Alcoholic energy drinks

ResearchBlogging.orgRaleigh News & Observer higher ed reporter, Eric Ferreri, had a nice frontpage article today on commercially-available energy drinks containing 12% (v/v) ethanol, similar to the amount in wine. These drinks are sold in 23.5 ounce servings, just shy of a 750 mL bottle of wine (25.4 ounces). North Carolina governor, Bev Perdue, wants these products removed from shelves temporarily while the state’s alcoholic beverage commission investigates after Washington and Michigan have banned sale of the products.

Perdue said in a news release Friday she wants the manufacturers to remove them from shelves voluntarily until they’re “proven safe.” A federal Food and Drug Administration study of these energy drinks is under way and eventually may answer the question.

The most prominent of these products is Four Loko, a malt beverage that comes in a variety of sweet, fruity flavors and also contains guarana, taurine and caffeine.

I hate to tell our governor but alcohol alone has been proven unsafe. But I digress.

As Ferreri notes, the trend of mixing caffeinated energy drinks with alcoholic beverages at bars has been common since the early 2000s. But the sale of the pre-mixed products has been relatively recent.

The overall concern with these products doesn’t seem to be that you pound back the equivalent of a bottle of wine. Instead, the caffeine in the products can cause one to appear alert when, in fact, one has a physiologically and functionally intoxicating blood alcohol level.

In 2006, the research team of Maria Lucia O. Souza-Formigoni at the Federal University of Sao Paulo, Brazil, tested subjects for a variety of subjective assessments and motor coordination tasks after a dose of alcohol (0.6 or 1.0 g/kg) with or without a Red Bull energy drink. Subjects had been previously given a meal of a Big Mac (a travesty for the IRB to let through given the amazing cuisine of the country).

The alcohol doses used allowed subjects to achieve peak blood alcohol level of about 0.04 and 0.10 g/dL in each treatment group. When data from the two alcohol groups were combined, those who had also had the energy drink reported less dry mouth, headache, dizziness and perception of impaired motor coordination. However, actual motor coordination (determined by the time it took to insert 25 pegs into a wooden board) and visual reaction time were equally impaired in the alcohol and alcohol plus energy drink group.  Moreover, the energy drink had no effect on blood alcohol concentrations at up to 2.5 hours after the dose.

Fig. 1. Breath alcohol concentration in grams per deciliter (gm/dL), after the ingestion of 0.6 or 1.0 g/kg alcohol (vodka 37.5% v/v) plus energy drink (ED) (3.57 mL/kg) or water. (Alcohol Clin Exp Res 30:598 (2006))

So, even if caffeinated energy drinks cause one to feel more alert while drinking alcoholic beverages, one’s blood alcohol levels can be deceptively high.

Whether states should disallow the sale of beverages that essentially mimic a practice that has been done in clubs for a decade is another issue.

I’m just blown away that one can of this stuff = one bottle of wine, caffeine or not.

Literature source:
Ferreira SE, de Mello MT, Pompéia S, & de Souza-Formigoni ML (2006). Effects of energy drink ingestion on alcohol intoxication. Alcoholism: Clinical and Experimental Research, 30 (4), 598-605 PMID: 16573577 DOI: 10.1111/j.1530-0277.2006.00070.x

Newspaper source:
Ferreri, Eric. Alcohol-caffeine mix raises state’s concern. Raleigh News & Observer, 13 November 2010.

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17 Responses to Alcoholic energy drinks

  1. Kierra says:

    I think part of the concern could also be dosing. The news report I heard said that the company that makes Four Loko doesn’t say exactly how much caffeine is in each drink, but the estimated amount was about the same as a 6-pack of Coke (204-274 mg depending on whether regular or diet). If this is significantly more than the energy drinks that are traditionally paired with alcohol (Red Bull by comparison is 80 mg per can), then this could be part of the safety issue.

  2. Janne says:

    Irish Coffee is of course a much older example of the very same thing, with a similar alcohol level. And it was invented specifically as a way to make people feel alert and awake. Nobody has seen fit to demand bars stop serving it as far as I know.

  3. Martijn says:

    In the UK there is a similar controversial drink called Buckfast Tonic Wine, a fortified wine (15% v/v) which contains the equivalent of 8 cans of cola in caffeïne per 750 ml bottle. It’s produced in license from a Benedictine monastery, who originally promoted it as a health tonic. No

  4. David says:

    @Kierra – Excellent points about the caffeine content. The Center for Science in the Public Interest has a good caffeine content page that obviously lacks information for the Four Loko products at this point. But they do list Spike Shooter and Cocaine, products with 288-300 mg caffeine per 8.4 oz serving – back in 2007, one of these was associated with a bunch of kids in Colorado Springs and Denver experiencing heart palpitations, shortness of breath, and nausea that scared at least two of them enough to seek medical attention.

    @Janne – Indeed. And Irish coffee is far more civilized and flavourful than what the taste of these beverages sound like. Thank you so much for coming by – I just happened over to your blog and quite enjoyed your perspective as a Swede living in Japan. Congratulations on the 77 kilo milestone and best of luck for continued good health! (and yes, the sofa photo does look like a good band promo)

    @Martijn – Now that sounds pretty bad – I wonder if the monks exhibit such poor behaviour while drinking this stuff.

  5. David says:

    Just a quick follow-up as I drove along the interstate yesterday and stopped at a convenience store to pick up a Red Bull (which I do when I can’t find good coffee). $2.99 for a 12 oz Red Bull but only $2.49 for the 23.5 oz, 12% EtOH Four Loko project. A few thoughts:

    1. If Four Loko can sell that much of a 12% EtOH product for $2.49 even with all the alcoholic beverage taxes, can you imagine how much the maker of Red Bull and other non-alcoholic energy drinks must be clearing in profits??

    2. To put the alcohol content in another perspective, one Four Loko product has the same amount of EtOH as more than four, 12 oz beers at 5% alcohol, or more than seven, 3.2% beers.

    3. I also realize that these calculations might be an incentive, not a deterrent, to some.

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  10. I think the concern is less with bars than with people getting hammered at a frat party and then walking into the street. That will kill you in Chapel Hill, drunk or sober!

  11. David Kroll says:

    Not dissimilar from Boulder then – right, Joel? :-)

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