A “meths drinker” is a person who consumes denatured alcohol, commonly known as methylated spirits, as a substitute for conventional alcoholic beverages. This practice is extremely dangerous because these industrial products are ethanol mixed with additives to make them undrinkable and poisonous. The primary toxic additive is methanol, or wood alcohol. Even a small amount of methanol can lead to irreversible organ damage, permanent disability, or death due to the body’s conversion of the substance into highly destructive compounds.
Defining “Meths” and Its Toxic Mechanism
Methylated spirits, or “meths,” consists primarily of ethanol, the same alcohol found in beer and liquor, but it is intentionally adulterated to prevent recreational consumption and to allow it to be sold without the heavy taxation applied to potable alcohol. The process, called denaturing, involves adding substances that are bitter, foul-smelling, or toxic, with methanol being the most common and dangerous additive. Conventional drinking alcohol is ethanol, which the body can metabolize relatively safely, while methanol is profoundly toxic.
The toxicity of methanol itself is initially minor, but the danger arises as the body attempts to process it in the liver. The enzyme alcohol dehydrogenase (ADH), which normally breaks down ethanol, metabolizes methanol into formaldehyde. This formaldehyde is then rapidly converted into formic acid. Formic acid is the true poison, accumulating in the bloodstream and disrupting cellular respiration.
Acute Health Crisis and Symptoms of Methanol Poisoning
The onset of severe symptoms is often delayed by a latent period of 12 to 24 hours while the methanol is slowly converted into formic acid. Initially, a person may experience symptoms similar to regular intoxication, such as dizziness and nausea, which can lead to a false sense of security. Once the toxic metabolite builds up, the patient develops profound symptoms related to cellular damage and a severe imbalance in the body’s chemistry.
Formic acid causes a life-threatening condition known as severe metabolic acidosis. The body attempts to compensate by breathing rapidly and deeply, a pattern called Kussmaul respiration, in an effort to expel carbon dioxide and restore pH balance. The most recognized long-term damage involves the nervous system, particularly the eyes, where formic acid damages the optic nerve. This leads to visual disturbances like blurred vision or “snowstorm vision,” which can progress rapidly to permanent blindness. Other acute symptoms include severe abdominal pain, vomiting, and central nervous system depression, which can progress to seizures and coma.
Social Context and Risk Factors for Consumption
The consumption of denatured alcohol is typically driven by severe alcohol use disorder (AUD) and socio-economic vulnerability. Individuals engage in this behavior out of desperation when conventional, regulated alcohol is unavailable or unaffordable. Meths, or other methanol-containing products like windshield washer fluid, are significantly cheaper than standard spirits and are more easily accessible in industrial or household settings.
This pattern of consumption is strongly correlated with poverty, homelessness, and social exclusion. Consumption is often a choice of last resort, used to mitigate the painful and dangerous effects of alcohol withdrawal. The risk of methanol poisoning is also elevated in cases of mass outbreaks where unregulated or counterfeit alcohol has been contaminated with methanol to increase volume at a low cost.
Emergency Medical Treatment
Immediate medical intervention is necessary to prevent death and permanent disabilities like blindness. The primary goal of treatment is to block the body’s ability to convert methanol into toxic formic acid. This is achieved through antidote therapy using an alcohol dehydrogenase (ADH) inhibitor.
Fomepizole is the preferred first-line antidote because it effectively blocks the ADH enzyme. If Fomepizole is unavailable, high-dose intravenous ethanol can be used as a temporary alternative because ethanol competes with methanol for the same enzyme, slowing the formation of formic acid. In conjunction with the antidote, patients require supportive care, including the administration of sodium bicarbonate to counteract the severe metabolic acidosis. For severe poisoning, where methanol levels are very high or acidosis is unresponsive to initial therapy, hemodialysis is required to filter the methanol and formic acid directly from the blood.