The foreign affairs department yesterday updated its travel advice on Indonesia, warning Australians to be cautious when drinking spirits, particularly the popular liquor arak. The warning comes after the recent death of Perth teenager Liam Davies, who was poisoned after drinking a cocktail containing methanol on Lombok.

In September 2011, Perth-based New Zealand rugby player Michael Denton died after drinking a cocktail containing methanol in Bali. Days earlier, Sydney nurse Jamie Johnston suffered brain damage and kidney failure after drinking arak (which contained methanol) on Lombok. A Sydney school-leaver was blinded after drinking arak in Bali in December last year.

So what is arak, why is it so popular — and so dangerous?

The Australian Medical Association also has concerns, recently advising travellers to Bali to stick to bottled beers like Bintang and avoid spirits altogether. But with cocktails available for as little as five Aussie dollars, many people are still willing to take the risk.

In January 2012, Melbourne administrative worker Nathalie Appere (then aged 21) had a bad experience drinking arak in Bali. She told Crikey she spent the night bar hopping in well-known tourist area Kuta, and drank “double drinks” (which have a high arak content) and bottled drinks that contain a mixture of arak and other spirits.

Appere spent the next day in her hotel bathroom, violently ill from the night before. “I woke up at 6am after a crappy couple of hours sleep and vomited for seven hours straight. Anything I ate or drank came back up within minutes,” she said.

Arak is a traditionally brewed liquor made from rice and coconut palm flowers. It can contain up to 50% alcohol. If it is not brewed correctly it can contain methanol, making the drink potentially fatal.

The Australian Medical Association of Western Australia has called for the Prime Minister to work with the Indonesian government to hold the bar which served Davies accountable for his death. “How many people need to die or be maimed before something is done? How many travellers need to be injured before both Australian and Indonesian authorities decide action is needed?” President Dr Richard Choong said.

“At the time you feel invincible and go about dancing and having a good time not caring about anything or the repercussions of your actions.”

Professor Robin Room from Turning Point Drug and Alcohol Centre in Melbourne says arak and other traditional liquors are not exclusive to Indonesia and are brewed in Africa and other Asian countries. “A lot of it is commercially distilled,” he said.

Room says the problem comes when the alcohol is distilled in backyards — that’s when things go wrong, and the alcohol contains methanol.

Appere, who is currently in Bali, says she felt euphoric and “high on life” while drinking arak. “At the time you feel invincible and go about dancing and having a good time not caring about anything or the repercussions of your actions,” she said. She has stayed away from arak this time around, sticking to drinks normally found in Australia.

“One of the girls I’m here with, my boyfriend and his mates all had arak one night last week and looked like death the next morning. The girl drinking the arak that night was acting exactly how I was acting — high on life and without a care in the world — but her head was in the toilet the next morning.”

Room says arak is no different to other distilled liquors like tequila or whisky, and does not have a stimulant effect like drugs such as cocaine or amphetamines. “A lot of what we experience is from expectations, so if you’re drinking something different, you are likely to expect a different outcome,” he said.

But Appere insists she felt something different that night, while she thought people were aware of the risks — to some degree. “I definitely do think there’s a correlation between arak and the amount of risk you’re willing to take,” she said.

There is no way to be certain if arak has been properly brewed. According to DFAT’s Smartraveller website, even bottled drinks may be incorrectly labelled and contents can be substituted with harmful ingredients.

So perhaps the best way to stay safe in Bali is to stay off the arak. And however cheap cocktails are, Bintang beer is about half the price!