How to avoid dying of methanol poisoning in South East Asia

Travel

The news this week about the deaths of young backpackers in Laos from methanol poisoning is terribly sad. Our thoughts go out to their families and friends.

And tragically, they are far from alone. According to Medecins Sans Frontieres (MSF), thousands of people report methanol poisoning every year, and the area with the highest number of cases is Asia, with outbreaks commonly occurring in Indonesia, India, Cambodia, Vietnam, and the Philippines.

As someone who has lived and traveled extensively in Asia, and has children planning their own solo backpacking trips across the region, this news is worryingly close to home. I’ve already spoken to my children about the risks, but felt the need to educate myself further, so I can protect them as best I can.

I also felt this might be helpful to others. So if you are planning a trip to Asia, or have children embarking on a holiday or gap year, I have compiled some information about methanol poisoning including:

  • How to avoid it
  • The symptoms to look out for
  • How to treat it

I hope you find this helpful. Please feel free to share to anyone you think needs to read it.

What is methanol?

Methanol is a colourless liquid that tastes similar to alcohol. Indeed, methanol and ethanol – the pure form of alcohol in alcoholic drinks – are very alike. However, methanol has a different chemical structure that makes it poisonous for humans.

Methanol is also known as wood alcohol, and is used to make solvents, pesticides, paint thinners, and alternative fuels.

What is methanol poisoning?

Drinking even a small amount of methanol can be lethal. It is absorbed in your gut within minutes and then gets into your bloodstream. As your body tries to clear the methanol, by breaking it down or metabolising it in your liver, an enzyme converts it to formaldehyde and formic acid. 

This has major consequences, affecting your breathing and attacking your nerves. Methanol poisoning commonly leads to partial or complete blindness. If left untreated, it can result in a coma and death.

Without treatment, methanol fatality rates are reported to be 20% to 40%, depending on the concentration of methanol and the amount consumed. However, according to MSF, “this is believed to be an underestimation of the real situation”.

How to avoid methanol poisoning

The best way to avoid dying from methanol poisoning is to eliminate the chances of drinking it in the first place. Here’s the advice given by the excellent Facebook page Just Don’t Drink Spirits in Bali for when travelling in South east Asia (and other countries and regions where there is a risk of methanol poisoning).

It is usually considerer safe to drink these alcoholic drinks (within the guidelines of drinking alcohol):

  • Duty free spirits that you have brought with you
  • Beers and ciders
  • Single served premixed drinks, like Smirnoff Ice etc
  • Wine

You should ALWAYS avoid these drinks:

  • Cocktails
  • Shots
  • Any drink someone serving you in a bar has to pour from a bottle of spirits of any kind

To be safe, we’d also recommend avoiding buying bottles of spirits locally, because moonshine can be decanted into branded bottles.

What are the symptoms of methanol poisoning?

So how do you know if you have, or might have, methanol poisoning? Here are some of the symptoms:

  • Dizziness or disorientation
  • Breathing difficulty
  • Convulsions
  • Stomach pain and/or diarrhoea
  • Blurred or snowy vision
  • Blindness
  • Intense headache
  • Vomiting

You may first begin to notice symptoms around 12–24 hours after drinking methanol. The amount of time it takes for symptoms to appear depends on the volume of methanol you have ingested.

What should you do if you think you have methanol poisoning?

Drinking just 25ml of methanol (just half a shot) can be fatal without proper medical treatment, so it is extremely important you seek help – ideally attending a hospital that has dialysis – as soon as you notice symptoms of methanol poisoning.

The first choice antidote to methanol is fomepizole. If this is not available then high doses of ethanol (spirits like whisky, vodka, etc) are used. Your liver will process the ethanol first, delaying the onset of methanol poisoning and giving your system more time to process the methanol and get rid of it.

If you don’t have immediate access to medical treatment then you may need to self-administer ethanol. Here’s the advice given on the Just Don’t Drink Spirits in Bali page:

If you are self-dosing ethanol, please make sure the alcohol you are using comes from a trusted source, and is not further contaminated with methanol. And please always seek urgent medical help.

Please note, I am not medically trained and the information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes.