The implications of alcohol mixed with energy drinks from medical and socio-legal standpoints

Abstract

Co-ingestion of energy drinks and alcohol has long been in practice and has been poorly regulated despite a growing body of literature of their potential negative health impacts. Co-ingestion of energy drinks with alcohol has multiple counter-active effects such as reduction of body sway, fatigue and sedative effects induced by alcohol, along with increased subjective feeling of alertness, which may lead to increased binge-drinking, intoxication, decreased perception of intoxication, dehydration, and alcohol poisoning. Adding energy drinks to alcohol may also have synergistic effects in causing alcohol dependency and addiction. The association between caffeine, a common active ingredient in energy drinks, and alcohol is relatively well defined, however association with other active ingredients such as taurine, niacin, and pyridoxine, is less understood, pointing to a gap in our knowledge regarding this practice. Nonetheless, the current associations between AMED (Alcohol Mixed with Energy Drinks) and risky behavior secondary to intoxication and cases of alcohol poisoning have led various national governing bodies to regulate this practice. This review highlights the potential effects of AMED on human physiology based on what is known from human and animal models, and sheds light on specific biochemical interactions between alcohol and active ingredients found in energy drinks; Caffeine, Taurine, and Glucuronolactone. The review also touches on the regulation of this practice around the world, and the impact it has on its users, and points researchers to gaps in our knowledge on the interactions between alcohol and EDs and the full extent of their effects.

Energy drink consumption among medical students in Jordan – prevalence, attitudes, and associated factors: a cross-sectional study

“…Alcohol mixed with energy drinks (AMED) results in various opposing effects including diminished body sway, fatigue, and sedation caused by alcohol, coupled with heightened subjective alertness. This combination may contribute to elevated instances of binge-drinking, intoxication, reduced awareness of intoxication, dehydration, and the risk of alcohol poisoning 33 . Some studies found also an association between ED consumption and the habit of smoking 1 , 15 – 17 .…”

Medical and forensic aspects of energy drinks and caffeine shots

“…Combining alcohol with energy drinks is a highly popular practice among young adults and adolescents. Although it is not fully understood why these age groups are so inclined towards this combination, some literature suggests that it may be related to improving the taste of alcohol and seeking an additional source of energy [50]. It has been demonstrated that consuming energy drinks with alcohol enhances the euphoric effects of the alcohol, acts as a stimulant, prolongs the drinking session, and also increases the likelihood of developing the alcohol use disorder (AUD) [51].…”

Binge drinking and the risks to adolescent health

“…Another very common practice among teenagers is to consume a mixture of energy drinks and alcohol, the mixture of which causes, among other changes, a false subjective sensation of alertness, which can lead to increased alcohol consumption and increase the harmful effects on the body 36,37 .…”