also cited several industrial uses, including as an antiseptic, a livestock supplement, windshield wiper fluid and as a fuel source for military transportation. – by Jason Laday