Rubbing alcohol is a common staple in most home medicine cabinets and a must-have in first aid kits. But despite warning labels cautioning that the product is for external use only, thousands of calls flood poison control centers every year from people seeking help after someone has drunk the poisonous liquid.
Many of those calls concern children who’ve accidentally swallowed the substance. In other cases, the consumption is deliberate. Individuals with alcohol addiction, for instance, have been known to resort to drinking rubbing alcohol in moments of desperation, such as when they have no access to beer, wine or liquor. People have also attempted suicide by drinking rubbing alcohol.
Rubbing alcohol is widely used in industrial and home-cleaning products because of its powerful antiseptic properties. It’s also an ingredient in antifreeze, industrial solvent, body rubs, skin lotions, aftershave lotions, cosmetics and pharmaceuticals, and it’s the main component in many hand sanitizers.
Although it has the word alcohol in its name, rubbing alcohol is completely different from the ethyl alcohol found in alcoholic beverages. Colorless and bitter-tasting, isopropyl alcohol, also referred to as isopropanol and IPA, is twice as toxic as ethanol. Swallowing just 8 ounces, or 240 milliliters, of rubbing alcohol can be fatal — but as little as 20 milliliters mixed with water can make a person sick.
The body rapidly absorbs isopropyl alcohol, with approximately 80 percent absorbed within 30 minutes of ingestion. And because of its different chemical makeup, isopropanol is not metabolized as efficiently as ethanol is in the human body.
10 to 15 percent of alcoholics hospitalized in detoxification units have consumed nonbeverage alcohol.
While ethanol, or drinking alcohol, is broken down into a substance called acetaldehyde, nearly 20 percent of isopropyl is metabolized into acetone, the toxic chemical found in nail polish remover. Acetone is a central nervous system depressant, and large amounts of acetone can cause damage to the liver, kidneys and nerves.
Unfortunately, people who consume rubbing alcohol intentionally are often unaware of its dangers.
Kitty Dukakis, the wife for former Massachusetts governor and one-time Democratic presidential candidate Michael Dukakis, said she had no idea it was poisonous when she consumed a small amount of the substance in 1989. Dukakis, who struggled with an alcohol addiction and an addiction to diet pills, had a severe reaction to the rubbing alcohol she drank and was hospitalized.
Fortunately, the former first lady of Massachusetts recovered from the incident, which she detailed in her 1990 memoir, “Now You Know.” In the book, she also wrote about resorting to drinking hair spray and nail polish remover when there were no traditional alcoholic beverages available.
Dukakis’ situation is not all that unusual. According to one study, 10 to 15 percent of alcoholics hospitalized in detoxification units have consumed “nonbeverage alcohol” such as mouthwash, aftershave and alcohol-based fuels at some point in their lives. Easy access to such substances is the primary reason for nonbeverage alcohol abuse, according to the report.
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After consuming isopropanol, an individual will appear intoxicated. But isopropyl intoxication typically lasts much longer than intoxication from ethyl alcohol and can be more dangerous.
Typical symptoms of isopropyl intoxication include drowsiness, an unsteady gait, slurred speech, headache and vomiting. Ingesting large amounts of rubbing alcohol can result in severe poisoning that may present with a deep coma, slow and noisy breathing, a racing heartbeat and low blood pressure. The pupils may become tiny, and the person may develop persistent nausea, vomiting, pancreatitis, cold clammy skin, muscle tenderness and other symptoms.
While isopropanol reaches its peak concentration in the blood 30 minutes to two hours from the time it’s consumed, the peak concentration of acetone occurs about four hours after ingestion and produces a characteristic fruity-smelling breath.
Serious central nervous system depression may last up to 24 hours, and individuals can end up with liver, kidney or brain damage. In severe cases, a person may go into respiratory arrest or suffer circulatory collapse resulting in death.
Inhaling, or huffing, rubbing alcohol can also cause serious side effects, including headache, nausea, vomiting and irritation of the nasal passages and lungs. Inhaling isopropanol fumes can cause a loss of consciousness.
Another troubling way people get isopropanol poisoning is by drinking hand sanitizer, which usually contains either ethanol or isopropanol as its active ingredient. Teens and preteens, in particular, have been drawn to abusing hand sanitizer because it’s cheap and readily available.
According to a report from the Centers for Disease Control and Prevention, there were more than 65,000 reported incidents, both intentional and unintentional, of children under the age of 12 ingesting hand sanitizers between 2011 and 2014.
But adults have also been known to abuse the substance. In a 2016 interview with The New York Times, Angie Payden, a former Wells Fargo banker in Wisconsin, said she began drinking hand sanitizer at work to cope with pressures of the job. Payden said she ended up completely addicted to hand sanitizer by the end of 2012, when she was consuming about a bottle each day. Eventually, she was confronted about her behavior and sought treatment.
In 2007, the New England Journal of Medicine detailed the case of a 43-year-old alcoholic who was admitted to the hospital with chest pain but developed low blood pressure and became delirious as he was being discharged. Staff eventually found the man in the bathroom drinking hand sanitizer, which he believed to be a suitable substitute for vodka because it contained such a high percentage of alcohol.
Because of the confusion over isopropyl alcohol and the erroneous belief by some that it is safe to drink, some physicians have suggested that products containing the poisonous substance should say isopropanol or propan-2-ol to discourage consumption of the substance.
If you or someone you know has accidentally or intentionally ingested rubbing alcohol, seek emergency medical care by calling 911 or your local emergency number.
Individuals who’ve consumed rubbing alcohol may develop severe central nervous system depression and breathing trouble that require aggressive life support measures, including intubation. Individuals with isopropanol poisoning may also require intravenous fluids to correct fluid loss and counteract low blood pressure that results from vomiting. In some cases, powerful drugs called vasopressors may need to be administered to prevent cardiovascular collapse and death.
If you or another person has swallowed rubbing alcohol, do not induce vomiting. Because isopropyl alcohol is caustic, it can cause chemical burns to the esophagus. For answers to questions about rubbing alcohol ingestion, you can reach your local poison center by calling the Poison Help hotline at 1-800-222-1222 from anywhere in the country.
Staff at poison control centers can also answer questions about the risks of mixing alcohol with other substances, including prescription drugs, over-the-counter medications and street drugs.
People who consume isopropyl alcohol or are tempted to drink nonbeverage alcohol should consider seeking professional help for alcohol addiction. Through monitored detox and comprehensive addiction care, you or your loved one can safely break free from the bonds of addiction and begin living a happier and healthier life.
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