Methanol poisoning explained: how to drink safely while holidaying overseas

The tragic deaths of two Victorian teenagers while holidaying in Laos in 2024 has led to more discussion about methanol poisoning and its effects on travellers.

Methanol poisoning is not new, but it is important to understand the risks so you can make smart decisions while drinking alcohol overseas.

Medecins Sans Frontieres (Doctors Without Borders) says there were 64 incidents worldwide over the past 12 months, affecting more than 1400 people and resulting in more than 500 deaths.

The two Aussie teens who tragically lost their lives, Bianca Jones and Holly Bowles, were among 12 suspected cases of methanol poisoning and six deaths in the one incident last November.

MSF says, if not treated, fatality rates are reported to be 20 to 40 per cent, however this is believed to be an underestimation of the situation.

Asia has the highest prevalence of methanol poisoning worldwide, with outbreaks commonly occurring in Indonesia, India, Cambodia, Vietnam and the Philippines.

Professor of chemistry at RMIT University, Dr Oliver Jones, says methanol is a type of alcohol similar in structure to ethanol - the compound in alcoholic drinks that gets people intoxicated - but far more toxic.

"Methanol poisoning occurs when people drink something with methanol in it instead of, or sometimes as well as, ethanol. Usually, this is unintentional and comes from drinking contaminated products," Dr Jones says.

"Methanol can be an unintended byproduct of the brewing process, but as it is much cheaper than ethanol, it is sometimes purposely and illegally added to drinks to save money."

Jones says the risk is higher in countries where alcohol is less strictly regulated than in Australia, and the best way to reduce your risk is to be suspicious.

"If something seems too good to be true, chances are that it is," Dr Jones says.

"Be careful drinking cocktails and drinks made with spirits. Ideally, drink only at reputable licensed premises, stay away from brands you don't know or recognise, avoid homemade alcoholic drinks, and don't be tempted by unusually cheap drinks which could be counterfeit."

Monash University Department of Forensic Medicine's Dr David Ranson, who is also an associate at the Victorian Institute of Forensic Medicine, calls it a "really significant" public health issue.

He says methanol is converted to toxins, including formaldehyde and formic acid, when metabolised, leading to poisoning. His advice is to drink in reputable places, buy recognised brands, and never buy bootleg alcohol from a backstreet seller.

It can be "really tricky" to work out if you have methanol poisoning, as you can't detect it in your drink, and it only takes "a mouthful" of pure methanol to cause death, he says. Symptoms can take 12-24 hours to develop, sometimes longer, and can overlap with the symptoms of hangovers.

"If you have an unexplained hangover that you just can't rationally think might be linked to your drinking pattern, then obviously that should be some sort of alert or warning," Dr Ranson says.

Visual disturbances, loss of vision or strange, fuzzy vision, seizures, chest pain, abdominal pain and rapid breathing are some of the possible symptoms. But if you're suspecting "anything at all" you should go "straight away to a major medical centre", Dr Ranson says.

Smartraveller says contaminated drinks could include local home-brewed spirits, spirit-based drinks such as cocktails, and unusually cheap or discounted brand-name alcohol.

They suggest drinking sealed pre-mixed drinks. Check smartraveller.gov.au and methanolpoisoning.msf.org for methanol poisoning incidents at your destination before you travel.