Why spurious liquor kills

Source: The post is based on the article “Why spurious liquor kills” published in The Hindu on 17^th May 2023.

Syllabus: GS 2 – Issues related to Health

Relevance: concerns associated with the consumption of liquor

News: Recently, 22 people had died after consuming spurious liquor in the Chengalpattu and Villupuram districts of Tamil Nadu. The article explains the harmful impact of alcohol and measures needed to treat those.

What is the alcohol in liquor?

Liquor is differentiated by its alcohol content, e.g., beer has 5% alcohol while wine has 12%. Alcohol, which is frequently consumed, is known scientifically as ethanol.

The World Health Organisation has found that “no level of ethanol consumption is safe for our health”. Long-term use leads to dependence, increases the risk of various diseases, and may eventually cause death.

How does ethanol affect the body?

Ethanol is a psychoactive drug that, in low doses, reduces the level of neurotransmission in the body, leading to its typical intoxicating effects.

Ethanol, inside the body, is metabolised in the liver and the stomach by alcohol dehydrogenase (ADH) enzymes to acetaldehyde. Aldehyde dehydrogenase (ALDH) enzymes transform the acetaldehyde into acetate.

Acetaldehyde becomes the main reason for harmful effects of ethanol in the body.

What is spurious liquor?

Spurious liquor is characterised by the liquid mixture containing methanol along with ethanol. Methanol is added in the liquor to strengthen the intoxicating effects and/or to increase its bulk volume.

The Food Safety and Standards (Alcoholic Beverages) Regulations 2018 has provided standard for the maximum permissible quantity of methanol in different liquors.

What is methanol?

Methanol is commonly produced by combining carbon monoxide and hydrogen in the presence of copper and zinc oxides as catalysts at 50-100 atm of pressure and 250°C.

Methanol has several industrial applications including the production of acetic acid, formaldehyde, and aromatic hydrocarbons. It is also used as a solvent and as antifreeze.

Use of methanol is governed by various central and state laws. For example, the Indian Standard IS 517, specifies how to determine the quality of methanol.

Whereas, the Tamil Nadu Denatured Spirit, Methyl Alcohol, and Varnish (French Polish) Rules 1959, specifies what labelling and packaging requirements should be present for methanol.

How does spurious liquor kill?

The deadliness of spurious liquor arises from methanol. Once ingested, methanol is metabolised in the liver by ADH enzymes to form formaldehyde.

ALDH enzymes convert formaldehyde to formic acid. The accumulation of formic acid leads to a condition called metabolic acidosis.

Acidosis can lead to acidemia, a condition wherein the blood’s pH drops below its normal value of 7.35, becoming increasingly acidic.

Formic acid also interferes with an enzyme called cytochrome oxidase, which in turn disrupts cells’ ability to use oxygen and leads to the formation of lactic acid, contributing to acidosis. This ultimately leads to death.

How can methanol-poisoning be treated?

First, pharmaceutical-grade ethanol should be administered by healthcare workers because ethanol checks methanol from being metabolised to formaldehyde. Thus, preventing it from becoming poisonous.

Second, Fomepizole should be administered. It slows the action of the ADH enzymes, causing the body to produce formaldehyde at a rate that the body can quickly excrete, preventing the deadlier effects.

Third, healthcare workers may also recommend dialysis to eliminate methanol and formic acid salts from the blood. They can also administer folinic acid, which encourages the formic acid to break up into carbon dioxide and water.