Outlaw Powdered Alcohol for Kids' Sake, AMA Says

June 22, 2016

CHICAGO — Powdered alcohol has yet to reach store shelves in the United States, and the American Medical Association (AMA) wants to keep it that way by banning this product as a potential public health threat to youth.

The fear? A teenager could sneak the powder into school, dump it in a glass of water, and sip the equivalent of a cocktail. Or add it to a glass of wine at home for a bigger buzz.

At its annual meeting last week, the AMA House of Delegates voted to support federal and state laws that prohibit the manufacture, importation, distribution, and sale of powdered alcohol. "We believe that powdered alcohol has the potential to cause serious harm to minors," said Jesse Ehrenfeld, MD, a member of the AMA board of trustees, in a news release. The AMA noted that alcohol is the most widely used "substance of abuse" among young people, accounting for 4300 underage deaths per year.

Mark Phillips, the creator of the only federally approved powdered-alcohol product, told Medscape Medical News that the AMA's stance is irresponsible because the association "lack[s] any evidence of potential harmful use." Phillips said that his product, called Palcohol, actually promises to benefit society, and healthcare in particular.

Palcohol, which comes in a cuplike pouch, gives six ounces of water an alcohol volume of 10%. Phillips hopes to market rum and vodka versions as well as three cocktails, including a margarita taste-alike called the "powderita." Each one is described as the equivalent of one shot of alcohol.

Powdered alcohol intended for mixing with water has been available in other countries for more than 10 years, according to the AMA. The Alcohol and Tobacco Tax and Trade Bureau approved the sale of Palcohol in 2015. However, plans to market Palcohol have encountered a stone wall of pre-emptive resistance on the state level. Thirty-two states have banned powdered alcohol, all but two of them since 2014, and lawmakers in other states are considering such a move, according to the National Conference of State Legislatures.

A poll conducted by the University of Michigan last year showed that 60% of adults support banning the product.

The Defense Case for Palcohol

Mark Phillips, who lives in Phoenix, Arizona, characterizes the backlash against powdered alcohol as hysteria abetted by ignorance. And that goes for the AMA, he said.

"If the AMA would have taken the time to learn about the product, they would have realized that Palcohol is safer than liquid alcohol," he told Medscape Medical News.

Palcohol's container, he said, is harder to conceal than a liquid equivalent of alcohol — think miniature liquor bottles. It's also harder to spike a drink with Palcohol than liquid alcohol, which dissolves 30 times faster. Snorting the product isn't likely. "It would take you approximately 60 minutes of painful snorting to get the equivalent of one shot of vodka up your nose," Phillips states on his website. It also isn't likely that users will dump multiple packets of Palcohol into a single drink, he said, because the result would become mush.

Phillips said that Palcohol would be sold in stores and online under the same laws and regulations that govern purchases of liquid alcohol.

The appeal of powdered alcohol, he said, goes beyond the hiker or traveler who wants an easily toted drink. An industrial version of Palcohol could serve as the basis for an antiseptic in remote areas, or an emergency fuel source. Phillips said he's received inquiries about incorporating it in windshield wiper fluid.

"No one wants a nanny government denying individuals and businesses access to this great product," he said.

The Precautionary Principle Applies, the AMA Says

The AMA's Council on Science and Public Health weighed Phillips' arguments for Palcohol, but nevertheless came down on the side of recommending a ban to the House of Delegates. "The harms that could arise from mixing powdered alcohol with liquid alcohol or even with energy drinks raises the potential for dangerous patterns of use," the council said in a report.

The council noted that, because Palcohol has not yet reached the marketplace, no research has been conducted to either confirm or disprove public health misgivings. However, "previous experience with novel alcohol products that appealed to youth, including alcohol energy drinks, has demonstrated the potential for overuse and harm."

The council cited the precautionary principle as a basis for action.

It reasoned that, in the face of a serious or irreversible threat to human health, scientific uncertainty should not postpone preventive measures.

The short version of the principle: Better safe than sorry.


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