PULLMAN, Wash. - Energy drinks were "part of the picture" in the alcohol poisoning death of a Washington State University student on Oct. 27, and it's time that sales of the popular caffeinated beverages were regulated by the federal government just as soft drinks are, said Dr. Bruce Wright, executive director of WSU's Health and Wellness Services.
What's more, the beverages, with aggressive sounding names such as Red Bull, Monster, AMP and Rip It, may be contributing to an increasing number of students sickened by larger amounts of alcohol than they would normally consume, he said.
"By promoting the drinks as ‘dietary supplements' instead of foods, the manufacturers can escape tighter FDA (U.S. Food and Drug Administration) scrutiny," said Wright. "I say, it's time for the scrutiny."
Freshman Kenny Hummel, who died of acute alcohol poisoning, drank several energy drinks the night of his death, according to reports made to campus police by his friends.
"These drinks, mostly marketed toward adolescents and young adults, contain high levels of caffeine that can produce medical and behavioral problems when combined with alcohol - and with no alcohol at all," said Wright, a psychiatrist and chairman of the university's Presidential Task Force on Alcohol Education and Prevention, formed by President Elson S. Floyd in the wake of the 18-year-old Hummel's death.
To make matters worse, Wright said, energy drink labels don't always reveal how much caffeine the drinks contain: "In some brands, two swallows deliver more caffeine than the amount in a full cup of coffee."
Mounting national concerns
Hummel's death and formation of WSU's task force occurred in the midst of escalating criticism of the energy-drink industry. At the same time, beverage sales continue to soar, with an increase of 16 percent nationwide last year, according to the industry tracker Beverage Digest.
• Consumer Reports recently released a study showing that five out of 27 top-selling energy drinks contained at least 20 percent more caffeine than listed and that 11 brands disclosed no amount at all.
"Consumer and scientific groups have for years urged the Food and Drug Administration to make companies disclose caffeine levels, but the agency says it lacks authority," according to the online magazine report. (See http://bit.ly/UHfAQf)
• Two U.S. senators have called on the FDA to assess the safety of energy drinks and to close "loopholes in current law that are exploited by energy drink manufacturers in order to avoid oversight…" according to a news release issued by Sens. Richard Blumenthal of Connecticut and Dick Durbin of Illinois.
• The kick people get from energy drinks has been linked to reports of dizziness, agitation, abnormal heart rhythms and nausea, all leading to more emergency medical treatments, according to a 2011 study by the Drug Abuse Warning Network that showed a tenfold increase in emergency room visits linked to energy drinks from 2005 to 2008.
"Consumption of energy drinks is a rising public health problem because medical and behavioral consequences can result from excessive caffeine intake," the report concludes. "A growing body of scientific evidence documents harmful effects, particularly for children, adolescents and young adults."
• New York's attorney general is investigating whether energy drink manufacturers are deceiving the public in their marketing of the product's ingredients and purported health benefits.
Many energy drinks contain additives such as vitamin B, ginseng, guarana and taurine – some listed, some not. Guarana is a plant-based stimulant that sounds harmless, said Wright, but mix it with caffeine and people are drinking a concoction of stimulant piled on stimulant. Conversely, the FDA caps the amount of caffeine in soft drinks at 0.02 percent.
While energy drinks consumed alone can pose risks, when combined with alcohol, "the effects of blending the stimulant of caffeine with the depressant of alcohol can be toxic," Wright said.
For example, two years ago, more than a dozen students at Ramapo College in New Jersey were hospitalized for alcohol poisoning after drinking premixed containers of Four Loko, a fruity, alcohol-laced energy drink. Then, following a rash of similar incidents at other colleges, the FDA issued warning letters to manufacturers of alcoholic energy drinks.
Caffeine masks the effects of alcohol, resulting in "a state of wide-awake drunk,'' said FDA commissioner Margaret Hamburg. Consumption of the drinks has led to alcohol poisoning, car accidents and assaults, she wrote.
Although Washington is the second state in the country to ban caffeinated alcoholic drinks, that didn't stop the problem, said Wright. Now, young people simply buy the two products and drink them alternately or blend them as cocktails.‘Not good enough'
Energy drink manufacturers defend their products as safe and designed for adults capable of making good choices. Some say they voluntarily place warning statements on the containers.
For a beverage "sold in cool colors with cool names and flavors that's found on the same shelf as soft drinks," that's not good enough, said Wright.
"The safety bar is justifiably higher in this day and age for products that have significant potential health risks," he said. "We've moved well beyond the days when big tobacco interests dictated public policy."