- Published on Tuesday, 30 November 2010 20:40
Despite multiple state bans on caffeinated alcoholic beverages (CABs) and an FDA warning to four companies to remove their products from the marketplace, the drinks, which may increase alcohol-related risk behavior, warrant further research, says an article co-authored by a BUSPH researcher and published online Nov. 30 in the American Journal of Preventive Medicine.
"Although several manufacturers of caffeinated beer have withdrawn their products from the market, there is no sign that young people have decreased the practice of combining alcohol and energy drinks," said lead author Jonathan Howland, professor of community health sciences at the BU School of Public Health. "Critically, CABs may increase alcohol-related risks in a number of different domains, but have been subject to very little systematic research."
The article provides numerous references from scientific literature, newspapers and magazines describing the current understanding of the effects of stimulants combined with alcohol. One study found that bar patrons who consumed CABs had a three-fold risk of leaving the bar highly intoxicated, compared to those who consumed alcohol without caffeine, and a fourfold risk of intending to drive after leaving the bar. Another study concluded that students who consumed CABs had approximately double the risk of experiencing or committing sexual assault, riding with an intoxicated driver, having an alcohol-related accident, or requiring medical treatment.
The root of the problem may have started with so-called energy drinks, the authors said. Depending on the brand, these beverages contain several stimulants, primarily caffeine, but also guarana, taurine, and sugar derivatives. Of the 577 caffeinated beverages listed on the Energy Fiend website in 2008, at least 130 contained more than the 0.02 percent caffeine limit for soft drinks imposed by the FDA.
Combining these energy drinks with alcohol became popular when marketers promoted the perception that energy drinks counteract the sedating effects of alcohol, the article says. According to a 2006 survey, 24 percent of college students reported mixing energy drinks with alcohol in the past month.
"Advertising messages depict energy drinks as a means to enhance energy and alertness and to prolong partying and nightclubbing," the authors wrote. "Marketing promotes the perception that energy drinks counteract the sedating effects of alcohol and related impairment."
Howland and his co-authors said research is needed "to examine the effects of CABs, relative to noncaffeinated alcohol and caffeine alone, on cognition and safety-related behaviors and outcomes. This is especially true in terms of functional outcomes, such as driving ability and sexual risk behaviors…
"The answers to these questions are knowable through well-controlled experimental trials and survey research, and the findings could directly inform changes in policy to reduce the risk from CABs. Thus, the emerging public health response to CABs should include a research agenda that provides evidence-based information for policymaking and public education."
The FDA issued warning letters on Nov. 17, 2010, to four companies, indicating that further actions, including seizure of their products, is possible under federal law. States with previously announced bans include New York, Washington, Iowa, Kansas, Massachusetts, Oregon, and Michigan.
The article -- "Caffeinated Alcoholic Beverages: An Emerging Public Health Problem" -- was co-authored by Damaris J. Rohsenow, Tamara Vehige Calise, James MacKillop and Jane Metrik.
Submitted by: Lisa Chedekel