Understanding the Crisis of Spurious Liquor in Kallakurichi

The Kallakurichi Incident

In June 2024, a devastating event unfolded in Kallakurichi district, Tamil Nadu, where at least 38 individuals tragically lost their lives after consuming spurious liquor. The incident also resulted in 82 others being hospitalized, highlighting a severe public health crisis. This tragedy mirrors a similar incident from the previous year in Chengalpattu and Villupuram districts, where over 20 people perished due to methanol-laced alcohol.

What is Spurious Liquor?

Spurious liquor refers to illicitly produced alcoholic beverages, often tainted with methanol to amplify their intoxicating effects and volume. Methanol, a toxic form of alcohol, poses significant health risks. When ingested, it is metabolized by the liver into formaldehyde and subsequently into formic acid, leading to severe poisoning.

The Dangers of Methanol

The ingestion of methanol can result in various health complications, including:

• Metabolic acidosis
• Optic neuropathy, which can lead to blindness
• Cerebral edema
• Hemorrhage
• Potentially fatal outcomes

How Methanol Affects the Body

Methanol is added to illicit liquor primarily to enhance its potency and increase the volume of the drink. Upon consumption, methanol undergoes a metabolic process in the liver, where it is converted by alcohol dehydrogenase (ADH) enzymes into formaldehyde. Aldehyde dehydrogenase (ALDH) enzymes then convert formaldehyde into formic acid. The buildup of formic acid can result in metabolic acidosis, damaging various organs such as the optic nerve, kidneys, heart, and brain. If untreated, methanol poisoning can lead to irreversible blindness or even death.

Treatment for Methanol Poisoning

Fortunately, there are several treatment methods available for methanol poisoning:

• Ethanol Administration: Pharmaceutical-grade ethanol competes with methanol for ADH enzymes, thereby slowing down the metabolism of methanol and reducing formaldehyde production.
• Fomepizole Administration: This antidote inhibits ADH enzymes, further decreasing the conversion of methanol to formaldehyde, facilitating safer excretion of methanol from the body.
• Dialysis: This procedure removes methanol and formic acid salts from the bloodstream, thereby minimizing organ damage.
• Folinic Acid: This treatment promotes the breakdown of formic acid into harmless carbon dioxide and water.

Both fomepizole and folinic acid are recognized as essential medicines by the World Health Organization (WHO). However, their effectiveness can be limited by availability and the need for specialized medical supervision.

The Ongoing Challenge

Despite the availability of treatments, methanol poisoning remains a pressing issue. Factors such as inadequate regulation, economic pressures that drive individuals towards cheaper illicit options, and a general lack of awareness regarding the dangers of spurious liquor contribute to this ongoing problem. It is crucial for the Tamil Nadu government to implement stricter regulations, enhance public awareness, and provide accessible legal alcohol to mitigate the risks associated with methanol poisoning.