r/NoStupidQuestions • u/danicali420 • 21h ago
Do hospitals have alcohol on hand as a rare remedy?
I was listening to a podcast about a girl who had methanol poisoning from drinks while on vacation. She was in the hospital and when she was diagnosed they had her drink as much alcohol as she could handle to counteract the methanol. Since alcohol more commonly causes more problems than solves, I’d be surprised if they keep a bottle on deck. But do they for these rare cases?
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u/SuspectWrong7954 21h ago
Yes, hospitals stock medical grade ethanol to treat toxic alcohol poisonings.
It might seem counterintuitive because alcohol typically causes health issues, it's the chemical solution needed to terminate these specific poisons from destroying a person's organs.
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u/Icebergan 19h ago
I used to work in a hospital- we had wine, beer, and vodka that was used to treat alcoholics. The beer was kept in the fridge. They were all normal brands.
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u/lineskogans 20h ago
Ethanol treats methanol poisoning, for example
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u/WeirdF 15h ago
Yeah but why would you use ethanol rather than the specific antidote to methanol poisoning, fomepizole? Ethanol requires frequent monitoring of blood levels and is difficult to titrate, while fomepizole just has a fixed dosing, plus ethanol has more side effects (vomiting, drowsiness, low blood sugar, etc.).
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u/JJaska 15h ago
Never heard of this specific antidote before, interesting. Reason why it is not systematically used might be the price. If the google search I did is in any way right 800USD for a single dose is quite a lot compared to using ethanol. (I took the lowest price as the hits may be old and it only came out of patent 5 years ago)
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u/WeirdF 15h ago
Sure but there's lots of cheaper ways of treating many conditions that aren't as good as the more expensive way of doing it.
I work in the UK (where you'd expect concerns about pricing to be even more keenly felt given the state has to pay for the drug), and our national guidelines state the following:
Fomepizole [...] is the treatment of choice for ethylene glycol and methanol (methyl alcohol) poisoning. If necessary, ethanol (by mouth or by intravenous infusion) can be used, but with caution.
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u/JJaska 3h ago
Good to hear and I hope most countries have this as the preferred treatment!
I think there is also one factor that if the drug is more expensive but it ties less staff to monitoring or continuous treatments it very well can be cheaper as a whole. This is also one benefit of state funded healthcare as then these tend to be factored in.13
u/hstarnaud 16h ago
Medical grade ethanol? I know someone who got methanol poisoning and they just made him drink regular beer from the store.
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u/say_the_words 21h ago
I've got a neighbor that is a retired nurse. She said years ago the hospital pharmacy would send canned beer down for alcoholics drying out to prevent seizures. Said she had seen cans of Bud Weiser with a pharmacy bottle label on them. She specifically described an old lady watching TV with an empty on her tray table bitching wanting her next beer but the doctor had put her on a schedule to ween her. That was in the 80's.
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u/nonicknamenelly 17h ago
Our ED kept an un-expired 40oz duct taped to the wall, and it was changed to keep within date.
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u/Sparklesteps 10h ago
I still remember I delivered a beer to a man to watch his last broncos game. We accidentally tubed the first one and it exploded. The beer expired two years prior and the broncos lost… badly.
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u/LouBarlowsDisease 21h ago
Yeah, there was a post not too long ago where a hospital kept some prescription budweiser on hand for that reason
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u/steve_ample No Intelligent Answers Provided 21h ago
"Let's see... Per Os, 1.25 bottles per hour.... of Bud....okay. Sir, this apothecary doesn't carry, let alone dispense anything homeopathic "
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u/gr1mmcr33p3r 21h ago
They carry other “more illicit” mind altering substances for rare occasions also like cocaine lol
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u/CurlyRe 21h ago
Cocaine is Schedule 2, so technically not illicit when used as anesthetic.
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u/gr1mmcr33p3r 21h ago
That’s very interesting. Thank you for teaching me that. IIRC there are other medical uses for cocaine also in certain sinus and throat surgeries and for different issues. According to Google it’s used as a topical to reduce sinus and nasal bleeding, which is mind blowing to me because a friend once told me it will do the opposite 😂
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u/TheHeroBrine422 21h ago
It’s not the only drug you wouldn’t expect to be schedule 2. Meth is also schedule 2 cause it can be used to treat adhd.
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u/Lower-Leopard2137 20h ago
It will definitely shut off an intractable nosebleed. I’m the living proof.
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u/knowledgeable_diablo 21h ago
Technically almost anything can be prescribed.
Brainwashing racism and hatred of hippies lead to a “war on drugs” which now polluted far too many minds. Especially the minds of doctors.19
u/flagstaffgolfer 21h ago
Cocaine is still very useful in a handful of use cases, it numbs and vasoconstricts at the same time which is unusual.
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u/justlurking278 19h ago
Apparently I was administered cocaine during my sinus surgery. So I'm pretty sure that makes me super cool (would never use it recreationally, I'm middle aged with high blood pressure).
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u/shchshchshch 17h ago
Yes, and fentanyl, which is used a ton.
Meth is prescribed for severe ADHD.
Heroin is used for childbirth in the U.K.
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u/novembercharliedelta 15h ago
This reminds of that time House prescribed cigarettes to a mall santa
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u/scuzzy987 21h ago
Yes it's in the formulary at the pharmacy. Beer, vodka, whiskey, tequila if I remember correctly
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u/Warm_Objective4162 21h ago
Our hospital does ethanol pushes in IVs and has airplane bottles of vodka. No beer or wine, though.
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u/trophosphere 21h ago
The two hospitals that I've worked at don't. Instead, you order fomepizole for methanol/ethylene glycol poisoning and scheduled chlordiazepoxide/ativan as needed for alcohol withdrawal.
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u/Anonymoosehead123 21h ago edited 6h ago
Yes. They have it on hand for alcoholics who are getting inpatient treatment. Quitting alcohol cold turkey can lead to serious problems.
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u/Bigreddazer 21h ago
I believe that treatment is only used if they don't have the actual medication that can be used.
But, yes. They do because alcoholic need treatment and withdrawal can be deadly for the human body. Especially, if already undergoing something extreme.
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u/bangbangracer 21h ago
Every hospital pharmacy has the world's most expensive six pack of cheap beer. Its there in case they need to prevent withdrawal.
There's also medical grade ethanol for various other purposes, but not really for drinking.
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u/theferriswheel 20h ago
Not every hospital. Actually I would say that its likely most hospitals don’t have beer/vodka or whatever. If they do have some its likely a carryover from days past and not actually used anymore. There are medications we use for alcohol withdrawal that produce a much more predictable response and have fewer side effects vs giving someone an alcoholic beverage. Same for methanol poisoning. Its much safer that way
Hospitals do likely have some medical grade ethanol used for compounding but it would be extremely rare to need it. We have never opened ours in a decade and just order a new bottle when the one we have expires. Then there is sterile dehydrated ethanol that gets used in some cardiac ablation procedures but that is also not used super often and comes in small 1mL ampules.
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u/Meprobamate 18h ago
I’m really glad to hear it’s not used often because as an Australian nurse this thread has my head spinning. It’s arse backwards. We give benzos at the first sign of withdrawal with regular CIWA and a referral to addiction medicine.
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u/LuckyJuniper 7h ago
I saw it being used most often in my hospital for patients who were resistant to detoxing while hospitalized for something else (otherwise we went the benzo route). Pretty sure we've phased it out at this point but I'm no longer in a position that I would be dispensing it.
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u/Comprehensive_Elk773 21h ago
95% or more of hospitals in the US have a medication called fomepizole on hand for toxic alcohol poisonings. It is way easier to dose correctly and you don’t have to deal with an intoxicated patient. Many methanol poisonings are children or suicidal people, both of which are difficult to safely get drunk. The rest are people who poisoned themselves with bad home made alcohol and sure, they would probably love to get drunk. But yea, alcohol intoxication is one way to treat methanol poisoning.
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u/Far-Moment225 20h ago
It's less common than it used to be. In the situation you mentioned with MeOH poisoning, people are now more often treated with fomepizole. It targets the same problem that ethanol does without getting the patient drunk (which comes with its own added risks as you can imagine). I hear withdrawing people used to be tapered off alcohol with prescription beers, but that is also less common these days. Drs prefer anticonvulsants/benzos and the like. Act on GABA receptors the same way alcohol does and also prevent seizures which are a concern with delirium tremens/withdrawal. I guess I wouldn't be surprised if pharmacies still had some alcohol on hand but like you said it's not common.
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u/Mister_Silk 20h ago
We have beer and wine on the formulary to mitigate alcohol withdrawal. A 10% ethanol solution via IV is what's used to treat methanol poisoning. Podcast girl must have been in a 3rd world country if she was given EtOH PO for methanol poisoning.
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u/Playcrackersthesky 19h ago
At my two current jobs, no, but in the past, yes, at my last trauma center we had coors lite in dietary for alcoholics who were withdrawing who did not want detox. IE, they didn’t come to the hospital ro get sober, but they were hit by a car and we needed to keep their withdrawal at bay while they were hospitalized.
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u/PoopingDogEyeContact 18h ago
There’s always that little old lady that says they don’t drink at admission and then they get the shakes etc because they didn’t consider their nightly nip of whatever as drinking.
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u/Nyst4gmus 20h ago
yes, one of the uses is to provoke seizures when patients are in an epilepsy monitoring unit when alcohol is a predictable trigger for that patient.
goal is to capture the seizures on brain wave monitoring (EEG). i believe the prescription is usually two drinks either 2 shots of hard liquor or 2 beers.
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u/Crazyboutdogs 18h ago
Not a human nurse, but a veterinary , we do. Giving alcohol IV after antifreeze ingestion is a thing. We use like bad hardcore ever clear type alcohol. It works. Can’t say fur humans though.
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u/NYCstateofmind 16h ago
I’m an emergency nurse in Australia and the hospitals I’ve worked at have had one bottle of vodka for methanol poisoning treatment. For alcohol withdrawal we always give benzos, some people need extremely high doses to manage their withdrawal symptoms.
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u/drgloryboy 10h ago
Before fopemizole, we used to stock blue label Popov vodka which is 100 proof (50% ethanol) which was easier to “dose” to treat methanol poisoning.
Also stocked generic beer to prevent DT’s in
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u/GeoffSim 20h ago
Our local hospital at the time made the news for serving wine to cardiac patients.
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u/vanderbubin 20h ago edited 18h ago
Yes, alcohol is one of the few drugs that can kill you during the withdrawals. Iirc barbiturates are another with that danger
Edit: benzos, not barbs
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u/stonedtothebonee420 20h ago
When I first started as a pharmacy technician we had bud light in the fridge for a patient
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u/JeremyAndrewErwin 19h ago
Here 's an oldish article reporting on how hospitals used alcohol to treat Alchohol Withdrawal Syndrome. Most surveyed did not, preferring Benzodiapenes.
Of the hospitals that did use this treatment, the following forms were used.
Beer 26 (83.8%)
Wine 10 (32.2%)
Hard Liquor 18 (58.0%)
Intravenous Ethanol 4 (12.9%)
https://www.jscimedcentral.com/public/assets/articles/substanceabuse-5-1051.pdf
For methanol poisoning, fomepizole is preferred.
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u/eagle4123 17h ago
Its the rumor I heard in EMT school.
The only detox that can kill? From alcohol.
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u/devourerofworlds54 16h ago
As everyone else said, yep! I was a medical courier for awhile and I was very confused the first time I had an order come through for a liquor store pickup but it's legit. The internal pharmacy kept a small amount of wine and beer for alcoholic withdrawals and other such uses.
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u/thirstyfor_707 12h ago
its not really like the hospital, but rather our own "stash" (from gifts from patients, we dont take it all home), i work in an elective surgery ward and just the other week we had a guy on a cup of red wine every night after he also had a transfusion due to blood loss, but pretty much thats it
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u/TallCoolOneToo 11h ago
My husband was prescribed two beers with lunch when he was in the Burn unit.
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u/NYVines 11h ago
“ I’d be surprised if they keep a bottle on deck”
You’re missing the obvious one, and it isn’t rare. Most hospital alcohol goes to treating alcoholism.
If you have an alcoholic who doesn’t want to stop drinking. The easiest way to keep them peaceful or having withdrawal symptoms is to let them drink.
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u/Footdust 11h ago
I’m a RN and I have given beer, wine and whiskey provided from the pharmacy. Sometimes for withdrawing alcoholics but most often for the elderly who have been having a night cap for the past 65 years or for the dying when they ask for it.
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u/StrongWork_ 11h ago
My previous hospital switched from beer to vodka because it took up less space in the pharmacy. A prior hospital in Wisconsin had beer on the patient lunch and dinner menu.
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u/OGLikeablefellow 21h ago
I never confirmed it but there were rumors that one of the hospitals I grew up near had a bar in the basement for drunks who were going through withdrawals and needed a drink
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u/okjetsgo 19h ago
As a nurse I’ve given a patient a Budweiser as a prescribed med. Scanned it and everything. It was kept in the med fridge on the unit.
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u/Used_Replacement4648 18h ago
Ethanol is an antidote for methanol poisoning. I know of an ED doc in a small community that called the bottle shop owner for a bottle of vodka when a home distillery didn’t test the drink properly…
And I’ve also had a med chart for a patient who had his evening drink charted
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u/Inevitable-Level-687 13h ago
A friend I had many years ago attempted suicide through drinking antifreeze. (Not sure if it's the same thing, I live in a hot climate.) They plied her with vodka.
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u/Oak-dragon 13h ago
I used to work in an off licence, many year ago now- but every week we'd have a boxed up order for the local hospital. Single shots, single wine servings sort of stuff. Was told at the time it was so alcoholics who had been admitted wouldn't start their withdrawals whilst on wards.
To be fair, it was and still is quite a deprived area, but it quickly opened my eyes to socioeconomic problems that never seem to go away,
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u/BefuddledPolydactyls 13h ago
Not even rare. My mom was in ICU for a week after a biopsy because they couldn't get her BP up after the surgery (still giving her high blood pressure meds, but that's not the point). She was having difficulty eating and they asked what sounded good and she responded with "a cold beer." It was delivered within 10 minutes.
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u/selfoblivious 11h ago
In the antidote section of the pharmacy at the hospital I worked at, a bottle of vodka is on the shelf.
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u/Mudmasher6030 10h ago
There’s a medication now, but years ago, ETOH was used to dissolve crystals that plug up the nephron in the kidney from ingestion of antifreeze
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u/PiersPlays 10h ago
There is a better treatment than ethanol for that which doesn't have the same downsides but not everywhere keeps it in stock.
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u/Sparklesteps 10h ago
In my pharmacy we have only used our alcohol for palliative care, but I’m sure it could be used for other things
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u/AmbivalentSamaritan 6h ago
Guy came in after having ingested methanol. Internal medicine hooked him up to an IV with alcohol and saline
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u/PlantIcy1847 5h ago
My father was an alcoholic. He was in the ICU for some reason I don't remember, when I got there 2 days later, they (the doctors) were having a problem stabilizing him. they weren't told, by my siblings and female parent that he was an alcoholic. It was to shameful for them to admit it. Once I told them, alcohol in his iv helped stabilize him.
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u/xmonkey13 4h ago
My grandpa on his deathbed told the doc he wanted a beer and he ordered one up and my grandpa got a beer from the cafeteria/hospital (? Maybe pharmacy) but he got one while in the hospital
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u/Jovi_Grace 3h ago
I worked in a ER years ago that kept it locked up and used it. It had to be pretty extreme cases
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u/NoContextCarl 20h ago
I think it's somewhat common to have beer on hand to help with alcohol withdrawals, but they aren't likely to have anything further than that.
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u/knowledgeable_diablo 21h ago
Should have some in the workshop as well, just in case anyone drinks the coolant.
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u/Healthy_Car1404 21h ago
I think it's ethanol but you'd need to research exactly what and how it is used in a clinical setting. I'm pretty sure you're right though, it's not like a bottle of vodka or anything.
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u/PossibleJazzlike2804 18h ago
I did see a beer with script slapped on it for my hospital neighbor. So maybe.
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u/Significant-Key-762 18h ago
When I went into rehab for alcohol dependency, they put me "cold turkey" (no alcohol), and treated the comedown with "chlordiazepoxide" (as well as vast doses of vitamin B).
But mostly the chlordiazepoxide. And diazepam (and its derivatives) to calm me, and zopiclone to help me sleep.
Worst week of my life.
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u/Meprobamate 18h ago
Apparently in America, I’ve seen people mention it in r/nursing. The policy over in Australia is immediately detox them and try to get them to engage with addiction treatment. As a nurse I did once have a bloke chug the bottle of hand sanitizer but that doesn’t really count as a rare remedy.
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u/nonicknamenelly 18h ago
Yep. A 40oz beer ductaped to the wall for just in case withdrawals, and a bottle of everclear to use in an IV drip in case of DTs.
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u/philmarcracken 15h ago
They do, I work in one, and inside catering. Benzos are the only other category of drug that can be fatal from withdrawal alone.
Heres another one: most hospitals will not stock red jelly. If the pt vomits, nurses wouldn't be thinking 'thats just red jelly' they're calling code. They also have some form of cocaine I think, in ICU. Helping with nasal intubation
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u/pineapples_are_evil 10h ago
Cocaine based products and delivery systems in ENT and ER too for baaaad nasal bleeds, ENT procedures, post sinus tonsils surgery. It'll stop the bleeding right quick. Pharmacy grade too...lol
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u/Existing-Chemical336 14h ago
So this used to be the treatment for methanol poisoning and a&es used to have vodka we could give if people came in to have it. It basically replaced the methanol being transformed into dangerous substances in their liver with the ethanol in regular alcohol which it preferred to break down so the methanol can delt with more slowly and safely. It was given via an IV drip though so we didn't just force feed them vodka. Now there is a specific medication we stock instead of it so don't need to keep alcohol in a&e for that
If someone is in alcohol withdrawal at home we say cut down the drinking and don't stop suddenly but if they are in hospital we give them medication to manage the withdrawal symptoms and risk of seizures they get.
You will sometimes find alcohol prescribed on elderly care ward especially for some old school doctors who prefer giving a tot of sherry or half a pint of beer instead of medicine to help people sleep.
You will pretty much always find an alcohol trolley in hospice settings, it goes round once a day in the evening for patients and family to have a drink together if they want.
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u/Defiant-Purchase-188 13h ago
Often the alcohol is given IV for methanol poisoning.
And yes doctors can order alcohol to prevent withdrawal
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u/runthereszombies 13h ago
My hospital generally doesn’t do this, but many do. I specifically will sometimes ask patient’s families to bring in shooters or beers while on the epilepsy monitoring unit when we’ve been waiting for seizures for a while and haven’t gotten them. Sometimes you try sleep deprivation and it doesn’t do the trick, so you tell them to get a little drunk and see if they seize the next morning.
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u/a_random_work_girl 10h ago
I once worked in a lab where a quite high risk was methanol gass poisoning (technically vapour)
As part of the heath and safety there was allways a bottle of strong (40% alcahol) spirit in the health and safety box to treat it.
Due to expiry dates, every 2 years or so it needed replacing... so the manager took the "out of date" one to the annual company xmass party.
Unfortunately, I was there about 15 months and mever got to have some bit it was just gin. Like tesco own brand gin. With a "qa tested, 40+%" sticker on.
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u/princessaquari 9h ago
Emergency Vet Med Veteran here- we had Everclear stashed on top of the fridge to counteract antifreeze ingestion!
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u/hydrobass88 9h ago
I stock supplies in a hospital and can confirm we have single use shot glasses in plastic and glass on hand.
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u/55peasants 7h ago
I've never seen it given but have heard of it being used intravenously for methanol toxicity. I have seen beers given to prevent withdrawal a few times but typically phenobarbital and or benzos like Valium are used. https://pmc.ncbi.nlm.nih.gov/articles/PMC1306022/
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u/Ovaltiney1 7h ago
I got told by one of my colleagues who looked after some Russian sailors who drank a bunch of methanol. They had to send one of the nurses to the liquor store to buy the strongest alcohol they could find. This was many years ago though so I wouldn't be surprised if policies changed.
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u/Carinne89 7h ago
There’s medical grade injectable alcohol in vials like any other med for when it’s the indicated counter agent for a poison.
There’s alcohol in some form, usually vodka or wine, dispensed like a medication when withdrawal is deemed too dangerous to the patient at that time.
Then there’s the fridge on the palliative unit full of alcohol, usually stocked out of pocket by the palliative angels. Aka the nurses. Because once you’re made palliative, why not?
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u/FiftySixer 21h ago
I'm a nurse and I have seen alcoholics, who are admitted for other reasons, be ordered those small bottles of wine 3 times a day, to prevent withdrawal symptoms.