Is inhalable alcohol a good idea?

Health and medicine explained.
Sept. 8 2004 7:40 AM

Vaporize Me

Is inhalable alcohol a good idea?

Less filling, and looks stupid, too
Less filling, and looks stupid, too

After years of working in the "leisure oxygen field" marketing oxygen for salons and spas in the U.K., businessman Dominic Simler came up with a novel idea: Why not create a device that would allow users to inhale vaporized alcohol along with oxygen? The machine Simler invented, called Alcohol Without Liquid, or AWOL, which takes hard liquor and disperses it as vapor in an oxygen mist, has been available at a small number of bars in the U.K. for several months; recently, a Greensboro, N.C.-based company called Spirit Partners purchased an exclusive license to sell the machines in the United States. Simler touts his invention, which looks like a slightly futuristic asthma inhaler hooked to an oxygen generator, as a low-cal, low-carb way to enjoy liquor, with no hangover. The AWOL Web site, where machines are available for purchase, also suggests it for "private parties, weddings, and Bar or Bat Mitzvahs." Needless to say, the device has already raised a few eyebrows in public health and law enforcement circles, with several local politicians expressing downright alarm at the possibilities for abuse.

Amanda Schaffer Amanda Schaffer

Amanda Schaffer is a science and medical columnist for Slate.

Is AWOL a potentially dangerous form of alcohol delivery or merely an intriguing novelty item? And given the political outcry, are we likely to see it in bars or lounges anytime soon?

First, it's important to understand the way inhalation affects the body. Normally, when you drink a glass of wine, say, or a shot of vodka, alcohol is absorbed over time, through the lining of your stomach and small intestine (roughly 10 percent to 15 percent in the stomach, 85 percent to 90 percent in the small intestine). The presence of food, especially starchy food, can slow this process further. When a shot of vodka or whiskey is poured into an AWOL machine and inhaled, however, alcohol enters the lungs and diffuses directly into the bloodstream, causing a much more rapid and potentially more intense buzz.

Part of what makes AWOL titillating is that it promises to deliver all the pleasures of alcohol with an irresistible twist—that is, none of the familiar downsides of drinking, such as calories and hangovers. Glowing commentary on the Web site promises, "Absolutely no side effects," and, "If you hate hangovers, you'll love this."

Unfortunately these marketing claims are dubious at best. Most of the calories in liquor come from ethanol, an alcohol that is present in all alcoholic beverages, liquid or vaporized. Ethanol enters the bloodstream following ingestion or inhalation and is broken down by the body, releasing roughly seven calories per gram (compared to nine calories/gram for fats and about four calories/gram for carbohydrates and proteins) in either case. Nor is a shot inhaled through the machine more "low-carb" than a regular one since hard liquor (in contrast to beer and wine) does not contain carbohydrates in the first place.

The issue of hangovers is trickier since there are several reasons they occur, including the presence of other substances called congeners (usually other alcohols, such as methanol, found especially in brandy and whisky); the effects of ethanol itself on the body; and the action of a fairly toxic substance called acetaldehyde, formed when ethanol is broken down in the liver. It is possible that some congeners would be left behind during AWOL's vaporization process and thus not ultimately inhaled. However, the many other factors that contribute to hangovers—dehydration, the disruption of electrolyte balances, and changes in sleep rhythms—are all caused by ethanol itself and would occur whether it was ingested or inhaled. Acetaldehyde, too, would be produced in either case since most ethanol in the blood is broken down by the liver. (Small amounts are also eliminated in urine and sweat and by exhalation.) All of which is to say that AWOL is unlikely to represent a milder, healthier alternative to old-fashioned drinking by ingestion.

In fact, depending on how much one inhales, the very opposite could be true. In particular, intensive inhalation may be more likely to cause alcohol toxicity than binge drinking. This is because vaporized alcohol, as it enters the bloodstream directly from the lungs, is not subject to the protective effects of the digestive system—notably, the impulse to vomit. The machine is apparently calibrated with this danger in mind—using AWOL, it takes 20 minutes to inhale the equivalent of one shot—and the company's promotional materials recommend no more than two sessions, or two shots, in a 24-hour period. Nonetheless, an enthusiast who exceeded this limit or tinkered with the amount delivered by the device itself could no doubt raise her blood alcohol level very dramatically.

Another serious risk is that the rapid rush of alcohol to the brain would make inhalation more addictive than regular drinking. Indeed, as Robert Swift, a professor of psychiatry and human behavior at Brown Medical School, told me, when researchers want to model alcohol addiction in rats—in order to study withdrawal and other phenomena—they often expose them to air mixed with vaporized alcohol. This method is useful because it's hard to get rats to drink liquid alcohol and also because the desired dependence is achieved extremely efficiently, sometimes in a matter of days: "It's a good way to addict animals," Swift said. And it would probably work for humans, too.

Whether for these reasons or for other, more reflexive ones, local New York politicians have been vocal in their opposition to AWOL. When Spirit Partners prepared to introduce the machine on Aug. 20—with a launch party at Trust, a trendy Manhattan lounge—several, including Westchester County Executive Andrew Spano, sounded the alarm. The matter came, inevitably, to the attention of Attorney General Eliot Spitzer, who referred it to the NYS Liquor Authority, whose attorney warned Trust that it ought to think twice about the AWOL launch party. (As a result, the machine was demonstrated using fruit-infused water and Gatorade instead of alcohol.)

The legality of AWOL—at least for venues licensed to serve alcohol in New York state—seems to turn on two relatively obscure provisions of the state's Alcoholic Beverage Control law—a law enacted in 1934, shortly after the repeal of Prohibition (in 1933). According to Thomas McKeon, counsel to the State Liquor Authority, this law prohibits 1) separating alcohol from the rest of a mixture and 2) dispensing it from a container other than the one it came in. These are both provisions that AWOL appears to violate. (For hyperspecific formulations, check out Sections 153 and 106, respectively, of the ABC law.) While McKeon said that disciplinary action would be considered against any bars that offered AWOL to customers, his office could not stop individuals from buying the machine and using it at home. (At roughly $3,000 a unit, AWOL may not sell very well, but at the moment individuals are still free to purchase it.)

At this time, it is unclear what other states will have to say, if anything, about the device since liquor laws vary from state to state. (Spirit Partners plans to sell franchises in all 50 states.) It is also unclear whether the federal Alcohol and Tobacco Tax and Trade Bureau would eventually become involved in regulation efforts, should sales from the Web site be significant. A new bill, however, introduced by state Sen. Patricia McGee and others, would ban the "sale, purchase or use of alcohol vaporizing devices" entirely in New York state; McGee argues that AWOL and similar devices "could potentially give rise to increases in alcohol abuse, underage drinking and drunk driving." It is not difficult to imagine lawmakers in other states proposing similar measures.

In other words, AWOL will probably not turn up at trendy lounges any time soon. Ultimately, though, the biggest issue may not be the device itself but the concept of inhaling alcohol in general—an idea that has been publicized by Spirit Partners' media campaign and, unwittingly, by the various agitated responses to it. As Swift told me, if people realize that this is "a good way to get high," they won't need an expensive, commercially made machine. They can make something at home for $5 or $10. The crowd we should probably worry about most, then, is the one that isn't legally allowed to drink alcohol in the first place.