As of May 5, experts in Nigeria have settled on alcohol poisoning as the cause of 23 reported deaths and 10 additional patients undergoing treatment in Ondo state since April 15. Victims, mostly male teenagers, reported neurologic side effects, including: headache, weight loss, dizziness/fainting, and blurry vision/blindness. Death occurred within 24 hours of symptoms when left untreated. After a hemorrhagic fever, like Ebola, was ruled out, authorities feared the alcohol had been contaminated with a pesticide used in crop management. A health ministry spokesman lent credibility to alcohol tainted with methanol, which is toxic and frequently used to make other chemicals. In the meantime, on April 27, the local Irele government in Ondo state banned the production and consumption of local gin, called ogogoro, as a link is feared.
The deadly situation in Nigeria underscores the need for awareness that consuming alcohol abroad comes with various risks that are not necessarily prevalent in the U.S.
Don’ts for Alcohol
Don’t Drink Homemade or Counterfeit Booze
Across the world, people brew their own alcohol to varying levels of toxicity. In 2014, some 24 people died and dozens more were sickened in Kenya after drinking “kathuvuria,” a bootleg alcohol. Some 31 people died and 160 were hospitalized in Uttar Pradesh, India, after consuming homemade brew tainted likely with methyl alcohol. Bootlegged booze is common in India where vendors cannot afford to buy a liquor license and may add chemicals or methyl alcohol (methanol) to make a cheaper alcohol, and police often solicit bribes to ignore complaints or violations. Local residents burned down the vendor’s stall in reprisal. According to open source reports, “In 2011 almost 170 died in West Bengal, 107 died in Gujarat in July 2009 and 30 died in September 2009 in Uttar Pradesh” due to alcohol poisoning alone.
Counterfeit alcohol, which is sold at a considerably lower cost than legitimate brand name beverages, is equally dangerous since it, like bootlegged booze, is unregulated and may be watered down with toxic items like fuel, chemicals, and antifreeze. In April, four people in Semarang, Indonesia, died from drinking fake imported Red Label and Black Label brands. Similarly, in April 2012, several dozen people in the Czech Republic and Poland died after drinking poisonous counterfeit spirits. In Mozambique, in January 2015, some 72 people died when a homebrewed traditional beer, called Pombe, served at a child’s funeral was maliciously contaminated, allegedly with crocodile bile. A toxicology analysis was being conducted, as experts are unsure if the bile is toxic or if the Pombe was contaminated with another agent, such as pesticides.
Don’t Overdo It
Wine, beer, and liquor may have a higher alcohol content than is customary in the U.S. This could lead to overconfidence in judging the number and volume of drinks.
Excessive alcohol consumption can lead to accidental falls or leave a person more susceptible to criminal advances. In early April, an American college student was found dead under a bridge in Rome’s Trastevere district after a night of ‘pub crawling.’ The circumstances of his death remain under investigation.
Americans, especially college students studying in Europe, notoriously over-imbibe at the Munich, Germany, Oktoberfest annual celebrations. Similarly, European and some African football (soccer) matches are customary locales for excessive alcohol consumption and often sites for violence and hooliganism. American students are similarly notorious for their excesses during Spring Break jaunts in Mexico and the Caribbean. Throughout Latin America, it is not uncommon for police to solicit bribes from drunk and/or underage students to avoid getting arrested.
Don’t Compete with Locals and their Brew
Cultural gastronomic traditions may involve multiple shots of high percent alcohol that a local may have become accustomed to, but a visitor may not. Hungarians have palinka shots, a digestiv fruit brandy that is 86 percent alcohol. Even Australian PM Tony Abbott was celebrated “skolling” (chugging) a schooner (2/3 of a pint) of beer before flipping the empty glass on top of his head at a pub. Finally, in South Korea, it is customary for business partners to drink various types of alcohol in multiple venues at least monthly (often Mondays, Wednesdays, and Thursdays) as a way to get to know the true personalities in a tradition known as hoesik. In these, and other, drinking customs, expatriates may want to keep pace with their hosts, who have likely practiced their national traditions for years. This level of inebriation can lead to cultural misunderstandings, ruined business relations or, worse, an increase in exposure to criminality.
Don’t Fall for the Friendly Stranger Trick
In many cases around the world, travelers (often, but not exclusively, men) succumb to an alcohol-related scam in which a friendly stranger, who is in cahoots with the bar staff, asks the victim to buy rounds of drinks. By the end of the session, the bar tab is excessive, and the victim is physically prevented, and sometimes assaulted, from leaving until the bill, typically in the hundreds of U.S. dollars, is settled. These cases are particularly prevalent in Eastern and Central Europe and often involve elements of organized crime.
Don’t Let your Drink out of your Sight
Just as the previous scam, around the world, drinks/food can be spiked with a knock-out agent, often called a date rape drug, like scopolamine. The date rape drug is commonly used to assist in sexual assaults. It works fast and causes you to become weak and confused. The most popular date rape drugs are Rohypnol (roofies), gamma hydroxybutyric acid – GHB (liquid ecstasy), and ketamine (special K). All of these chemicals can come in a pill, powder, or liquid form. In December 2014, a South African man and Somali woman were arrested in Johannesburg with 12,600 Roofie pills concealed in a truck. Similarly, in July and August 2014, five employees of a U.S. firm were victimized by drink spiking in a St. Petersburg, Russia, clubs and were subsequently robbed.
Don’t EVER Drink and Drive
In most countries, citizens and police have little to no tolerance for drunk drivers, and the consequences for being found drinking and driving are quite severe in most cases. For example, if caught drunk driving in China, the penalty is life in prison if you hurt someone, and in most European countries the punishment usually consists of a steep fine and possible jail time. It is worth knowing what the legal blood alcohol level (BAC) is, and the estimated number of drinks allowed, before you get behind the wheel.
Countries of Note
Alcohol is strictly prohibited in most Muslim-majority countries and in some parts of India. U.S. citizens have been detained for possessing alcohol in their luggage upon arrival in some Muslim countries.
For example, Indonesia, in mid-April, passed a ban on small retailers, including minimarts, convenience store, and small shops (it does not impact hotels, supermarkets, or food outlets), from selling “Class A” liquor (less than five percent alcohol), which includes beer and pre-mixed drinks throughout the nation, except on Bali or Lombok, where street vendors can still sell beer at the beaches. Two Islamic political parties called for a full ban on drinks with more than one percent alcohol nationwide – and those found guilty would face up to two years in prison and harsh fines -- in what is widely seen as pandering to conservative voters. Experts fear that even this ban will drive people to bootleg distributors and unregulated brews and will adversely impact tourism. However, as it stands, the current government does not support a complete booze ban, and the conservative bill is unlikely to pass Parliament.
Drinking in Oman will continue to be confusing, as the Shura Council passed an alcohol ban in December but continue to debate it, as a ban would adversely impact their burgeoning international tourism market.
In much of the Middle East, alcohol is banned, and for those places where it is legal, it is only for men. Not so in Jordan, where even single women can drink openly in bars and nightclubs.
Impact to Private Sector
Overindulging alcohol can lead to blackouts, injury, assault, abuse, reckless behavior, impaired judgment and decision-making, long-term health consequences, and death. Medical care may not be up to Western standards, increasing the risk should medical attention be required. Cultural, linguistic, and ethno-national nuances may be heightened with increased alcohol consumption.
Most countries do not have a legal drinking age, although frequently one must be 18 to purchase liquor, and it is not uncommon for young adults to have beer or wine with a meal. Based on a small sampling of U.S. college students, those already over 21 actually consumed alcohol more frequently but in less volume. Conversely, students under 21 took advantage of the novelty of unfettered access to alcohol. In some places, booze is actually cheaper than water; in others, it is prohibitively expensive due to import taxes or transit costs. And, increasingly a service size is standard while the alcohol is priced based on the percentage of alcohol. All of this may promote a culture, particularly for younger U.S. citizens, of over-indulging.
It is important to research the customs, traditions, and laws of your destination prior to travel. Consume alcohol in moderation. Purchase liquor from legitimate sources, and inspect packaging for irregularities, broken seals, or errors on the labels. Experience local customs, traditions, and gastronomy, but stay within your faculties. Employ the ‘buddy system’ when possible to ensure safe return to your residence. Further, review OSAC Crime and Safety Reports for specific destinations, as they may highlight destination-specific alcohol-related guidance. Peruse the Consular Affairs brochure “Alcohol and Drugs Overseas,” which is tailored to the study abroad demographic but is applicable to most travelers.
If traveling overseas for an academic program, refer to the school’s guidance and policies on alcohol consumption. Some universities may offer pre-planning alcohol-use questionnaires to help identify possible risks and triggers for excessive use, and many require signing an alcohol/drug policy. Many academic institutions have resources for awareness training and student safety that apply to both the domestic and international domain, as is the case with this fee-based Alcohol Awareness for Study Abroad Guide and Video.
Some destinations issue Security Messages in anticipation of an influx of U.S. students for particular events or periods, such as U.S. Embassy Nassau, which released a message regarding safety in the Bahamas for Spring Break. Consular Affairs has a dedicated Spring Break website.
For Further Information
For additional information on public health concerns and pandemic outbreaks, please contact OSAC’s Health and Disease Analyst. For country-specific concerns, please contact the appropriate regional analyst.