Mixing Energy Drinks with Alcohol - Research Paper Example

Table of Contents Introduction………………………………………………………………………………………..2 Ban of Alcoholic Energy Drinks on College Campuses………………………………2 What Has Occurred Since The Ban?.............................................................................2 Harmful Effects of Mixing Energy Drinks with Alcohol……………………………..3 Health Risks of Mixing Energy Drinks with Alcohol………………………………...6 Literature Review………………………………………………………………………………….7 Short and Long-Term Risks of Caffeinated Alcoholic Beverages……………………7 How CABs Work……………………………………………………………………...8 Universities Respond to CABs………………………………………………………11 The Problem……………………………………………………………………………………...12 The Plan………………………………………………………………………………………….12 Awareness...………………………………………………………………………….12 Benefits………………………………………………………………………………13 Summary…………………………………………………………………………………………14 References………………………………………………………………………………………..15 Introduction Ban of Alcoholic Energy Drinks on College Campuses On the 17th of November, 2010, the United States Food and Drug Administration (FDA) issued written warnings to manufacturers of alcoholic beverages that included caffeine, such as Four Loko, Tilt, and Torque (FDA, 2010). The FDA gave these manufacturers 15 days to either take out caffeine from their beverages or to stop selling them altogether. When the FDA issued these warnings in 2010, many New Jersey colleges and universities took action, such as Drew University, Fairleigh Dickinson University, Rider University, and Ramapo College. According to the New York Times, the president of Ramapo College, Peter Mercer, banned energy drinks that combined caffeine and alcohol after many students were hospitalized because of their consumption of these products, particularly Four Loko (Goodnough, 2010a). Although Rutgers University did not take any action, a university spokesman, Greg Trevor, told the The Star-Ledger the following: “We support the proposed federal ban on caffeinated alcoholic beverages nationwide” (starledger). However, since the year 2010, Rutgers University has so far not banned alcoholic energy drinks. What Has Occurred Since The Ban? Even though there have been bans on alcoholic energy drinks at many universities across the country, students have discovered alterative ways to experience the same effects of alcoholic energy drinks; this includes mixing energy drinks with alcohol by themselves. Mixing these drinks based on their own ratios can cause more problems than if they were on supermarket shelves (Cloud, 2008). Harmful Effects of Mixing Energy Drinks with Alcohol Immediate neurological impairments are caused when students consume alcohol. These impairments may cause the drinker to physically injury themselves or put themselves into situations they may later come to regret. The Center for Disease Control (CDC) recommends “when alcoholic beverages are mixed with energy drinks, which is a popular practice among youth, the caffeine in these drinks can mask the depressant effects of alcohol” (CDC, 2010). When an energy drink is mixed with alcohol, a natural chemical known as adenosine is produced by the human body. When a person becomes tired, the brain receives a signal to become sleepy through the use of adenosine (Crane, 2011). However, this is not the case when caffeine is ingested. When this happens, the message never gets to the brain; instead, adrenaline is produced. Adrenaline can have a significant effect on your body. It “…raises your heart rate and blood pressure and triggers the liver to release sugar into the bloodstream. All of this results in a temporary jolt of energy” (Crane, 2011). Often times, the mixture of energy drinks with alcohol may require an emergency room visit to a local hospital. According to The Drug Abuse Warning Network (DAWN), “…more than two-thirds (67 percent) of ED visits involving energy drinks were classified as adverse reactions, and approximately one-third (33 percent) involved the misuse or abuse of drugs” (The Dawn Report, 2011). Figure 1: Reason for Emergency Department (ED) Visits Involving Energy Drinks Only or in Combination with Other Drugs: 2004 to 2009 These statistics are very alarming considering that over half of all energy drink combinations occur as a result of misuse or abuse. Facts regarding mixing energy drinks and alcohol from the Center for Science in the Public Interest are displayed below: Research shows that 31 percent of energy drink consumers are between 12 and 17 years old, while 34 percent are aged between 18 and 24 Almost 25 percent of college student drinkers report mixing alcohol with energy drinks Fifteen percent of college students mix alcohol with energy drinks in order to drink more so as to not feel drunk College students who report consuming alcohol with energy drinks drink significantly more during a typical drinking session. Compared to drinkers who do not consume alcohol mixed with energy drinks, they report twice as many heavy drinking days and twice as many episodes of weekly drunkenness 5000 people under the age of 21 die each year from alcohol-related injuries According to this source, “…users consumed one energy drink with a reported frequency of one to four days per month, and many users consumed three or more drinks when combining alcohol while partying” (Malinauskas, 2011). Caffeine can be very addictive, especially for students due to their long hours of high stress. This reduces sleep patterns, but caffeine allows them to stay alert. “One hundred and thirty of these products [energy drinks] contain more than the 0.02 percent caffeine limit that the U.S. Federal Drug Administration requires for soft drinks” (Howland, 2011). Energy drinks have become very popular for college students because of its perceived positive effects: “Using energy drinks is a popular practice among college students for a variety of situations, such as to compensate for insufficient sleep, increase energy while studying, driving for long periods, and drinking with alcohol while partying, and also to treat a hangover” (Attila, 2011). Cardiovascular problems are very common among caffeine drinkers. “Energy drinks have stimulating properties that can boost heart rate and blood pressure, dehydrate the body, may aggravate the effects of other stimulants, and can prevent sleep” (Attila, 2011). It is recommended to get at least eight hours of sleep per night, but a study has shown that students are getting nearly an hour less than that figure (Carskadon, 2011). Another study found that respondents had a caffeine intake that exceeded the recommended maximum amount by three to five times (Mcllvain, 2011). Excessive caffeine intake causes the heart to overwork, and this could lead to cardiac arrest (Melina, 2011). Individually, caffeine and alcohol both have negative outcomes, but together the outcomes are exasperated. Caffeine masks the feelings of intoxication. Many students here at Rutgers University are often inexperienced when it comes to alcohol let alone mixing energy drinks with it too. Consuming caffeine and alcohol together it makes more difficult for a person to know their limits; blacking out is common when drinkers do not know that they are intoxicated. Health Risks of Mixing Energy Drinks with Alcohol The combination of mixing energy drinks with alcohol can cause health risks that develop from the use and abuse of alcohol. These include but are not limited to: liver problems, multiple cancers, and immediate neurological impairments. Alcohol and caffeine can cause short-term and long-term problems when adding young people to the equation; it is like adding salt to the wound. The problems associated with caffeine are osteoporosis, addiction, and cardiovascular risks. Although college students are still relatively young, they may not be aware of the long-term risks that alcohol poses. Students, mainly young adults, are often pressured by their peers into situations that may cause harm to themselves or others. More often than not, alcohol is involved in poor decision making, and mixing highly caffeinated beverages only makes the situation worse. Not only are energy drinks being used to help students stay awake, the use of energy drinks at parties is becoming a growing problem, especially on college campuses. The feeling from energy drinks gives a greater affect when used in conjunction with alcohol (Marczinski, 2011). Multiple cancers are associated with alcoholic consumption. “Alcohol may act as an irritant, especially in the mouth and throat. Cells that are damaged may try to repair themselves, which may lead to DNA changes in the cells. This can be a step towards cancer” (American Cancer Society, 2012). The definition of cancer is abnormal cells that reproduce and create other abnormal cells that inhibit the body’s natural way of acting (National Cancer Institute, 2012). In a similar way to cancer, osteoporosis affects the protein cells in the bones. Caffeine causes the protein cells to weaken by absorbing the body’s calcium. Osteoporosis can lead to broken bones, and many know that this may disable a geriatric for the remainder of his or her life. Literature Review Short and Long-Term Risks of Caffeinated Alcoholic Beverages The FDA had both reviewed existing medical literature and conducted independent lab tests on alcoholic beverages and found them to be representative of a significant public health concern (FDA, 2010). As more data has surfaced suggesting the health risks associated with these beverages, it is necessary to evaluate how their use and availability on college campuses could impact students’ general health and well-being. Based on an analysis of recent peer-reviewed studies, this literature review will provide a background context from which to view the issue, contribute to the identification of methods and interventions that will raise awareness on campus at Rutgers, and contribute suggestions for reducing the harm that results from the use of alcoholic caffeinated beverages. Alcoholic beverages with added caffeine are relatively new products. In 1997, the first energy drink to achieve mainstream popularity, Red Bull, was introduced (Malinauskas et al., 2007). The first Caffeinated Alcoholic Beverages (CABs) entered the market about five years afterwards in 2002 (CDC, 2010). These beverages saw a very rapid and sharp increase in popularity, with 337,500 gallons sold during the first year, and 22,905,000 gallons sold during 2008 (CDC, 2010). What was at one time a niche product is now available in retail outlets and convenience stores. By 2008, there were 25 brands selling the beverages (CDC, 2010). The advertising industry has capitalized on these drinks’ attractiveness to young people by creating advertising campaigns that are attractive to this particular age group (CDC, 2010). With names like “Sparks,” “Tilt,” “Joose,” and “Four Loko,” these beverages seem to have a language and culture all of their own (Cloud, 2008). Besides packaging and advertising, even the flavors and appearances of these liquids seem to speak directly to young people (Cloud, 2012). One of the beverages (“Joose”) looks and tastes like a strawberry flavored soft drink despite it being one-tenth alcohol (Cloud, 2012). This overtly youth-targeted strategy has resulted in an explosion in sales on and near college campuses. As a result, this places universities in a unique position to intervene in a positive manner (Arria & O’Brien, 2011). How CABs Work The combination of ingredients in a typical CAB (including sugar and flavorings in addition to caffeine and alcohol) results in an exceptionally dangerous combination (Cloud, 2008). There are several distinct effects resulting from the ingestion of a caffeinated alcoholic beverage. First of all, there are alcohol-related effects. Second, there are caffeine-related effects. Additionally, there are a whole different set of effects at work when the beverage also counts energy enhancers such as guarana or ginseng in its ingredients (Cloud, 2008). Finally, there are unique effects caused by a combination of high caffeine doses and alcohol. The effects of alcohol consumption are well-documented and researched, as are the secondary effects on the society—or campus—in which alcohol use occurs. Alcohol is consumed for its intoxicating effects, but those same effects are responsible for increasing rates of injury, motor vehicle accidents, and assaults on campuses (Avci & Fendrich, 2010). Beyond these short-term risks, alcohol use is also linked to serious health complications (American Cancer Society, 2012). Cancers of the liver, mouth, esophagus, colon, and breast (among others) are associated with alcohol use, and the more that a drinker consumes, the higher the risk of developing one of these cancers is (American Cancer Society, 2012). Alcohol also causes inflammation of the liver, organ damage to the pancreas and brain, and elevated blood pressure (American Cancer Society, 2012). Clearly, alcohol use is a practice that carries numerous risks on a multitude of different levels. Just like alcohol, there are a variety of risks associated with caffeine. These risks have been studied from a new perspective due to the introduction of “energy drinks” into the retail market; some experts even suggest that non-alcoholic energy drinks may pose as much as a threat as their alcoholic counterparts (Arria & O’Brien, 2011). Besides caffeine, these beverages also have amino acids, herbs, vitamins, taurine, and plant-based stimulants, such as guarana, to boost energy (Crane, 2011). The research of Attila and Cakir (2011) indicates that college students were completely unaware of the ingredients in energy drinks and sometimes even confused them with sports drinks. Research describes how these drinks are linked to sleep difficulties and high blood pressure, while pregnant women that drink these beverages show an increased risk of miscarriage, low birth weight of babies, and other complications (Arria & O’Brien, 2011). Although caffeine has a reputation as a harmless stimulant, these studies suggest that this is an inaccurate description of the drug. Furthermore, caffeine in large doses can cause anxiety, jitters, stomach upsets, and the sensation of a racing heart; these effects can occur after drinking just one or two energy drinks (Crane, 2011). Caffeine overdoses are also possible, and these symptoms are further exaggerated during an overdose, making the subject dizzy, start to sweat and shake, and exhibit signs of irritability (Medina, 2011). These facts demonstrate that caffeine drinks are made even more dangerous by their highly attractive image of working as a performance enhancer for tired students who may not realize the potentially serious impacts that excess caffeine can have on their physical well-being. Instead of getting the sleep that their bodies truly need, college students perpetuate the myth set forth by a popular energy drink advertisement that says “nobody ever wishes they’d slept more during college” (Carskadon, 2011). Figure 2: Amount of caffeine per container in caffeinated alcoholic and non-alcoholic beverages Note. The data on caffeine in Figure 1 is based on information from McIlvain et al., Crane, and Canning. Even in the absence of alcohol abuse, non-alcoholic caffeinated beverage use seems to predict certain behavioral patterns that are related to alcohol (Rose, 2011). Most notably, the consumption of non-alcoholic energy drinks has been associated with higher rates of alcohol abuse and drinking at earlier ages (Rose, 2011). Products such as Red Bull, Monster, and Rockstar may not contain alcohol, but there is a relationship between regular consumption of the beverage and alcohol dependence (Rose, 2011). The use of these beverages is also a predictor for alcohol-related risks, including driving under the influence (Rose, 2011). This seems to confirm that individuals likely to use energy enhancing beverages are also likely to use alcohol in excess. While caffeine and alcohol in moderation may not pose any serious risks, their combined use and excessive consumption can prove to be a deadly mixture. Howland et al. describe how the consumption of CABs may “increase risk-taking behaviors,” and how the high dose of caffeine can serve to mask understanding of one’s true level of impairment through intoxication (2010). The tendency for CAB consumers to engage in risky behaviors is the main reason why the FDA considers these types of drinks a public health risk (Howland et al., 2010). On college campuses, the results of these risks can have a devastating impact. Universities Respond to CABs With the presence of caffeinated alcoholic beverages making such an impact on college campuses, universities have had to establish guidelines and restrictions concerning their availability. McIlvain et al. (2011) recommend interventions for students aimed at filling in gaps in information. Students should be educated on caffeine as well as its interaction with alcohol (McIlvain et al., 2011). As universities identify significant numbers of their students as frequent users of these beverages, the importance of preventing harm should be evident (Malinauskas et al., 2007). Being institutions that specialize in educating young adults, universities are uniquely positioned to provide preventative interventions and to give their students with the necessary knowledge for maintaining their health and safety. The Problem As stated earlier, Rutgers University has not banned alcoholic energy drinks like other universities in the area. As a result, awareness must be made to the Rutgers community about this increasing problem. With area universities making a ban and not Rutgers, area students may come to Rutgers to party for the reason that there are no bans on alcoholic energy drinks. Even with the FDA putting a ban on the selling of these products, there is no way of stopping people from mixing the two products themselves. However, awareness is very important to help keep the Rutgers community safe. After looking at the Rutgers Health Services website (rhshope.rutgers.edu) I found that there was no mention of the negative effects of mixing energy drinks with alcohol. Rutgers does have an alcohol and other drug policy which can be found on the health services website; but it never mentions energy drinks. On their website, there is a section for a required alcohol education workshop, but this is only for those who have been referred by either Residence Life or the Office of Student Conduct. It is only a one hour workshop addressing the ways alcohol can impact a person both academically and physically. I found this to be a problem since it seems as Rutgers University is being reactive and not proactive with the problem of alcohol abuse. People will make their own decisions, but having an proactive approach to this problem of mixing energy drinks with alcohol will be very beneficial especially since there is very little, if any, awareness. The Plan Awareness As stated earlier, energy drinks and alcohol is a matter to which one can see needs attention. Awareness about this problem must start now. To help the problem, it should start in the freshman and transfer orientation classes so that our incoming students will start on the right foot. Transfer students have to take a course that is called “Students in Transition.” It would be very beneficial for this topic to be added to the curriculum. By starting with the freshman and transfer students, this is a cost-free solution that would reach all Rutgers students and help the problem. By educating students as they come to Rutgers, we are able to prevent this problem from escalating. Even though we are starting by making incoming students aware, it is also important that our current students, faculty, and staff are made aware of the concern. Student volunteers who are interested in this problem will assist in handing out flyers with information regarding the concerns of mixing energy drinks and alcohol. A website and Facebook page will also be created for students to understand in writing the risks associated with mixing energy drinks with alcohol. On the website there will also be an area for students to post questions and also learn where they can go to get help if they are currently addictive to this combination. The facebook page will allow for students to press the “like” button if they are committing to not partaking in the combination of energy drinks with alcohol. Benefits This program will provide benefits to not only our current student population, but will continue on with them when they become alumae/alumi. When habits are broken at a young age it is more likely for them not to occur again later on in life. With the long term health risks of this mixed beverage so high, it is important to stop it early before it becomes a problem. Here is an alarming fact, “College students who drank energy drinks more than six days each month were significantly more likely to smoke cigarettes, drink alcohol, get into a serious fight, abuse prescription drugs, have unsafe sex, not use a seat belt and play extreme sports” (Rose, 2011). Being able to prevent these harmful actions from occurring is definitely a huge benefit. Summary In closing, I hope it is easy to see why my proposal would be a benefit to the Rutgers University. Young people consuming excessive amounts of alcohol has been a popular for a long time; however mixing it with energy drinks have created more problems/risks. Rutgers University is one of the top schools in the nation especially when it comes to research. I think it would be beneficial for Rutgers University to be one of the first schools to lead the nation in awareness on mixing energy drinks with alcoholic beverages References American Cancer Society (2012). Alcohol use and cancer. Retrieved from: http://www.cancer.org/Cancer/CancerCauses/DietandPhysicalActivity/alcohol use-and-cancer Arria, A. M. and O’Brien, M. C. (2011). The “high” risk of energy drinks. JAMA, 305 (6): 600- 601. Attila, S. and Çakir, B. (2011). Energy-drink consumption in college students and associated factors. Nutrition, 27 (3): 316-322. Canning, A. (2010, November 10). Four loko drops caffeine from controversial alcoholic energy drink. ABC News. Retrieved from: http://abcnews.go.com/US/loko-removes-caffeine- energy-drink/story?id=12167659 Carskadon, M. A. (2011). Forget A's, B's, and C's—what students need is more zzzz's. Chronicle of Higher Education, 58 (14): A22-A22. CDC (2010). Fact sheets—Caffeinated alcoholic beverages. Retrieved from http://www.cdc.gov/alcohol/fact-sheets/cab.htm Center for Science in the Public Interest. (n.d.) Alcoholic Energy Drinks. Retrieved from: http://www.cspinet.org/new/pdf/alcospeed_fact_sheet.pdf Cloud, J. (2008). Alcoholic energy drinks: A risky mix. Time Magazine. Retrieved from: http://www.time.com/time/health/article/0,8599,1810802,00.html Crane, C. (2011). Energy-drink alert. Scholastic Choices, 27(1): 12-14. FDA (2010). FDA warning letters issued to four makers of caffeinated alcoholic beverages . Retrieved from: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm234109.htm Goodnough, A. (2010, October 26) Caffeine and Alcohol Drink Is Potent Mix for Young. The New York Times. Retrieved from: http://www.nytimes.com/2010/10/27/us/27drink.html?_r=1 Goodnough, A. (2010, November 17) FDA to energy-drink makers: remove caffeine. The Seattle Times. Retrieved from: http://seattletimes.nwsource.com/html/nationworld/2013461306_energydrink18.html Howland, J., Rohsenow, D. J., Arnedt, J., Bliss, C. A., Hunt, S. K., Calise, T., and Gottlieb, D. J. (2011). The acute effects of caffeinated versus non-caffeinated alcoholic beverages on driving performance and attention/reaction time. Addiction, 106 (2): 335-341 Malinauskas, B. M., Aeby, V. G., Overton, R. F., Carpenter-Aeby, T., and Barber-Heidal, K. (2007). A survey of energy drink consumption patterns among college students. Nutrition Journal, 6, 35-41. McIlvain, G. E., Noland, M. P., and Bickel, R. (2011). Caffeine consumption patterns and beliefs of college freshmen. American Journal of Health Education, 42 (4): 235-244. Medina, L. (2011). What happens if you absorb too much caffeine? Livestrong. Retrieved from: http://www.livestrong.com/article/466931-what-happens-if-you-absorb-too-much- caffeine/ Rose, G. (2011). Shocking facts about energy drinks. Livestrong. Retrieved from: http://www.livestrong.com/article/426006-shocking-facts-about-energy-drinks/ The Dawn Report. (2011, November 22) Emergency Department Visits Involving Energy Drinks. Retrieved from: http://www.samhsa.gov/data/2k11/WEB_DAWN_089/WEB_DAWN_089.htm Read More