If you're thinking about using energy drinks to stay up into the wee hours to welcome in the New Year, take care. The whopping caffeine dose and other additives in those drinks may be more harmful than you think.
"Unintentional caffeine overdoses have resulted in serious illness and rare deaths from caffeine poisoning," says Dr. Kent A. Sepkowitz a physician at Weill-Cornell Medical College in New York, in an editorial in the Journal of the American Medical Association. "Caffeine poisoning has only recently been characterized."
Considered "dietary supplements" by the U.S. Food and Drug Administration, energy drinks do not have to conform to the same regulations as traditional caffeinated sodas or over-the-counter caffeine pills. The same additives that give energy drinks their special status may also interfere with the body's ability to metabolize caffeine. This could lead to increased or prolonged levels of caffeine in the blood.
Alcohol can also be very dangerous when added to the equation, experts say. Very little is known about the combined effect of alcohol mixed with energy drinks -- or AMED, for short. These include cocktails mixed at bars -- like the popular RBV, or Red Bull and vodka -- and alcohol and energy drinks consumed separately but within the same night. Premixed caffeinated alcoholic drinks (like the original Four Loko and Sparks) were essentially banned by the FDA in 2010.
The current theory is that the high dose of caffeine in energy drinks offsets the sedating effect of alcohol, making your brain think you're less drunk than your body feels. This disconnected and inebriated version of you might be more likely to engage in risky behaviors such as drunken driving or sexual assault. The masked intoxication may also lead people to drink more than they would normally.
However, there is very little evidence to support these theories. Studies show that compared to the usual alcohol drinker, people who drink AMED are more likely to leave the bar drunk, try to drive drunk or engage in other risky behavior. In another JAMA editorial, lead author Jonathan Howland at the Department of Emergency Medicine at Boston University said that AMED consumers may be "inherently more prone to risk-taking behaviors. It is possible that personality traits such as impulsivity and sensation seeking cause AMED consumption, rather than AMED causing risky behavior."
Although the studies on these products are inconclusive, 2012 has not been a good year for energy drinks.
"The swift change in public perception of energy drinks from harmless mild stimulant to lethal, unregulated drug is unprecedented," said Sepkowitz in his editorial. After reports of illness, injury and death after consuming energy drinks, the FDA reinvigorated its investigation of these products. Even the Air Force is concerned, launching a survey of 12 bases to better understand energy drink use.
Recently, the FDA reported that Monster energy drink may have been involved in five deaths. Additionally, the five-hour energy drink, a popular energy shot loaded with caffeine, may have played a part in 13 deaths and 33 hospitalizations over the past four years. According to Sepkowitz, "To reach the possibly lethal dose of 3 grams of caffeine, a person would need to ingest at least 12 of the highly caffeinated energy drinks within a few hours."
Despite the bad publicity, energy drink makers will not likely lose their buzz – sales of energy drinks in the U.S. were $9 billion in 2011. Six percent of young American men and 45 percent of US overseas troops consume energy drinks daily.
The best advice? Experts advise welcoming the New Year with moderation and safety. In general, less than 500 mg of caffeine per day is considered a safe daily dose for an adult, 100 mg for an adolescent and none for young children. While the interaction of energy drinks and alcohol is unclear, one thing is for sure: excess caffeine will dehydrate you and slow your New Year's Day hangover recovery.