Inhaled isopropyl alcohol for substance-related nausea in adults at electronic dance music festivals: a randomized...

Inhaled isopropyl alcohol has demonstrated benefit in managing nausea in emergency departments. This study investigated inhaled isopropyl alcohol's effect on patients with substance-related nausea at 20 Canadian electronic dance music festivals.

This double-blind randomized control trial enrolled patients aged 18 years or older, who self-reported substance use, and presented with nausea. Exclusion criteria were allergy to isopropyl alcohol, inability to inhale through nares, inability to verbally report nausea level, and prior antiemetic given by medical staff. Randomization was to 70% isopropyl alcohol or placebo saline, inhaled from a soaked pad for ten breaths. Nausea was rated on an 11-point scale (0 = no nausea, 10 = worst nausea imaginable) before and ten minutes post-intervention. Percentage of cases where patients vomited and cases where rescue antiemetics were requested were also computed.

Self-reported reduction in nausea ten minutes post-intervention occurred with isopropyl alcohol (n = 34) and placebo (n = 23). Isopropyl alcohol reduced average nausea scores from 6.4 to 4.5 (- 30%, p < 0.001, r = 0.74); placebo reduced nausea from 5.8 to 4.9 (- 16%, p = 0.009, r = 0.66). The magnitude of nausea reduction from isopropyl alcohol was greater than placebo by an additional 14% (p = 0.024, rrβ = 0.35). No side effects were reported. Post-intervention vomiting occurred in 15% versus 13% for isopropyl alcohol versus placebo, respectively (n.s.). Post-intervention request for antiemetics occurred in 35% for isopropyl alcohol versus 70% placebo, respectively (p = 0.01, NNT 3).

Inhaling isopropyl alcohol or placebo reduced nausea in patients who consumed recreational substances. Isopropyl alcohol reduced nausea by two-fold that of placebo and reduced requests for antiemetics by half that of placebo. Inhaled isopropyl alcohol offers a simple approach to managing nausea in the electronic dance music festival context. Trial registry NCT04307550 (registered 13 March 2020).