OK, in light of this CDC report, here's a quick #ToxicologyThursday about drinking hand sanitizer. https://twitter.com/newschambers/status/1291109343115522048

People have been drinking hand sanitizer for as long as it's been around, this isn't a new phenomenon because someone suggested we inject bleach. There are a lot of reasons people choose to do this, and it's not always to get drunk.

People that are dependant on alcohol probably top the list of hand sanitizer drinkers. It could be as a source of alcohol (i.e. they ran out of beer or liquor) or to stave off alcohol withdrawal seizures. People DIE from this. That's why I was OK with liquor stores staying open.

We also find people that drink it because this is all they have access to. People incarcerated in prison or committed to a hospital are often around industrial-sized containers of the stuff. They want alcohol, and this is what's available.

So what's the danger of drinking hand sanitizer? Well, you really don't know what you're going to get. It's kinda like a box of chocolates. Here are two examples on my desk.

We've got Germ-X. It says it is 63% ethyl alcohol (ethanol) . That's "drinking alcohol" that we find in beer, wine, and liquor. For comparison, most vodkas, gins, whiskey, etc is 40% ethanol.

Next up we've got "Black Cherry Merlot." It tastes like crap, and nothing like merlot. Or black cherry. But it has blue sparkles! It is 68% alcohol. Which alcohol? I have no idea. It could be ethanol. Or methanol. Or isopropanol.

This is a bad label. If it were ethanol, you'd probably be OK drinking a small amount...pissed that it doesn't taste like merlot, but alive.

What if it were methanol, the one that the CDC has warned us about recently? That would be bad.

Methanol is commonly called "wood alcohol" and made from fermented wood, as opposed to ethanol from fermented sugars. You can "get drunk" off methanol - it has central nervous system depressant effects just like ethanol. But with a difference.

Methanol uses the same enzymes that is used to metabolize ethanol, but the end products are different. See the format acid on the right? That will make you blind. It permanently destroys your optic nerve.

So, yes, you can get drunk off methanol, but at the price of blindness. And it doesn't take much, either. An ounce of methanol can cause blindness and send you to the ED. Several ounces will kill you.

So let's say you get to the hospital, what do they do?

Well, one drug used is fomepizole. It inhibits alcohol dehydrogenase - that 1st step in the sequence a few tweets ago. That stuff is expensive and your ED may not even have it? Oh no! What then?

No fomepizole? No problem! They'll just give yo ethanol. The good stuff. It competes with methanol for alcohol dehydrogenase, so your body is metabolizing more ethanol than methanol, decreasing the production of formic acid. Pretty cool, huh?

In one of Michael Crichton's (the Jurassic Park guy) autobiographical works (Five Patients or Travels, I forget). He tells the story of a frequent flyer that would come to his hospital drunk off methanol, knowing that the cure was an IV drip of ethanol.

So the take-home message is: people have been drinking hand sanitizer since forever, for a variety of reasons, and it's important to know what's in the hand sanitizer - ethanol vs methanol. You shouldn't drink any type of hand sanitizer, though, they all taste bad.