Date: Mon, 23 Mar 1998

Source: JAMA, The Journal of the American Medical Association, Nov 19, 1997 v278 n19 p1553(1). Title: Concealed alcohol in drugs. (JAMA 100 Years Ago) Author: T.D. Crothers Subjects: Drugs - Composition Alcohol - Usage Magazine Collection: 91H4010 Electronic Collection: A20062194 RN: A20062194

The fact is well known that nearly all proprietary drugs contain large quantities of spirits, particularly the bitters and tonics that are advertised so widely. Several authorities have made extensive examinations of drugs advertised as temperance drinks and free from alcohol, and in every instance have found spirits from 3 to 50 per cent. of volume, literally ranging all the way from the lighter beers up to the alcoholic drinks in common use. Dr. Bradner has published tables of these drugs compiled from the reports of the Massachusetts Health Board and the examination of State chemists in different parts of the country. His paper appeared in the Journal of Inebriety for January, 1890, and the second paper on this subject will be found in the July issue of that journal. These papers bring out the fact, not well known, that nearly all the more prominent proprietary drugs on the market contain large quantities of alcohol.

How far these drugs depend on alcohol to increase their attractiveness and sales is not known, but it is evident that many of the widely used drugs would have no demand if it were not for the alcohol which forms the bases of the combination.

The Medical Press and Circular and the Lancet have called attention to the great danger from the so-called temperance drinks advertised as antidotes for inebriety. An examination of many revealed cocain, opium and alcohol in nearly all of them. Several instances are given of persons who used large quantities of these drugs under the impression that they were cured of the alcoholic crave and were building up against it in the future. In reality they were worse and more incurable than they would have been, using spirits alone....

In this country the substitution of ginger compounds for alcoholic drinks are common and always end disastrously, leaving the victim worse and more incurable. Coca wine preparations are also dangerous, and although I have used them in the first period of withdrawal of alcohol for the treatment of inebriety, it was evident that in many cases they would completely take the place of alcohol and require as much difficulty to remove as the spirits....

There is some doubt expressed by many authorities as to the potency of a drug which is covered up in a strong tincture. It is clear that the value of a drug is not enhanced, and it is certain that a new force producing or exploding agency has been added to the body.

In experience, any drug which contains alcohol can not be given to persons who have previously used it without rousing up the old desire for drink, or at least producing a degree of irritation and excitement that clearly comes from this source. It is also the experience of persons who are very susceptible to alcohol, that any strong tincture is followed by headache and other symptoms that refer to disturbed nerve centers.

In many studies I have been surprised at the increased action of drugs when given in other forms than the tincture. Gum and powdered opium have far more pronounced narcotic action than the tincture. Yet the tincture is followed by a more rapid narcotism, but of shorter duration and attended with more nerve disturbance at the onset.

I am convinced that a more exact knowledge of the physiologic action of alcohol on the organism will show that its use in drugs as tinctures are dangerous and will be abandoned.

There are many reasons for believing that its use in proprietary drugs will be punished in the future under what is called the poisoned act. It is certainly clear that we are now at the beginning of the study of alcohol and our knowledge of its effects.

JAMA. 1897;29:1000-1001 -- End --