When crates arrived for a new hospital pharmacy, staff expected bottles of gin and bargain-basement brandy. But one crate of red wine raised eyebrows. The order had not been bungled. It was communion wine, meant for the chaplain: a reminder that alcohol in all its guises still threads through pharmacy.
The story of British pharmacy is steeped in draught and dram. The (now Royal) Pharmaceutical Society of Great Britain was founded in 1841—not at a university, but at the Crown and Anchor Tavern in London. The public house was more than a watering‐hole: it was a gathering place, a social nexus and a symbol of the profession’s communal and humble roots. But both community pharmacies and public houses are closing year on year.
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However, alcohol still claims shelf-space in dispensaries. Oramorph oral solution contains 10% ethanol, and its antecedent, Brompton cocktail, was once used in palliative care. That elixir might have contained diamorphine hydrochloride titrated for that patient, honey, orange syrup, gin and chloroform water. I have dispensed extremely high doses.
Covid arrived. Distilleries modified production from spirits to drink for sanitiser to wash hands. With temporary regulatory waivers, many pivoted to hand sanitiser production. Their secret weapon: a 30% dilution of water to enhance ethanol’s sanitising efficacy. At home, your correspondent replicated the dilution, substituting laboratory-grade isopropanol. It remains splendid for cleaning an olive oil-splattered hob in the kitchen.
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Animals, too, like booze: birds fall from perches after feasting on fermented apples; bees, drunk on fructose turned to ethanol, stagger home; elephants have knocked down walls for the spirits smelled within and grey squirrels raiding garden nuts sometimes appear tipsy.
At a 2025 state banquet in London, Silicon Valley glitterati sipped Hennessy Cognac Grande Champagne 1912. But the guest of honour abstained; broader trends mirror. Young people across high-income nations, including the UK, are drinking less. Many British twenty-somethings regard wine at dinner as “boring”. Instead, tap water—cheap, unpretentious, seen as healthier—has become the default beverage.
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The statistics back this shift. A Portman Group / YouGov survey found 44% of 18–24-year-olds now describe themselves as regular or occasional drinkers of low- and no-alcohol alternatives, and about 39% report not drinking alcohol at all. Public health surveys mirror the shift. In England’s 2022 Health Survey, the proportion of 16–24-year-olds engaging in risk-level drinking was highest in that age band (20%)—yet the data also show a growing tide of abstainers and light drinkers.
Alcohol’s cultural and nutritional role extends through history. Ancient Egyptians permitted a (generous) ration of beer to pyramid labourers as staple sustenance. In medieval England, “small beer” at under 2.8% alcohol served as low-alcohol hydration and caloric support. Even today, in parts of Germany, beer contributes significantly to daily energy intake.
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Ritual and prestige entwine with fermentation, too: archaeological graves often include cauldrons of fermented beverages, a sign of status and remembrance. Buckfast Abbey in Devon continues that tradition: its tonic wine, originally cultivated by Benedictine monks, has long been marketed as a medicinal pick-me-up.
Patrick McGovern (1944–2025), biomolecular archaeologist, helped rewrite our understanding of ancient fermentation. By analysing residue biomarkers (succinic, citric acids etc.) in archaeological pottery, he traced the world’s earliest known fermented drinks, from rice and honey in Neolithic China to grape wine in Iran and mead in Turkey.
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Some community pharmacies even stock home-brewing tools—fermentation airlocks functioning with moist glugging, hydrometers and more. The substrates often remain traditional such as elderflowers, gooseberries and rhubarb: rich in malic, citric, and the intriguingly-named shikimic, acids.
Today in the UK, pharmacists cannot distil spirits for recreation but compounding prescribed medicines or “specials” using spirit remains exempt from duty. Alcohol persists in tinctures, elixirs, sanitising agents and, occasionally, tonic wines. Its presence is more than chemical. It is cultural.
That crate of communion wine, the palliative elixir, the home-made sanitiser, the bees buzzing drunk on dropped apples—all these are signposts. Alcohol is woven into pharmacy’s past and present, but so is change. However, whatever the future holds for pharmacy, I suspect it will retain alcohol, somewhere.