Caffeine + alcohol: deadly combo

by Dr. Philip S. Chua.
December 10, 2010
In this column seven months ago, April 26, 2010, we warned the public about the dangers of caffeinated energy drink plus alcohol, with the following article:
Combining alcoholic beverage with caffeine energy drink is a popular cocktail today. This mix has been found to be dangerous, leading to higher state of drunkenness and severely impaired driving, compared to drinking alcoholic drink alone. “There’s a very common misconception that if you drink caffeine with an alcoholic beverage the stimulant effect of the caffeine counteracts the depressant effect of the alcohol, and that is not true,” says Bruce Goldberger, director of toxicology in the University of Florida College of Medicine. Being wide awake and drunk can lead to dangerous, if not deadly, behaviors.

FDA to ban energy drinks
Last week, following reports of several deaths and dozens of hospitalizations among young adults who ingested the caffeinated alcoholic energy drink, the US Food and Drug Administration decided to ban the sale these beverages. New York Sen. Charles Schumer supported the ban on the drinks marketed as Four Loko and Joose, and stated that “the Federal Trade Commission planned to notify manufacturers that they are engaged in the potential illegal marketing of unsafe alcoholic drinks.”

The super caffeinated beverage, which contains anywhere between 50-500 mg of caffeine and between 5-12% alcohol, has been deemed unsafe by the FDA.

The drinks are very popular among college students and young children. The US Centers for Disease Control and Prevention estimated that the concoctions “are consumed by 31% of 12- to 17-year olds and 34 percent of 18- to 24-year olds.”

Individuals who drink these energy drinks are 3 times more likely to lead to binge drinking, compared to those who consume alcoholic drinks only. The caffeine in the energy drink appears to “keep the drinker less sedated,” masking the feeling of drunkenness from the initial effect of the alcohol and prolong the drinking session. Then, after a few hours, the cumulative effects of the high dose of caffeine and the high alcohol level in the blood take their toll. These energy drinks also make it easier for people to develop alcohol addiction.

Unsafe, pre-mixed or not
New studies revealed that drinking caffeine and alcohol, even not pre-mixed in a can, even if ingested separately but one after the other, almost simultaneously, poses the same danger and risk to health.

Another finding reported by showed that “college students who consume nonalcoholic energy drinks such as Red Bull at least once a week are more than twice as likely as their peers to show signs of alcohol dependence, including withdrawal symptoms and an inability to cut back on drinking, according to the study,” which was published in the journal Alcoholism: Clinical & Experimental Research.

The common scenario describes students who party the whole night and have to cram for an exam the following day. They then resort to energy drinks with alcohol during the party, and drink non-alcoholic drink like Red Bull in the morning to shake hangover and keep them awake for the test. The amount of caffeine in Red Bull has the adverse effects of nervousness, anxiety, headache, rapid heart rate, palpitation, and insomnia. Other energy drinks include Rockstar, Monster, Burn, Full Throttle, and Amp, which, led by Red Bull, the market leader, had around $5 billion sales in the United States in 2008.

Cocaine controversy
There were reports in April and June 2009 that Red Bull cola drinks imported from Austria were found to contain between 0.1 – 0.3 microgram of cocaine per liter, according to Hong Kong officials. Importing cocaine is illegal and carries life imprisonment or death. Out of 16 German states, 11 have already banned the energy drinks as of May 25, 2009.

An article in The Daily Telegraph on February 3, 2000 reported, “Red Bull may have triggered heart condition that killed the 21 year-old woman who died after drinking four cans of Red Bull and alcohol.”

Synthetic marijuana
Another teenagers’ new drug of choice is synthetic marijuana, sold under the names K2 and Mr. Nice Guy. A death claimed to be due to this substance has brought it under scrutiny by the FDA, the media, and the public. These items, peddled on the streets and some stores discreetly, are cheaper than genuine marijuana and are not detectable by standard lab exam. This synthetic drug causes paranoia, hallucination, vertigo, mental confusion, and exacerbate schizophrenia. Driving under the influence of this drug could kill not only the driver but other drivers, passengers and pedestrians.

Calling BFAD and DOH
In view of these startling developments, it behooves the Philippine Bureau of Food and Drug, the Department of Health, and other related national and local government agencies to ban these dangerous substances in the entire nation.

As concerned citizens, we must also do our share in protecting our own communities by being proactive in addressing this issue at home, in school and in public in general. Let us not wait for fatalities before we do something about it.

After all, when it comes to health, prevention is the best cure. #
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