Killer Drinks: Food Allergies Turn Imbibing Into Surviving

We’re all warned about the inherent dangers of drinking too much: Cloudy judgment leads to a bar fight. Decreased coordination causes a tumble to the pavement. Alcohol poisoning lands you in the Emergency Room.

Though scary consequences to be sure, none of the above will happen after a single drink on a full stomach – you’ve obviously over-indulged. But for some, a near-death experience is the result of sipping or even just sniffing one wrong drink.


These folks are the unfortunate sufferers of food allergies. A massive percentage of adults and five percent of children in the United States suffer from food allergies, and the numbers are growing (according to the U.S. National Institutes of Health, 2012). As a result, we’ve become more allergy-aware. You’ve probably been out to eat and read this disclaimer on a menu: Before placing your order, please inform your server if a person in your party has a food allergy. In Rhode Island and Massachusetts, restaurants are required by law to include the allergy disclaimer and to train staff in food allergen awareness.

Bars, pubs, and nightclubs on the other hand, rarely include any language about food allergies on their drink menus, and even though kitchen and bar staffs are working more and more closely together to design well-paired and carefully crafted menu options, no food allergy training is mandated for the bartenders.


Food allergy-ridden drinkers are expected to fend for themselves in a world where cocktail ingredients are trending towards the unexpected. The following eight ingredients account for 90% of all allergic reactions in the US:

•        Peanut

•        Tree nuts

•        Milk

•        Egg

•        Wheat

•        Soy

•        Fish

•        Shellfish

None of the so-called “Big 8” may seem like typical drink components, but beware these sneaky uses:

•        Tree nuts in some specialty beers (particularly seasonal ales)

•        Hazelnuts in Frangelico

•        Tequila “gold” variety aged in oak barrels

•        Almonds in amaretto

•        Almonds in some brands of gin

•        Milk in white chocolate liqueurs

•        Milk in Irish cream

•        Milk derivatives used to bind margarita mixes

•        Egg used to create froth on top of some beverages

•        Wheat in beer

•        Clamato (tomato juice with clam broth) in bloody marys

Even if the drink itself is “safe,” don’t be blindsided by the ever-more-elaborate garnishes. A martini olive surreptitiously stuffed with blue cheese could send the lactose intolerant into a fit of wheezing, vomiting, itching, and cramping.


Cross-contamination takes place when a bartender uses the same cocktail shaker or stirrer for multiple drinks. It’s an unsanitary and potentially life-threatening side effect of a busy, understaffed establishment, where the crowd of customers awaiting drinks runs the entire length of the bar, three-people deep. By taking a shortcut, a bartender runs the risk of sending their patron into anaphylactic shock. If not treated immediately, the mistake can be deadly.
Keep in mind, alcohol can influence how quickly a food allergen is absorbed into the body, meaning symptoms which may not be as severe to the sober body will occur at a faster pace than usual in the intoxicated individual.


Elizabeth O’Sullivan, nut allergy:

I bartended in Maryland, Texas and Pennsylvania over the course of ten years. The only place that really considered allergies to be worthy of concern was Local 44 in West Philly. They worked with me as well as customers to minimize reactions. It wasn't perfect, but it was the first step towards caring I had experienced.

I'm deathly allergic to any nut or nut derivative. I rapidly experience swelling of the mouth and throat and my breathing is blocked. It's like being strangled, but from the inside instead of the outside. Even today, after over 20 years of knowing my triggers, accidental exposure is terrifying.

As a bartender, it is not easy to hand orders off to others if a drink is ordered that contains something you are allergic to. Speed, efficiency, and service are the bedrock of your job. Exposure, though, can be worse. I know what goes into a German chocolate cake shot. When I am attempting to multitask, chances increase that something will expose me to the crucial hazelnut liqueur that makes this drink. When it has, the back splash caused immediate swelling and redness on my face and arms. I had to walk away and rinse under scalding water to clean the exposed skin.

Patrons seldom share allergies at the bar. As someone who has been on both sides, I feel it is my responsibility to tell the bartender ahead of time. An aware staff member is a cautious staff member. As a customer and a server, knowing early can change the entire experience. No bartender, no matter how busy, wants to be the reason a customer is in danger. Special requests result in eye rolls and annoyance, but that is temporary. Ultimately, our goal is safe interaction while consuming food and beverage. It's simple, but scary for many.

Katie Medernach, gluten allergy:

I have Celiac – it’s an autoimmune disorder.  When I eat gluten, my body attacks my intestinal system. I’ve probably had it for longer than I’ve known. My stomach issues started when I was in high school (I’m 31 years old now). I went to the emergency room 7 years ago because of severe stomach pain, but the GI didn’t even mention Celiac or test my blood. Then, 3 years ago during a routine checkup, I mentioned my stomach pains to my doctor, who suggested I see a GI specialist. I got a blood test and was diagnosed as having Celiac.

I was drinking a lot of beer at that point. I haven’t had a regular beer since being diagnosed. I loved beers, but luckily I love wine more. At bars, I’ll drink cider a lot because it’s the best option. The wine selection isn’t that good at a lot of bars and if I don’t feel like going hard and drinking vodka, cider is a good option. But it’s really sweet. Gluten-free beers aren’t offered at many places, but I will buy some for home. They’re ok but not great. They usually try to make them lagers, but they don’t have the taste you’d expect. If a child comes of age having Celiac and knows no different, they probably wouldn’t have any problem with them, but I’ve been spoiled by too many really good craft beers.

Any malt beverages – Twisted Teas and Smirnoff Ice, for example – also contain gluten. They’re not distilled. I can have liquors that come from rye and wheat because they are distilled. So, on the plus side, I’m immune to getting Iced.

Now that my stomach is normal, if I accidentally consume gluten, I have to go to the emergency room or clinic. In Mexico, I ate corn tortillas that had flour in them.  I experienced nausea, severe stomach pain, vomiting and diarrhea. I had to have injections of Zofran for the nausea. I’m very careful. My husband and sister joke that there should be a Friends of the Gluten-Free support group.Every time we go out, I have to ask a million questions. Oh well – it’s just not worth the risk.


In order to better protect patrons with food allergies, follow these six simple suggestions:

1. Avoid “The Big 8” Food Allergens on your drink menu;

2. List EVERY ingredient from spirit infusions to garnishes to rimmed glasses;

3. Print a disclaimer on bar menus and drink special chalkboards;

4. Require staff to properly clean out shakers between orders;

5. Carry gluten-free beers and other allergy-friendly offerings;

6. Train your staff to ASK customers if they have any food allergies.

The 2016 Nightclub & Bar Show will offer ServSafe training. Make sure to check for certification classes. 

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