I am moved to re-post the early Ethics Alarms entry from 2010, titled “The Amazing Mouthwash Deception: Helping Alcoholics Relapse For Profit,” for a few reasons.

It raises an important and shamefully under-reported topic, one that despite my exhortations then has yet to be adequately examined in the media. If one googles various combinations of “mouthwash,””Listerine,”‘alcoholism,” and “alcoholic,” the first result is, sadly, my post. Most people who are not afflicted with the disease of alcoholism have no idea that mouthwash is a popular stand-in for liquor, or that is used to deceive family members who think an addict is no longer using or intoxicated. None of the recommended policy changes I suggest in the post have been implemented, either.

Last week I chanced to mention the use of Listerine by alcoholics to a friend who is a doctor who treats alcoholics. He was shocked, and had no knowledge of this at all. “Eww!” he said. “Isn’t that poison? You can drink it? I had no idea.” And he is a professional who keeps up  with the literature. (But obviously doesn’t read his friend’s blog.)

Despite my frustration that what I regard as a true exposé that should have sparked an equivalent article in a more widely read forum has remained relatively unknown, I am encouraged by the effect it has had. Most posts have their greatest traffic around the time they are posted, but since 2010, the page views of this article have increased steadily every month. More importantly, it has drawn comments like this one, from yesterday:

“Am looking after my twin sister who is a chronic alcoholic. She has been three days sober and then she just walked in and I couldn’t work out what the hell happened. She was in a stupor , but there was no alcohol and I am dispensing the Valium for detox period and she smelt like mint!! Found three bottles of it !!! This is my last big push to help her and she pleaded innocent and no idea it had alcohol in it! Hasn’t had a shower for two days but keeps her month fresh and sweet !! Thanks for the information. Much appreciated XXX”

Most of all, I am revolted that what I increasingly have come to believe is an intentional, profit-motivated deception by manufacturers continues, despite their knowledge that their product is killing alcoholics and destroying families. I know proof would be difficult, but there have been successful class action lawsuits with millions in punitive damage settlements for less despicable conduct. Somewhere, there must be an employee or executive who acknowledges that the makers of mouthwash with alcohol know their product is being swallowed rather than swished, and are happy to profit from it.

Few had discovered Ethics Alarms by April of 201o. I hope that by re-publishing the post now, it might find its way to more social media pages and even be sent to some investigative reporters. As I ended the original post, spread the word. Mouthwash is killing your friends and family members, or if not yours, those of someone not far away.

Thus, for the second time and hoping for more impact than the first, here is “The Amazing Mouthwash Deception: Helping Alcoholics Relapse For Profit.” Even if you read it the first time, refresh your memory.

People are killing themselves right under our noses, and we are being thrown of by the minty smell of their breath.

It has been with us for centuries, as long as man has been fermenting vegetable matter to produce alcohol, and it is a plague on the human race. Virtually every one of us has friends, relatives or close associates with the disease, or battle the addiction ourselves; although accurate figures don’t exist, estimates of the prevalence of alcohol addiction in the U.S. range between 5 and 12%. Whatever the real figure is, it is a lot, and the disease causes a wide range of problems. For example, close to 50% of all automobile fatalities involve alcohol. Yet the public remains shockingly ignorant about alcoholism, to the detriment and convenience of alcoholics, and the devastation of their families

The ignorance is also profitable to some corporations that are not even officially in the beverage business. The ethics question is, do those corporations knowingly and intentionally encourage and facilitate that ignorance? If so, they have a lot to answer for, and so do government consumer agencies and the media. This ignorance kills.

The corporations in question are those that manufacture mouthwash, specifically mouthwash containing ethyl alcohol. Most Americans don’t know or suspect that mouthwash containing alcohol is a primary tool of the alcoholic’s craft, which is deception. Keeping the progressive disease, a debilitating addiction with genetic roots, hidden from fellow workers and family is a full time occupation, and popular mouthwashes like Listerine, a Johnson and Johnson product, are a godsend.  Original formula Listerine is 26.9 percent alcohol, making it approximately 54 proof , though other flavors contain less. This means it is more potent than beer or wine, and comparable to some varieties of hard liquor.

But, you may ask, aren’t Listerine and similar mouthwashes poison? I always thought so, because I read the labels, a typical example of which reads:

“Do not swallow. In case of accidental ingestion, seek professional assistance or contact a Poison Control Center immediately.”

This is effective, all right: effective at putting those who live and work around alcoholics off the scent—literally. The breath of an alcoholic who is drinking mouthwash will smell “minty fresh,”  and in the morning, when liquor on the breath is a warning sign even the most trusting associate will notice with alarm, this is wonderful subterfuge. It just never occurs to a non-alcoholic that drinking Listerine or other mouthwashes is a possibility, because the bottle suggests it is poison.

It isn’t, and alcoholics know it isn’t. Drinking  mouthwash is openly discussed and joked about at AA meetings, which are, for good reasons, confidential. Occasionally an endorsement of mouthwash drinking appears on the web. Here’s a typical example, from a British website:

“Been drinking Listerine on the streets for ages now, gets you mashed good and proper. Best bit, it’s cheap and makes you smell great. With 4 different colours and flavours,  you just can’t get bored with it. Nothing beats going down the park on a Friday night with a bottle of Listerine and getting mashed with your mates. It even comes with that cap which doubles as a shot-glass. My favourite though is Listerine on the rocks you can’t beat that, add an umbrella and your south of the border.”

If you are surprised that anyone could actually drink the mouthwash “for ages” and still be active on the internet, it means one thing: you’re probably not an alcoholic.

There are other benefits of mouthwash for the secret drinker besides the convenient shot glass and the variety of flavors—and, of course, the misleading warning:

• The bottles come in small sizes that can be stored in purses and pockets.

• Mouthwash with alcohol  continues to be sold at supermarkets and convenience stores, 24 hours a day, after sales of liquor are prohibited. “Watch the mouthwash aisles on a Saturday night some time,” an alcoholic friend suggested. She was right.  There was a run on the shelves, and the purchasers looked like the cast of “Barfly.”

• Most people find the taste of mouthwashes so strong and medicinal that they can’t imagine anyone wanting to drink them. Of course, they aren’t thinking like alcoholic, who do not drink for taste.

• Mouthwash is relatively cheap, and

• If you are under age, you can still buy a jumbo bottle of Listerine without raising a store clerk’s eyebrow.

As I  stated at the beginning, the consequences of the mouthwash deception are devastating. Alcoholism is a progressive disease that destroys families, businesses and lives, and recovery is difficult, intermittent, and never-ending. Families of alcoholics have to be vigilant for a recovering family member to have a fighting chance of surviving the illness. The existence of a secret back-door to intoxication, aided and abetted by a false warning that assists secret drinking by deluding non-drinkers, undoubtedly impedes the recovery of thousands and perhaps millions of desperately sick individuals. For many alcoholics, the alternative to recovery is death.

Do mouthwash manufacturers know this? I do not know, but I wonder: how could they not? They see the sales figures, and presumably they know the market; selling mouthwash is, after all, their business.  Figures don’t exist, but it seems reasonable to assume that sales to drunks hiding their addiction must account for a significant percentage of profits, meaning that assisting alcoholics in sabotaging their recoveries and fooling their co-workers and families is worth millions of dollars. Would millions of dollars a year in sales motivate a corporation to keep the public in the dark about a widespread and destructive use of its product? Even if families are torn apart, businesses destroyed, and people killed as a result? We know it could, because we have seen other corporations do worse. We can’t know, at this point, if that is what is going on.

If it isn’t, however, then the naivete of mouthwash manufacturers is mind-boggling. They know that their mouthwashes are not poison, but place misleading labels on their products which only convince the consumers who would never dream of drinking mouthwash anyway. Meanwhile, it lets those who do drink it operate in secrecy. Is it possible that this practice, which has been going on for decades, is accidental and innocent? Are there no alcoholics in the families of Pfizer executives and the other companies?

They are not the only entities I wonder about, either. I find it difficult to believe that supermarket chains and convenience stores don’t know that when they sell Listerine to red-faced, homeless people on  Saturday nights, they are supplying binges. The media’s failure to inform the public about this phenomenon is also inexplicable. Journalists are not strangers to problem drinking. Why hasn’t this story been in the New York Times? On “60 Minutes”? Where is Dr. Oz? We see alcoholism portrayed in television dramas frequently now, a good thing. Have you ever seen a character drink mouthwash? If it has happened, I missed it, and I watch more TV than is good for me.

This has to stop.

What needs to be done, and what manufacturers and the media have an ethical obligation to do:

1. Manufacturers should begin public service campaigns aimed, not at alcoholics, but at their families and friends, warning them that Listerine and similar mouthwashes are alcoholic beverage substitutes for those who abuse alcohol or have alcohol addiction, and that if they have a recovering alcoholic loved one, friend or worker, they need to be aware of the meaning of that mouthwash bottle the alcoholic is carrying around, and the minty-fresh morning breath.

2. Local television news, cable news, and talk shows should produce features and news segments on the misuse of mouthwash by alcoholics and teens as a liquor substitute.

3. Manufacturers must change the warnings and labels on alcohol-containing mouthwashes so that the people alcoholics need to fool will not be misinformed.

4. Lesislators must change the laws so that purchases of alcohol-containing mouthwashes are covered by restrictions on beer, wine, and hard liquor.

5. Alcoholics should be counseled to reveal the mouthwash dodge to their families before they are in the throes of a relapse.

6. Families of alcoholics should be instructed in Al Anon and elsewhere to be on the look-out for mouthwash abuse as a sign of an alcoholic’s relapse.

Whether through negligence, ignorance, carelessness, irresponsibility or greed, a strange convergence of factors has been aggravating one of the nation’s most serious health and social problems.  All that is required to address the problem is information and education.  If those who have a responsibility to publicize this information continue to fail to do so, our ethical judgment of them should be harsh. As always, however, the priority is to fix the problem. If mouthwash makers, retailers and journalists won’t do the right thing, we need to do it for them, and fast. We can deal with their conduct later.

Spread the word.