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Mixing Alcohol and Energy Drinks: Potential Risks and Effects

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Consuming drinks that contain both caffeine and alcohol can be detrimental to your health and also mask the signs of intoxication, which may lead to greater alcohol consumption and risk of injury and other dangers.1,2 The U.S. Food and Drug Administration (FDA) limits how companies can combine energy drinks and alcohol in their products, and experts believe that the popularity of this pairing continues to create personal and public health problems worldwide.3 A firm understanding of these potential problems can help you to understand the risks of mixing energy drinks and alcohol.

How and Why People Mix Energy Drinks or Caffeine and Alcohol

Despite the reported risks of mixing energy drinks or caffeine and alcohol, people still feel motivated to consume this potentially dangerous combination.2 Regulations limiting the sale of premixed beverages containing energy drinks and alcohol cannot stop people from ordering these drinks at bars and restaurants or simply making them at home.

Researchers conducted a literature review in 2012 that examined college students’ motivations for consuming energy drinks and alcohol.4 The studies these researchers examined described the following situations and reasons that motivated people to mix these beverages:4

  • Parties
  • Celebrations
  • To improve the flavor of alcoholic beverages
  • Preference for the taste of energy drinks and alcohol
  • To become intoxicated
  • So they could consume more alcohol
  • To reduce the intoxicating effects of alcohol

Energy drinks and alcohol can be dangerous.Just as people hold different motivations for mixing energy drinks and alcohol, the mixtures themselves can have unique recipes.3 In November 2010, the FDA banned the manufacture and sale of several premixed beverages containing caffeine and alcohol, including:2

  • Four Loko
  • Joose
  • Max
  • Moonshot
  • Core brand drinks

Some companies removed these products from the market by changing the formula and reusing the original product’s name.2

Popular mixed beverages offered to patrons at bars and restaurants include Jagerbomb and Vodka mixed with Red Bull.3 Given the possible combinations and risks associated with mixing energy drinks and alcohol, the Centers for Disease Control and Prevention (CDC) describes public education as one way to prevent harm when consuming these beverages.2

The Effects of Mixing Energy Drinks or Caffeine with Alcohol

The CDC states that, compared to people who drink alcohol on its own, people who mix energy drinks and alcohol are more likely to report the following:2

The CDC lists these concerns as some of the apparent dangers of mixing energy drinks and alcohol.2 Still, some researchers have concerns that experts and the general public may draw inaccurate conclusions about the harms of mixing energy drinks or caffeine and alcohol.4,5

In 2018, Joris Verster and colleagues stated that researchers and the public hold several misconceptions about how mixing energy drinks and alcohol could impact a person’s functioning.6 After reviewing several studies, researchers concluded that evidence could not support mixing energy drinks and alcohol as a clear cause for increased alcohol use or risky behavior. Their study also concluded that mixing energy drinks and alcohol did not necessarily change how people experienced intoxication.

Some researchers caution against mixing energy drinks and alcohol because these substances impact physical and mental health.7 Authors Ibrahim Nadeen and colleagues cite research that shows that people who mix energy drinks and alcohol consume more alcohol than those who do not combine the two beverages.

Ultimately, researchers agree that addiction research needs a better understanding of the effects of mixing energy drinks and alcohol.3,4,5,6,8

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The Risks of Caffeine and Alcohol Misuse

Beyond conflicting research on the dangers of mixing energy drinks or caffeine and alcohol, it is well-established that both substances individually can be harmful to a person’s health, particularly if misused or abused.1

Short-Term Risks of Caffeine and Alcohol Use: Intoxication and Overdose

Caffeine and alcohol misuse can lead to intoxication when taken in high doses over a short time.1 Intoxication can cause many different symptoms that negatively affect your body and mind.

Short-term effects of caffeine intoxication may include:1

  • Nervousness
  • Feeling restless
  • Trouble sleeping
  • Stomach problems
  • Twitching muscles
  • Changes in heart rate
  • Rambling speech and thinking

Short-term effects of alcohol intoxication include:1

  • Slurring your words
  • Unable to walk steadily
  • Mood changes
  • Poor coordination
  • Memory problems
  • Coma

The short-term effects of alcohol intoxication hold more significant risks than caffeine use.1 Alcohol intoxication can contribute to aggression, risky behavior, inappropriate sexual contact, poor judgment, and challenges in other areas of your life. It can also negatively affect your mood and mental state.1

Still, excessive amounts of caffeine or alcohol can become poisonous and life-threatening.1 Beyond the life-threatening risks of violence and suicide, using too much alcohol can lead to an alcohol overdose, also known as alcohol poisoning.9 Though not as immediately life-threatening, taking too much caffeine can lead to caffeine overdose.10

Signs of an alcohol overdose include:9

  • Vomiting
  • Seizures
  • Breathing problems
  • Inability to remain conscious or wake up
  • Extreme confusion
  • Clammy skin
  • Becoming cold
  • Turning pale
  • Blue skin tone

Signs of a caffeine overdose include:1,10

  • Confusion
  • Seizures
  • Breathing problems
  • Fever
  • Feeling dizzy
  • Diarrhea
  • Fever
  • Changes in heartbeat
  • Sleeping problems
  • Agitation
  • Hallucinations

If you suspect you or someone you know may have taken too much caffeine or alcohol, call 911 right away.9,10 Remain with the person while waiting for emergency care. Medical providers may provide specific instructions over the phone to help keep the person safe.

Long-Term Risks of Caffeine and Alcohol Use

The long-term effects of these substances will depend on how much you use and how long you use them.1,11

Misusing addictive substances like caffeine and and alcohol can lead to tolerance and dependence.11 As tolerance develops, you become less sensitive to the effects of these substances. If you consistently misuse alcohol, you may notice that you need to drink more to experience intoxicating effects. This tolerance can cause you to consume higher amount of alcohol at once, a risk factor for alcohol use disorder, or alcohol addiction.1

Over time, you may depend on alcohol to function optimally.1,11 This is known as alcohol dependence and will lead to distressing and potentially dangerous withdrawal symptoms if you attempt to quit.1 The same can happen with caffeine dependence and withdrawal, although caffeine withdrawal is not severe or potentially life-threatening.1

Beyond these symptoms, excessive and long-term alcohol and caffeine use can cause other health problems.1 Heavy caffeine use can lead to stomach problems and sleep problems, which may be associated with other mental health concerns. Long-term and heavy alcohol use can impact several systems in your body, including mental health, liver functioning, blood pressure, sexual or reproductive health, and digestive tracts.1

Depending on how your caffeine and alcohol use affects your health, you may benefit from an addiction treatment program.11

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Who is Most Likely to Mix Caffeine and Alcohol?

Several different groups are at risk when mixing caffeine and alcohol, specifically energy drinks and alcohol. One group is college-aged young adults. Studies show the college studies most likely to mix caffeine and alcohol include:12

  • Fraternity and sorority members
  • Athletes
  • Off-campus residents
  • Binge drinkers
  • Substance users

Another high-risk group is that of adolescents. One survey of teens mixing energy drinks and alcohol shows the reasons behind this behavior. Teen participants reported they mix caffeine and alcohol to:13

  • Stay awake
  • Hide the flavor of alcohol
  • Enjoy the flavor
  • Have more energy
  • Enjoy the effects
  • Treat or avoid a hangover

The survey also shows more males mix energy drinks and alcohol than females. Also, many teens and young adults mixing caffeine and alcohol combine those two with additional substances, including prescription pain pills, marijuana, and other illicit drugs.13

Treatment for Mixing Energy Drinks or Caffeine and Alcohol

Both caffeine and alcohol have traits that can be addicting. Therefore, a substance use disorder can develop among those who mix energy drinks and alcohol. Some researchers apply the diagnostic criteria for alcohol use disorder to caffeine use disorder.14

They measure tolerance, and whether a person must increase the amount of caffeine and alcohol to achieve the same effects they did when they first began mixing the two substances.

They also assess withdrawal symptoms if a person is substituting another substance to avoid withdrawal symptoms. For example, some people may take a benzodiazepine like Xanax to relieve alcohol withdrawal. Other criteria examine whether caffeine and alcohol mixing is interfering with school, work, or home life. Or if a person spends much of their time seeking and consuming the mixture. Cravings and unsuccessful efforts to cut back or quit mixing energy drinks and alcohol are also taken into consideration.14

If someone meets the criteria for caffeine and alcohol use disorders, they can get help no matter the level of misuse. Treatment options range from medical detox for those who need medication to ease withdrawal symptoms to inpatient and outpatient addiction treatment services. For more information on connecting with a treatment program, call 800-948-8417 Question iconCalls are forwarded to these paid advertisers today.

Resources

  1. American Psychiatric Association. (2013). Substance-related and addictive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).
  2. Centers for Disease Control and Prevention. (2020). Alcohol and caffeine.
  3. Marczinski, C. A., & Fillmore, M. T. (2014). Energy drinks mixed with alcohol: what are the risks?. Nutrition reviews, 72 Suppl 1(0 1), 98–107.
  4. Verster, J. C., Aufricht, C., & Alford, C. (2012). Energy drinks mixed with alcohol: misconceptions, myths, and facts. International journal of general medicine, 5, 187–198.
  5. Roemer, A., & Stockwell, T. (2017). Alcohol mixed with energy drinks and risk of injury: a systematic review. Journal of studies on alcohol and drugs, 78(2), 175–183.
  6. Verster, J. C., Benson, S., Johnson, S. J., Alford, C., Godefroy, S. B., & Scholey, A. (2018). Alcohol mixed with energy drink (AMED): A critical review and meta-analysis. Human psychopharmacology, 33(2), e2650.
  7. Nadeem, I. M., Shanmugaraj, A., Sakha, S., Horner, N. S., Ayeni, O. R., & Khan, M. (2021). Energy drinks and their adverse health effects: a systematic review and meta-analysis. Sports Health: A Multidisciplinary Approach, 13(3), 265–277.
  8. Benson, S., Verster, J. C., & Scholey, A. (2020). Consumption patterns of alcohol and alcohol mixed with energy drinks in Australian students and non-students. Nutrients, 12(1), 149.
  9. National Institute on Alcohol Abuse and Alcoholism. (2021). Understanding the dangers of alcohol overdose.
  10. U.S. National Library of Medicine. (2021, September 1). Caffeine overdose.
  11. Miller, W. R., Forcehimes, A. A., & Zweben, A. (2019). Treating addiction: A guide for professionals. The Guilford Press.
  12. Patrick ME, Macuada C, Maggs JL. (2016). Who Uses Alcohol Mixed With Energy Drinks? Characteristics of College Student Users. Journal of American College Health, 64(1):74-9.
  13. Bonar, E. E., Cunningham, R. M., Polshkova, S., Chermack, S. T., Blow, F. C., & Walton, M. A. (2015). Alcohol and Energy Drink Use Among Adolescents Seeking Emergency Department Care. Addictive Behaviors, 43, 11-17.
  14. Evatt, D. P., Juliano, L. M., & Griffiths, R. R. (2016). A Brief Manualized Treatment for Problematic Caffeine Use: A Randomized Control Trial. Journal of Consulting and Clinical Psychology, 84(2), 113-121.
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