In a former tanning salon in midtown Atlanta, three athletic-looking guys recline on pleather La-Z-Boys, occasionally glancing at a flat-screen TV while plastic tubing pipes yellow fluid into their arms.
One of the guys has stopped talking to me because we've just disagreed about how much water is safe to drink in a day. But the other two are still friendly, telling stories of preternaturally quick hangover recovery after epic ragers, exercise extravaganzas, and flu-season barf marathons.
Their secret, they say, is intravenous treatments with that yellow fluid, which hangs in bags on walls behind them. Treatments like these are sold at this and other Vida-Flo "hydration stations" for anywhere between $40 [$30 USD] and $99 [$75 USD] a pop.
The elective IV industry is a growing one, marketing its product as an elixir for the "ain't got time to feel shitty" young professional with cash to spare. Although there's no way to know for sure how many elective IV providers exist, internet searches suggest IV boutiques have been popping up in every major North American city since 2010.
Among them are Atlanta's Vida-Flo—which has opened two local outlets since 2013 and has two more planned in Breckenridge, Colorado, and Charleston, South Carolina—and Toronto's VitaminDrip, which offers services in six Canadian locations and over 20 operations internationally, including many franchisees.
Despite its roots as a naturopathic treatment, elective IVs really gained traction with use as a hangover cure, building on the experience of generations of medical professionals who self-administered bags of saline post-bender. (A well-behaved cardiologist told me it was common practice during his residency training.) For profitability, many IV therapy providers are now refocusing on marketing the therapies in the "health and wellness space."
It sells, even to people who have no idea what the health and wellness space is. That's due in part to the treatment being plastered all over celebrity Instagram and Twitter feeds, alongside photos of Miley Cyrus, Rita Ora, and Ryan Phillippe, all crumpled glamorously in luxurious armchairs while tanking up. Depending on their target demographic, company websites depict guys clinking glasses of brown liquor or miles of white-sand beaches with distant twinkling lights.
Fans of the therapy embrace it for what they insist are measurable health benefits. In Toronto, Daniel Myerson has gotten 15 to 20 similar treatments from VitaminDrip over the last six months. "I used to get colds all the time," he claims, "but I haven't gotten sick once since starting to get the drips."
The therapies they're receiving are similar to what you'd get if you showed up dehydrated at a hospital. Typically they include sterile saline or lactated Ringer's solution—saline plus potassium and calcium—along with a cocktail of a half-dozen vitamins and/or anti-nausea or pain-relieving medications. The difference in this case is that they are elective. Meaning, they're completely medically unnecessary.
"There's really a minimal chance of something going wrong with this," says David Lee, the director of the Adelaide Health Center, a VitaminDrip franchisee. But experts disagree, warning that not only are the risks very real, they are invisible, underreported, and all but lost in a thick layer of crafty marketing.
Joseph Perz is an injection safety specialist at the Centers for Disease Control and Prevention (CDC) in Atlanta. Much of the risk for infusion-related infection, he says, is in the manipulation of the material being infused. "Any time you handle a bag of fluids, even if you're not putting anything into it, there's a risk of bacterial contamination."
Consider Vida-Flo's "Illness Recovery" drip, which contains Toradol, Zofran, and Pepcid in saline. Most of those medications are stored in multi-dose vials, which contain enough of whatever's inside to treat more than one person. To get the medication into the drip, a provider uses a syringe and needle to withdraw each dose from one of these vials, then adds that dose to a bag of fluid using the syringe.
If any one of those steps is done without proper precautions, bad things can—and do—happen. A CDC publication listing recent outpatient outbreaks describes multiple clusters of hepatitis B, hepatitis C, and bacterial bloodstream infections, almost all resulting from unsafe injection practices by providers.
While systematic violations of injection safety might be quickly noticed and shut down in a hospital due to their accreditation procedures—which include unannounced inspections—outpatient facilities aren't subject to the same amount of regulation in either Canada or the US. Unless there's a complaint about an outpatient clinic, it might never be inspected.
No large outbreaks of infection associated with elective IVs have been made public—but that doesn't mean they aren't happening.
"Even if multiple patients were infected in the same day, if they were at different hospitals—or even had different doctors—nobody puts the pieces together. The outbreaks we know about are the tip of the iceberg," Perz says.
VitaminDrip's patient safety procedures include an exhaustive intake form and an informed consent procedure. Like any clinic performing invasive procedures, all providers of VitaminDrip products must comply with an infection control plan and are required to maintain an emergency plan. On paper, the company is doing everything it can and should to minimize the likelihood of infectious complications. We asked VitaminDrip for an overview of their safety regulations but did not hear back by time of publication.
Infectious risks aside, elective IVs aren't cheap. VitaminDrip charges between $75 and $250 CAD [$57 and $190 USD] for each of its treatments, and most US services charge between $100 and $400 USD per treatment, more for additional supplements or treatment in your own home. Meanwhile, a large bottle of water costs nothing, tastes fine, and involves zero people sticking you with needles.
This is a particular problem when there is no scientific evidence that these treatments actually do anything. Despite the anecdotal evidence, several good medical studies have shown that in otherwise healthy people, vitamins—whether administered IV or in pill form—have essentially no effects, and that IV hydration offers no benefit to athletes over oral hydration and may actually reduce performance in elite athletes.
So why bother getting an elective IV? Despite the scientific evidence, fans of the procedure say they feel it works. Glen Schaffer, the Vida-Flo client who looks most likely to have just done an obstacle course marathon, says the relief he gets from an IV treatment is stronger, faster, and more palatable than if he were to down a few Gatorades after a workout. "If you're sick, if you've lost a lot of fluids during a workout, it's instantaneous relief," he says, "whereas you might not have the stomach to drink a whole lot of fluids in that situation."
"Also, if you party," adds Steven Cundari, a customer at Vida-Flo. He makes a point: Dehydration—i.e. what causes many hangover symptoms—is one of the few conditions IV fluids can treat faster than oral hydration. A somewhat shorter hangover won't be worth the infectious risk and the cost to everyone, but elective IV services don't need to sell their therapies to all people—just to a few hundred a week.
According to VitaminDrip's website, "taking vitamins orally [is] last season." But is marketing enough to convince people that an expensive, invasive procedure is preferable to, you know, drinking fluids and eating food? If nothing else, says Perz, it builds on peoples' assumption that elective IV services are regularly evaluated for compliance with hygiene and safety regulations.
"They might be thinking, like when [they] go to a restaurant and see they're inspected and got an A, [there are] similar protections in place for this therapy. And that's usually not the case," Perz says.
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