Caffeine Experts Urge Warning Labels on Energy Drinks

In one 2008 study of 1,253 college students, energy drink consumption significantly predicted subsequent non-medical prescription stimulant use, raising the concern that energy drinks might serve as a gateway to other forms of drug dependence. In another 2007 survey of 496 college students, 51% reported consuming at least one energy drink during the previous month. Of these energy drink users, 29% reported weekly "jolt and crash” episodes, and 19% reported heart palpitations from drinking energy drinks. This same survey revealed that 27% of the students surveyed said they mixed energy drinks and alcohol at least once a month. The researchers are currently collecting case reports of intoxication from energy drinks in children and adolescents, who are not habitual caffeine users; their vulnerability to caffeine intoxication, therefore, may be markedly increased due to an absence of pharmacological tolerance. Genetic factors may also contribute to an individual's vulnerability to caffeine-related disorders including caffeine intoxication, dependence, and withdrawal. Another concern mentioned is that the combined use of caffeine and alcohol is increasing sharply, and studies suggest that such combined use may increase the rate of alcohol-related injury. The review was published in the September 20, 3008, issue of the journal Drug and Alcohol Dependence.

"The caffeine content of energy drinks varies over a 10-fold range, with some containing the equivalent of 14 cans of Coca-Cola, yet the caffeine amounts are often unlabeled and few include warnings about the potential health risks of caffeine intoxication,” said co-author Roland Griffiths, Ph.D. "It's like drinking a serving of an alcoholic beverage and not knowing if its beer or scotch.”

Caffeine intoxication, a recognized clinical syndrome included in both the Diagnostic and Statistical Manual of Mental Disorders and the World Health Organization (WHO) International Classification of Diseases, is marked by nervousness, anxiety, restlessness, insomnia, gastrointestinal upset, tremors, rapid heartbeats (tachycardia), psychomotor agitation (restlessness and pacing), and in rare cases, death. Since the introduction of the popular energy drink Red Bull in Austria in 1987 and in the United States in 1997, the energy drink market has grown exponentially. Hundreds of different brands are now marketed, with caffeine content ranging from a modest 50 mg to an alarming 505 mg per can or bottle.

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