Your Cocktail Could Kill You

Cocktail garnished with baby’s breath, which can cause skin rashes if handled, and digestive distress if consumed, photo with permission from @bittersweet.melissa on Instagram

Avoid deadly homemade tonic water recipes, and other seemingly harmless ingredients

At the end of March, cocktail writer, drinks educator and clear-ice pioneer Camper English got an alert from Google that one of the pages on one of his websites was getting unusually high traffic. “I’ve never actually gotten a message like that from Google before,” he says.

The extra-popular page was the entry for tonic water on CocktailSafe.org, a site English launched early last year to collect reliably sourced information about potentially dangerous drinks ingredients. And the reason it was trending was a spike in media coverage of two malaria drugs—chloroquine and hydroxychloroquine—after President Trump repeatedly touted them as a treatment for COVID-19.

What do these things have to do with each other? Cinchona, a genus of trees native to South America.

The bark of cinchona trees has high levels of quinine, which cures malaria, a deadly mosquito-borne disease that’s afflicted hot and swampy regions since at least as far back as the Roman Empire. Quinine’s a great malaria treatment, but it’s also extremely bitter-tasting, so British soldiers stationed in India in the early 1800s took to mixing it with sugar, soda water and other botanicals to make it taste better. They called the result “tonic water”, and as it turns out, it’s very tasty with gin. (English’s own book Tonic Water AKA G&T WTF digs deeper into this fascinating history.)

Do not ingest anything in this photo by Jason Horn

Besides the fact that quinine, chloroquine and hydroxychloroquine are all used to treat malaria, they don’t really have much to do with one another: The latter two are synthetic chemicals and aren’t contained in cinchona bark, and there’s been no suggestion by any reputable scientists that quinine, or any other chemical found in tonic water, can treat COVID-19. (And even the synthetic drugs may not be effective against COVID-19 at all, per recent studies.)

But the spike in traffic convinced English to add a warning to the page, saying in part, “…it is clear that one should Not attempt to treat or prevent malaria, COVID-19, or any other illness with cinchona tree bark. Follow your doctor's recommendations.”

As with any drug, too much of the powerful chemicals in cinchona bark can also be very dangerous. “They have problematic side effects—to the point where they can kill you,” he says. Too much cinchona bark can cause muscle weakness, incurable tinnitus and heart issues. In people with long QT syndrome—a rare but often undiagnosed genetic heart condition—a cinchona overdose can even cause sudden cardiac arrest and death.

In fact, it was homemade tonic water that convinced English to launch CocktaiSafe in the first place, long before the global coronavirus pandemic. Some of the recipes he found online used more than ten times the legal limit of cinchona set by the FDA. “There was plenty of discussion online” about homemade tonic and other potentially dangerous cocktail ingredients, “but I felt that there needed to be a central location to put all this information in the same place,” he says. Tales of the Cocktail announced its grants program around the same time, and money from the organization funded the development and web hosting for the site, whose ever-expanding encyclopedia of potentially dangerous ingredients and techniques now includes more than 80 entries covering hundreds of botanicals, fruits and vegetables, colorings and other items you might not want to put in your drinks.

Other trendy, yet potentially lethal, cocktail ingredients

CocktailSafe lists lots of ingredients you’d never expect could be so dangerous. Activated charcoal, a popular ingredient used to make food and drinks black in color, can inactivate medications for things like blood pressure or birth control, especially if they’re taken in close proximity to consuming the activated charcoal. Tobacco leaves, which were a trendy flavoring for bitters and liqueurs among craft mixologists a few years ago, can deliver a potentially fatal overdose of nicotine thanks to infusion in alcohol making the chemical much more easily absorbed into the bloodstream than by smoking cigarettes or even chewing tobacco.

If you’re bored and home and looking to experiment with some botanical infusions, English has a few words of advice. First and foremost, “homemade amaretto is a terrible idea,” he says, explaining, “there’s cyanide in the pits of apricots, cherries and other stone fruits.”

Cinchona bark is used to make tonic water, but most online recipes call for potentially lethal amounts of it, photo by Katherine Perez via Flickr

One garnish to avoid is flowers: “Instagram is driving a lot of people to stick flowers in their drinks, but they can be poisonous,” English says. “Just because it’s organic doesn’t mean it’s safe to eat—poison ivy is organic too!” Plenty of flowers—chamomile, elderflower and hibiscus, for instance—are perfectly edible, but not all. Baby’s breath has been a popular cocktail garnish recently, but handling it can irritate the skin, and eating it can cause vomiting and diarrhea. Other common flowers including marigolds, tulips and hydrangeas are similarly mildly toxic, and there are even a few—like foxglove and lily of the valley—that can be fatal if ingested.

It’s also more complicated than just one ingredient is safe while another isn’t. “Not all parts of plants are edible just because one part is,” English says. A perfect example is rhubarb: The plant’s sweet-and-tart stalks are a springtime favorite in pies (and another type of rhubarb’s root is used in many bitter liqueurs), but the leaves contain high levels of oxalic acid, which can cause kidney stones, joint pain, breathing problems, and even birth defects in pregnant people. You can sometimes find rhubarb with leaves still attached at farmers’ markets or produce stands—make sure to remove them completely before cooking or eating.

One ingredient English was very surprised to find out might be dangerous is citrus juice. Yes, the near-ubiquitous cocktail ingredient can harm you: In a process called phytophotodermatitis, exposure to the juice of limes and other citrus fruits makes your skin extra-sensitive to sunlight. If you juice a bunch of citrus and then go out in the sun (if you’re spending the day drinking on the beach, say), you could end up with a painful rash and blisters all over your hands.

Thankfully, to avoid what’s sometimes known as “Margarita burn,” (or, more punnily, “lime disease”) all you have to do is wash your hands thoroughly after handling citrus juice.

Washing your hands thoroughly is generally a good idea to avoid coronavirus, for that matter.