Caffeinated alcoholic beverages raising concerns of abuse

Alcohol and caffeine long have enjoyed a cozy relationship, from drinking coffee to sober up after a night of drinking (See: any black-and-white movie or TV show) to nightclubbers employing energy drinks as cocktail mixers (See: any nightclub on the Strip at about 2 in the morning).

But a new generation of beverages that combine alcohol with caffeine in one hefty, easy-to-chug serving may, critics contend, pose some unique health risks, particularly among young and inexperienced drinkers.

Unlike energy drinks (which contain no alcohol) and malt beverages (which typically contain little or no caffeine), this new breed of caffeinated alcoholic beverage packs both stimulant (caffeine and guarana, a caffeine-containing fruit) and depressant (alcohol) in one drinkable dose.

The problem, explains Dr. Elissa Palmer, chair of the University of Nevada School of Medicine's family and community medicine department, is that "the alcohol is depressing your system, but the caffeine stimulates it so you don't really feel the effects of the alcohol still taking place."

The body typically defends itself from the harmful effects of alcohol by making the drinker sick or sleepy or even causing him to pass out. Here, Palmer says, the caffeine "stimulates your body so that you can still continue to drink and make you think you averted the effects of the alcohol, but the alcohol level in the bloodstream is still rising."

Dr. Michael Bachman, medical director of emergency services at Sunrise Children's Hospital, notes that a single can of a caffeinated alcoholic beverage -- one popular brand, Four Loko, comes in 23.5-ounce cans that contain 12 percent alcohol by volume -- can equal the alcoholic content of three cans of beer as well as "a large amount of caffeine, so the person drinking it doesn't know how intoxicated they are and just keeps on drinking."

That's where things can take a potentially lethal turn. With the body's natural defenses against intoxication short-circuited, the drinker's blood alcohol level could rise to dangerous levels, resulting in a trip to the emergency room at best.

And, at worst, adds Dr. Dale Carrison, chairman of emergency medicine at University Medical Center, alcohol intoxication "can kill you. You can have alcohol poisoning and die from it."

"We, obviously, worry about that," Carrison says. "But the other worry is that they're going to do dumb things, because alcohol makes you feel invincible. And when you're jacked up on this, the last thing we need is for them to get behind the wheel of a car or go and try to do some stunt they normally never would try to do and get traumatized and end up in the hospital."

Carrison says UMC's pediatric ER regularly sees intoxicated kids and youths -- including, most recently, several on Halloween -- while Bachman says Sunrise's pediatric ER treats youths with alcohol intoxication "at least a couple of times a week."

"There are children who die from this," he adds. "This is not a joke. Kids do sometimes die from alcohol intoxication."

While caffeinated alcoholic beverages aren't new -- several classic cocktails, including Irish coffee, are built upon a combination of alcohol and coffee -- Bachman says this new breed of pre-mixed drinks "are packaged and marketed in such a way that they attract young, impressionable teenagers and college students."

Larry Ashley, an addiction specialist in the University of Nevada, Las Vegas' Department of Counselor Education, notes the drinks' cans are "hot and funny and psychedelic. It's a business, so it is a marketing thing. They're not targeting older folks. They're targeting the in-crowd, so to speak."

Recently, several incidents involving such drinks have hit the news -- including reports of students at college parties in Washington and New Jersey ending up in emergency rooms after allegedly drinking the beverages -- have prompted some to call for their ban.

The website of the manufacturer of Four Loko, the drink reportedly involved in the Washington incident, notes that Four Loko is not, and is not marketed as, an energy drink but, rather, as a caffeinated alcoholic beverage. Four Loko cans do describe the drink as a "premium malt beverage" while the words "contains alcohol" circle the cans' tops.

The company also argues that its products are being unfairly singled out and notes that, in the Washington incident, police reports indicated that other alcoholic beverages also were found at the scene and that some of the drinkers there reportedly were underage.

Several colleges have taken the unusual step of urging students to avoid the drinks completely.

UNLV spokesman Dave Tonelli says university administrators there "haven't seen any particular issue" with such drinks at UNLV. But, he adds, "that's not to say students aren't aware of it and may not consume it off campus."

Tonelli says the university encourages students who do drink "to drink responsibly and, to that end, we're actually preparing a communication out of our student health office about the dangers of mixing caffeine and alcohol."

Given the recent incidents, he says, "we felt a prudent response to the recent publicity around these products is to talk to students about the dangers, so they're at least informed about how mixing caffeine and alcohol can shortcut some of the defenses your body has, and to please be responsible."

And that, Bachman says, ultimately may be the most effective weapon parents have in steering their kids away from potentially dangerous incidents.

"Kids should understand the dangers of alcohol and should understand that it's not simply an energy drink they're drinking," he says.

"It is an alcoholic beverage," Bachman says, and one that poses "serious risks. So parents really need to discuss the issue with their kid and should be aware of what's going on nationally with these trends."

Contact reporter John Przybys at jprzybys@ or 702-383-0280.