Testimony on Powdered Alcohol by Corey Fearheiley, MD
House Committee on Licensing and Administrative Procedures
Aug. 23, 2016
Chairman Smith and members of the committee, the Texas Medical Association and the Texas College of Emergency Physicians, representing more than 49,000 physicians and medical students, appreciates the opportunity to testify today on this committee’s interim charge to study powdered alcohol. I am Corey Fearheiley, MD. I am currently the Medical Director for Seton Medical Center Williamson, in Round Rock. As a practitioner for Emergency Service Partners, I have worked in numerous central Texas sites with the Seton Medical hospital system since I came to Texas in 2007. On behalf of our membership I would like to express our support for your work examining policy and the potential impact powdered alcohol may have on alcohol use in Texas.
Though powdered alcohol is not yet on any liquor store shelves in the United States, this product has attracted much attention among public health officials and physicians. The U.S. Alcohol and Tobacco Tax and Trade Bureau (TTB) in 2015 approved product labeling for several variations of a product under the brand name Palcohol. According to the U.S. Food and Drug Administration (FDA), TTB, which has the authority to review the formulation and labeling of distilled spirits products, consulted with the agency to review the nonalcohol ingredients. FDA concluded that the use of ingredients complies with federal regulations. Powdered alcohol is encapsulated into powder using a sugar derivative base, which can absorb alcohol but will remain a powdery base.
The creation of powdered alcohol dates back to the 1800s, when product development was aimed mainly at the food industry as a food additive. Though the product was never sold, starting in the 1970s, industry research expanded to powdered alcohol’s use as a base for alcoholic beverages. At that time, several states passed laws regulating the sale of powdered alcohol.
Physicians join others throughout the country in sharing our concern about the potential sale of powdered alcohol products, but our focus is on the risk for abuse or binge use among adolescents. While there has been a decrease in alcohol use by Texas teens in the past 10 years, alcohol continues to be the leading substance abused among Texas high school students. Texas still leads all other states in the number of alcohol-impaired fatalities and in alcohol-impaired driving (2014 Traffic Safety Fact Sheet, NHTSA). Almost 9 percent of the 639 Texas drivers who died in an automobile collision were under the age of 21 and under the influence of alcohol (DUI Drivers in Fatal Crashes by Driver Age, TDOT, 2015). From 2006 to 2010, excessive alcohol use caused an average of 372 deaths in Texas for people under age 21 (Alcohol and Public Health: Alcohol-Related Disease Impact, CDC). According to the most recent national Youth Risk Behavior Surveillance study (of those who had driven a car in the 30 days before the survey), almost a third of our children had drunk alcohol. A high school student who drinks alcohol, texts while driving, or uses marijuana contributes to the leading causes of death for those aged 10-24 years. And a young person drinking alcohol also is more likely to become involved in harmful behavior such as smoking, driving while intoxicated, or high-risk sexual activity.
The promotion of alcohol products can be particularly effective among youth. National surveillance studies (e.g., Alcohol Advertising Compliance and Cable Television, John Hopkins Bloomberg School of Public Health, 2015) have shown that the more young people are exposed to marketing on alcohol, the more likely they are to begin using alcohol or increase their alcohol use.
And while industry officials may highlight the convenience and portability of the product and yet remind us of the prohibition of sales to minors, a national survey on substance use found that 40 percent of Texas high school students had used alcohol at least once in the previous 30 days and at least one- third of them obtained the alcohol from someone who gave it to them, or they rode with a driver who had been drinking (Office of Adolescent Health, Texas Substance Abuse Data, DHHS, 2011).
As physicians, we know that teens and adolescents often are more willing than adults to take risks and experiment. They may be more willing to add powdered alcohol to other alcoholic beverages, thereby increasing the concentration. Powdered alcohol would be easy to conceal from parents or law enforcement. In other words, powdered alcohol seems to have the characteristics of a product young people would embrace.
The potential for powdered alcohol products to cause harm raises numerous concerns. This is especially troubling as physicians recognize the need to continue addressing underage alcohol use throughout Texas.
Physicians and public health often follow a principle of precaution when guiding decisions about products or environmental changes that may harm our patients. We must continue to monitor powdered alcohol, keeping in mind that alcohol use by children is a current contributor to death and disability in our state and much more so than in other states.
Drug and alcohol use trends can emerge quickly and can vary among communities. Physicians do play an important role in informing our young patients about the risks associated with substance use, including alcohol. But because we don’t yet know the impact of the availability of powdered alcohol products, we must monitor any eventual sale, marketing, or use of powdered alcohol and recommend actions to limit access to it and potential harmful outcomes.
States alone have the responsibility to adopt policies to prevent underage alcohol use. Powdered alcohol presents another option for increasing underage alcohol use. This is an opportunity to assess the appropriate levels of protection and regulation to prevent underage drinking. We will join you and the industry in achieving the safest outcome for Texas.
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