Wednesday, 26 September 2007

Smells of breathalyser myth

The Sun on September 22 carried a sensational story, Prince Harry snorts vodka: "BOOZE-loving Prince Harry was blasted last night for snorting VODKA in a potentially lethal drinking game". Some of the medical backup to the sensationalism, however, looked iffy: "Professor Ian Gilmore, president of the Royal College of Physicians, explained that snorting alcohol meant it was absorbed directly through the lungs — bypassing the liver. He warned bluntly: 'This could kill'. Alcohol Concern’s Frank Soodeen said: 'There is nothing cool or glamorous about snorting alcohol. The medical view is clear. Taking alcohol up the nose increases the risk of direct alcohol damage to the brain'".
      Not exactly: it first bypasses the stomach, where initial detoxification takes place through the alcohol dehydrogenase in the stomach lining. Even after this, when blood from the stomach goes to the liver via the portal vein, only part of the alcohol is dealt with on the first pass (otherwise it'd be impossible to get drunk) and it's progressively swept up each time it goes round.
      It's fair to say that this is a way of getting alcohol into your system fast, and there's a risk of overdose if you choose to ingest alcohol very rapidly (whether by sniffing it or knocking back shots in quick succession). However, this story taps into a strange myth that sniffed or inhaled alcohol mysteriously goes direct to the brain without getting into the body at large. For instance, Experts blast 'snorting alcohol' craze quotes Professor Oliver James, head of clinical medical sciences at Newcastle University: "He added that people may also be able to inhale alcohol for 20 minutes, get drunk, drive and still be able to pass a police breathalyser test as alcohol levels in the blood remained very low". The BBC story Inhaling alcohol may 'harm brain' repeated the same quote. I wonder if he's being quoted out of context, because the physiology of this is plain wrong. However you take alcohol, it goes into the bloodstream and the brain gets it by that route; there's no way to target the brain exclusively and be drunk without corresponding blood alcohol levels. The story has been repeated, for instance, at the site of Susan Westrom, 79th District Kentucky State Representive.
      As to the dangers, there are other views. The Guardian Science section referred to this practice in 2004 - Is sniffing alcohol bad for you? - consulting Professor Alastair Hay of Leeds University, one of Britain's foremost toxicologists, with the conclusion "Probably not, well no worse than drinking it anyway". He did warn, however, that the irritant and defatting action of alcohol might long term produce "some pathology" to the nasal passages. This is why, as The Sun says, "He throws back his head to take the full 'hit' of vodka — and then reels in shock. The Prince is seen shuddering as his friends cheer". It's not the alcoholic hit, but simply that it's seriously painful, which seems plenty reason not to do it.
      There's no doubt that excessive alcohol consumption isn't good for you, but alcohol safety initiatives aren't helped by spreading scary falsehoods. Alcohol: Problems and Solutions makes interesting reading. Its creator, Professor David J. Hanson, is an eminent researcher and expert on alcohol-related topics, and he cites a number of alcohol myths and various scare stories, such as "alcohol is a solvent" (as are "water, olive oil, vinegar, milk and almost all other liquids"), that are similar if not identical to those of 19th century Temperance campaigners.

No comments: