Caffeinated Cocktails: Energy Drink Consumption, High‐risk Drinking, and Alcohol‐related Consequences among College Students

Abstract

Objectives: The consumption of alcohol mixed with energy drinks (AmED) is popular on college campuses in the United States. Limited research suggests that energy drink consumption lessens subjective intoxication in persons who also have consumed alcohol. This study examines the relationship between energy drink use, high-risk drinking behavior, and alcohol-related consequences. Methods:In Fall 2006, a Web-based survey was conducted in a stratified random sample of 4,271 college students from 10 universities in North Carolina.Results: A total of 697 students (24% of past 30-day drinkers) reported consuming AmED in the past 30 days. Students who were male, white, intramural athletes, fraternity or sorority members or pledges, and younger were significantly more likely to consume AmED. In multivariable analyses, consumption of AmED was associated with increased heavy episodic drinking (6.4 days vs. 3.4 days on average; p < 0.001) and twice as many episodes of weekly drunkenness (1.4 days ⁄ week vs. 0.73 days ⁄ week; p < 0.001). Students who reported consuming AmED had significantly higher prevalence of alcoholrelated consequences, including being taken advantage of sexually, taking advantage of another sexually, riding with an intoxicated driver, being physically hurt or injured, and requiring medical treatment (p < 0.05). The effect of consuming AmED on driving while intoxicated depended on a student's reported typical alcohol consumption (interaction p = 0.027).Conclusions: Almost one-quarter of college student current drinkers reported mixing alcohol with energy drinks. These students are at increased risk for alcohol-related consequences, even after adjusting for the amount of alcohol consumed. Further research is necessary to understand this association and to develop targeted interventions to reduce risk. ACADEMIC EMERGENCY MEDICINE 2008; 15:453-460 ª 2008 by the Society for Academic Emergency MedicineKeywords: energy drinks, alcohol, injury E nergy drinks are beverages that claim to provide a burst of energy by using a combination of caffeine (the principal active ingredient), other plant-based stimulants (e.g., guarana, yerba mate), simple sugars (e.g., glucose, fructose), glucuronolactone (a naturally occurring glucose metabolite), amino acids (e.g., taurine, carnitine, creatine), herbs (e.g., ginkgo biloba, ginseng), and vitamins. The effects of these ingredients are incompletely understood. A 6-ounce serving of brewed coffee contains 100 mg of caffeine; the caffeine content of energy drinks varies considerably, with some energy drinks containing more than 300 mg or more per serving.

Energy drink use frequency among an international sample of people who use drugs: Associations with other substance use and well-being

“…It may also be that co-consumption of alcohol with EDs reduce hangover effects, making alcohol use less subjectively problematic. Use to reduce hangover symptoms is flagged by a significant minority of consumers (O'Brien et al, 2008), although these studies have typically focused on university students, with few experimental studies exploring this possible phenomenon (Rohsenow et al, 2014). Regardless, frequency of ED use could serve as flag in clinical settings for potential hazardous alcohol use, important given possible stigma associated with reporting problematic alcohol use (Fortney et al, 2004).…”

Caffeinated Alcohol, Sensation Seeking, and Injury Risk

“…15 Even after adjusting for the increased alcohol consumed, college students who drank CaffAlc beverages reported significantly higher prevalence of serious alcohol-related consequences, including alcohol-related illness or injury, sexual assault, and riding with a drunken driver. 14 Several mechanisms have been suggested to explain the observed association between CaffAlc, risky drinking, and alcohol-related harms. Drinkers who believe that caffeine neutralizes the depressive effects of alcohol may expect that by consuming CaffAlc, they can safely tolerate greater quantities of alcohol without impairment.…”

“…13 The consumption of caffeinated alcohol (CaffAlc) has been found to be significantly associated with increased frequency of high-risk drinking behaviors in college students, including heavy episodic drinking and weekly drunkenness. 14 A study of patrons exiting a U.S. college bar district found individuals who consumed CaffAlc to be three times more likely to be legally intoxicated than individuals who consumed alcohol alone, 15 and four times more likely to report intention of driving, compared to patrons who consumed only alcohol. 15 Even after adjusting for the increased alcohol consumed, college students who drank CaffAlc beverages reported significantly higher prevalence of serious alcohol-related consequences, including alcohol-related illness or injury, sexual assault, and riding with a drunken driver.…”

“…A target response quota of 33% over a 5-week fielding period was set, based on power calculations for the overall SPARC trial. 14,31,36 The survey procedures have been described in detail previously. 14,31,36 The survey site was shut down shortly after the required number of surveys was received; the final response rate was 34.8%.…”

Alcohol Mixed with Energy Drink Use and Sexual Risk-Taking: Casual, Intoxicated, and Unprotected Sex

“…[20][21][22] A growing body of research has found AmED use to be associated with significantly more risky behavioral outcomes than noncaffeinated alcohol use alone. O'Brien et al 23 found that college student AmED users reported more drinks per typical occasion, twice as much drunkenness and binge drinking, and more alcohol-related unwanted outcomes than those who drank alcohol alone; they were more likely to take advantage of someone or be taken advantage of sexually, ride with a drunk driver, be hurt or injured, require medical treatment, and (for moderate drinkers) drive while intoxicated. These findings were largely replicated by Brache and Stockwell 20 in a Web survey of Canadian students, for whom frequent AmED use was associated with more frequent drinking and with higher odds of heavy episodic drinking, drinking and driving, or being hurt or injured.…”