Snorting the powder may also cause burns, sinus infections, and fungal infection with bacterial overgrowth, said Dr. Glatter.

When used properly, Palcohol should not be any more problematic than liquid alcohol, and Dr. Glatter noted that banning it could create a black market similar to those that have popped up when other substances, like “bath salts,” have been prohibited. He noted that physicians have expressed their concerns about the product.

“I think this is a disaster in the making, especially for kids,” he said. “We really need to have our guard up and really educate children, teens, and schools about this.”

Ms. Tyrrell is a freelance journalist based in Wilmington, Delaware.

Key Points for Emergency Physicians to Know

By Robert Glatter, MD, FACEP

1. Six ounces of liquid are used to reconstitute the alcohol-based powder. It takes about one minute to reconstitute it, so it might be difficult to use powdered alcohol to spike a drink.
2. The biochemistry of Palcohol is based on cyclodextrins, compounds that can absorb up to 60 percent of their own weight in water.
3. It is unlikely that Palcohol could be easily snorted since it would likely cause a chemical burn or irritation to the nares and upper airway. It is also unlikely that snorting would represent a significant route to rapid absorption or a quick high, as many packets would be required. The risk for infection and inflammation developing in the sinuses due to elevated sugar content might also be a potential concern. Snorting of the powder might also trigger bronchospasm, especially in persons with asthma or lung disease, and could result in chronic cough or even aspiration.
4. Co-ingestion of other substances with the powdered alcohol should be a continued concern when evaluating a patient who may have consumed Palcohol. Its novelty as a powder with multiple flavorings could entice teens to mix in other drugs, resulting in additive effects.
5. One packet of Palcohol reconstituted with six ounces of liquid has the equivalent alcohol content of a standard mixed drink.
6. Consumers, and especially teens, have the potential to overdose on Palcohol because they may underestimate the potency of the powder and choose to combine multiple packets to gain a more intense effect.

Dr. Glatter is an attending physician in the department of emergency medicine at Lenox Hill Hospital in New York City and clinical assistant professor at Hofstra North Shore-LIJ School of Medicine in Hempstead, New York.