Since Red Bull was introduced in the USA in 1997, its popularity has soared and given it wings. (Haha you know you love my corny jokes). From festivals to bars, this drink and the other competitor, Monster Energy, are super convenient to find. I never liked them, but growing in West Virginia, you learn to do what your friends do to be accepted. I drank a Monster energy drink once and felt nauseated and light headed. That was my first and last experience with energy drinks.
Which leads me to ask, just how safe are these sugary, mood boosting drinks?
How Much Caffeine is in an Average Energy Drink?
Energy drinks contain anywhere from 50mg to 500m mg of caffeine per can. Many other countries have set rigorous standards for warnings and cautions surrounding energy drinks. The United States unfortunately, has very lax regulations compared to others. Iceland, Norway, Scotland, Denmark and Turkey have recently limited the amount of caffeine in any alcoholic drinks to 150 mg per liter. The absence of regulation in the USA has led an explosion of marketing of energy drinks, especially to male teenagers for the purposes of performance enhancing and stimulation.
There are increasing reports of young adults being rushed to the ER, suffering from caffeine intoxication (yes this is a thing!) or even dying from the effects of these drinks. In May 2017, a 16 year old boy passed away after consuming an energy drink, a latte and a Mountain Dew. The coroner ruled the cause of death as a cardiac arrhythmia. Although this is rare, more and more research is revealing that energy drinks may not only be different than “normal caffeine sources,” but may be a gateway drug for adventure seeking teens. As surprising as this may sound, when you look at the science, it makes sense.
How are Energy Drinks Different than A Normal Cup of Joe?
There are approximately 320 mg of caffeine in four cups of coffee. Plenty of people drink 4 cups of coffee in a day without any ill effects. Energy drinks, however, contain 4 ounces of sugar, several synthetic B vitamins and a proprietary “energy blend” of taurine and other secret ingredients are found in Red Bull, Monster or 5 Hour Energy. It seems that this blend effects the body somewhat differently. I don’t know about you guys, but I had one friend who had physical withdrawal symptoms from Red Bull.
For example, in one study, Sachin A. Shah of David Grant Medical Center on Travis Air Force Base and University of the Pacific in Stockton, California, and colleagues measured the participants’ blood pressure and used an electrocardiogram (or EKG) to measure heart electrical activity for 24 hours after the subjects consumed the drinks versus a caffeine only placebo.
“The QT interval is the measurement of the time it takes ventricles in the heart, the lower chambers, to repolarize, or prepare to generate a beat again,” the researchers said. “It’s the pause from the end of the electrical impulse generating the heart to beat to the next impulse. If this time interval, which is measured in milliseconds, is either too short or too long, it can cause the heart to beat abnormally. The resulting arrhythmia can be life threatening.” This is how the 16 year old mentioned above actually died. Very scary indeed.
In the study, compared to the caffeine-only group, those in the energy drink group had a corrected QT interval 10-milliseconds higher still at two hours. Most medications require a warning if they prolongate the QT interval longer than six milliseconds! As would be expected, both caffeine and the energy drinks had an increase in blood pressure, however after six hours, the blood pressure of the placebo had returned to normal while the energy drink group had not.
This suggests that the other ingredients in energy drinks may purport other effects on the body that we are not aware of…..
With that being said, lets dive into how energy drinks could lead to other pleasure seeking activities that infer a higher risk for drug use.
Energy Drinks: A New Gateway Drug?
Caffeine withdrawal alone is listed as as a research diagnosis in the Diagnostic Manual IV which is kinda like the Bible of Psychiatry diagnoses. Not saying all caffeine is bad. Don’t get me wrong I love it too. But here, as in most things on earth, the devil is in the dose. Most things are toxic when used in extreme.
According to Psychology Today, adolescent brains, which are still developing, react differently to caffeine than adult brains. Long term caffeine consumption leads to greater tolerance faster suggesting it produces changes in the brain chemistry. Moreover, long term caffeine consumption in teens leads to greater sensitivity to amphetamines like Ritalin, used to treat Attention Deficit Hyperactive Disorder (ADHD). “Recently a new study highlights how adolescent consumption of caffeine actually altered the brain’s neurochemistry so that the adult brain’s response to cocaine was enhanced!”
A paper in the Journal of Addiction Medicine reported that 1/3 of teens consume energy drinks and the kids that do also report higher rates of alcohol, cigarette or drug use. Once adjustments for other factors were made, it still found that personalities which are attention and stimulation seeking, may be more likely to seek out not just energy drinks, but other feel good substances as well.
Energy drinks are also promoted for use with alcohol, which masks the intoxicating effects of alcohol, leading to higher consumption. One theory is drinks like Monster, mask the depressant effect of alcohol when consumed together. Alcohol boosts levels of adenosine in the brain, whereas caffeine blocks it, leading to the feeling of less intoxicated than one actually is. It seems we have perhaps been programmed to think one thing is a drug when another is not?
“In one 2006 survey Published in the Academy of Emergency Medicine, 4,271 students from ten universities in North Carolina, some 24% said they had consumed alcohol mixed with energy drinks in the previous 30 days. This group was significantly more likely than other students to engage in binge drinking, and got drunk twice as often. Even after adjusting for the amount of alcohol they consumed, this group was at increased risk of alcohol-related consequences including being taken advantage of sexually, taking advantage of another person sexually, riding with an intoxicated driver, being physically hurt or injured, and requiring medical treatment.
In another study published in 2010 in Addiction Behavior, researchers interviewed approximately 800 people as they left bars near a university area, and then measured their alcohol concentrations with breathalyzers. Those who had consumed alcohol mixed with energy drinks were three times more likely to be leaving the bar highly intoxicated, and four times more likely to be attempting to drive home, compared to other patrons! Yikes not good huh?
Let me note that this not exactly a open and shut case for cause and effect. These studies do not PROVE that energy drinks lead to substance abuse, although circumstantial evidence is convincing.
So are caffeinated energy drinks a gateway drug? Possibly and the evidence so far is quite convincing. Although energy drinks vary greatly from plain old caffeine, it seems both infer a risk to the developing teenage brain and should possibly be treated more like a drug than a daily food.
Be Your Own Best Doctor
Thombs, D. L. et al. Add. Behav. 35, 325-30 (2010).
Walters Kluwer Health