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11-fold hike in emergency room visits related to energy drinks

by December 6th, 2011

Despite a Washington state ban and tough federal enforcement against energy drinks containing alcohol, alcohol-free energy drinks with up to five times the caffeine blast of a cup of coffee pose growing public health concerns. According to a new study published in late November by an arm of the U.S. Department of Health and Human Services, emergency department visits related to alcohol-free energy drinks – consumed alone and sometimes with other substances – were 11.6 times greater in 2009 than in 2005. Energy drink-related emergency visits grew in number from 1,128 in 2005; to 3,126 in 2006; 10,052 in 2007; 16,053 in 2008, and 13,114 in 2009, the most recent year for which data were available.

Researchers also concluded that the majority of the energy drink-related ED visits were made by patients aged 18 to 39 and nearly 45 percent of the visits involving energy drink-related emergencies were made by young adults aged 18 to 25. There are many different variations of energy drinks. Some contain alcohol, which researchers say may compound the effect of the stimulant effects of caffeine. However, this study focuses on energy drinks which alone, do not contain alcohol.

Researchers working for the Drug Abuse Warning Network (DAWN) of HHS’s Substance Abuse and Mental Health Services Administration divided the ED visits into two categories; visits which only involved energy drinks and those visits which involved energy drinks in combination with pharmaceuticals, alcohol, and/or illicit drugs. Of those reported visits, an estimated 56 percent involved energy drinks only, while roughly one quarter of the visits involved energy drinks combined with pharmaceuticals, 16 percent energy drinks combined with only alcohol, and another 10 percent energy drinks combined with illicit drugs.

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Additional reports have found that high levels of caffeine in energy drinks when mixed with alcohol can actually induce an artificial sense of mental alertness amongst college students. This false sense of sobriety after a night of drinking could in turn lead to higher risks of driving drunk, researchers report.

Caffeine and alcohol – a bad brew
One study cited in the DAWN report found that bar-goers who consumed alcohol mixed with energy drinks were four times more likely to leave the bar with the intent of driving than those who did not consume alcoholic beverages mixed with energy drinks. This same study also established connections between energy drink consumption and detrimental behaviors including fighting, drinking, smoking, and drug use.

However, such reports which expose the associated risks with energy drinks have done little to stymie the high grossing sales of companies such as Red Bull, Monster, Rockstar, Full Throttle, and Amp which make up the majority of the energy drink market. The DAWN study says the caffeine dose in a can or bottle of an energy drink ranges from 80 to 500 milligrams, versus about 100 in a five-ounce cup of coffee or 50 in a 12-ounce cola.

Sales spiked sharply from ’04 through ’09
Sales from energy drinks have increased 240 percent from 2004 to 2009, and marketing and ad campaigns of energy drinks have become increasingly savvy and innovative. Many energy drink companies claim added benefits such as increased energy and stamina, enhanced mental abilities, and even weight loss, while masking the potential of harmful side effects, especially when combined with alcohol and/or other drugs.

More public education urged
The study warns that excessive caffeine intake from energy drinks has its risks, especially when combined with alcohol and/or other drugs and strongly recommends that public awareness campaigns focusing on the health effects of energy drinks are needed.

Permanent ban on alcohol-containing energy drinks in Washington, other states
Energy drinks already containing alcohol are outlawed in several U.S. states. After a fall 2010 college party gone wrong in central Washington state, they were banned state-wide under a 120-day emergency rule. Following public testimony in early 2011, the ban was made permanent in April. It will stay in place after the state gets out of the retail liquor business in June, 2012, according to Liquor Control Board Communications Director Brian Smith. For good measure, the U.S. Food and Drug Administration effectively banned caffeinated alcoholic beverages as well by mid-November 2010, through direct intervention with manufacturers. But according to a report by The Local: East Village, a blog partnered with the New York Times, despite a New York state ban the popular brand Four Loko was still found for sale in some stores in New York City in July, 2011.

Video from UW pharmacology doctoral candidate Paul Tran
More on health guidelines for non-alcoholic energy drinks in the video below from Paul Tran, vice president and co-founder of the Youth Health Alliance, and a University of Washington 2012 pharmacology doctoral candidate. From 3:15 forward, Tran warns against mixing energy drinks with alcohol, and recommends a daily limit on energy drink intake.

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