Caffeine with alcohol: A dangerous combination
The bottom line
Lots of alcohol plus lots of caffeine equals danger, with possible results ranging from sexual assault to automobile crashes to alcohol-induced coma or even death.
Prevention Tips
If you choose to drink caffeine with alcohol, avoid too much of either.
This Really Happened
A school nurse called their poison center. A 13-year-old boy had ingested 2 cans of a caffeinated energy drink containing alcohol. He was vomiting, sweating, and intoxicated. The poison center reviewed the toxicity of these products with the nurse, and recommended supportive care until the ambulance arrived. The child was treated in the emergency room where he received intravenous fluids and a medication to stop his vomiting. After a period of observation, he was sent home.
The full story
College students across the country were treated for alcohol poisoning after drinking inexpensive, fruity, carbonated, high-alcohol drinks with a hefty dose of added caffeine. Brand names included Four Loko®, Joose®, Max, Core High Gravity, Lemon Lime Core Spiked, and Moonshot. A single can of such drinks contained as much alcohol as four beers and as much caffeine as a large cup of strong coffee.
These beverages contained malt liquor plus caffeine, often along with caffeine-containing guarana and taurine. The U.S. Food and Drug Administration (FDA) ruled that there is no evidence that adding caffeine to alcoholic beverages is safe and required manufacturers to remove caffeine from caffeinated high-alcohol beverages.
Consumed quickly, a single can of a carbonated, high-alcohol beverage caused rapid intoxication. The presence of large quantities of caffeine meant that typical feelings of intoxication might be masked, even though the drinker's blood alcohol level is high. Drinkers consumed more of the beverage, not realizing that they were already drunk. Caffeine alters the way drinkers perceive the effects of their alcohol intake, but does not in any way affect the actual level of alcohol in their systems.
Studies compared college students who drank alcohol plus caffeine-containing energy drinks with students who drank alcohol alone. Those who consumed caffeine with alcohol were more likely to be intoxicated and more likely to plan to drive. Also, they were more likely to be victims or perpetrators of sexual assault, to be injured, and to require medical attention.
It is true that anyone is free to combine and drink alcohol and caffeine. Irish coffee, rum and Coke, and, more recently, spiked energy drinks (e.g. Red Bull and vodka) can be mixed at home or served in a bar. The caffeinated high-alcohol drinks, though, combined enough, or nearly enough, alcohol in a single serving to constitute binge drinking, plus enough caffeine to override the expected feelings of inebriation.
To sum up: Lots of alcohol plus lots of caffeine equals danger, with possible results ranging from sexual assault to automobile crashes to alcohol-induced coma or even death. If you believe that someone has swallowed too much alcohol or caffeine, use the webPOISONCONTROL online tool to get help, or call your poison center at 1-800-222-1222. If someone is unconscious or nearly so, call 911 immediately.
For More Info
References
FDA Warning Letters issued to four makers of caffeinated alcoholic beverages: These beverages present a public health concern. Accessed 5/24/2014.
