Mixing caffeine and alcohol is hardly a new trend; Irish coffee, for example, has warmed many a belly in the United States since the 1950s. And as long as such drinks have been around, so has the question of whether combining a stimulant (caffeine) and a depressant (alcohol) poses any health risks. However, unlike the newer alcohol-caffeine fusion cocktails that are popular among the college crowd these days, Irish coffees haven’t put numerous people in the hospital for alcohol poisoning, rapid heartbeats, and other serious problems. Compared with the standard Red Bull and vodka or any of the malt liquor–stimulant juice blends that come conveniently premixed, Irish coffee seems about as dangerous as a warm cup of milk.
One brand in particular, Four Loko, made headlines recently in connection with a rash of college students’ who ended up in the ER with alcohol poisoning after drinking it at parties. With an alcohol content of 12 percent (that’s around four to six beers) and the caffeine equivalent of a cup of coffee in each 23.5-ounce serving, Four Loko is called “blackout in a can” for a reason—its elevated levels of caffeine and alcohol make for risky situations that can escalate into something worse all too easily. (Just ask the hospitalized students in New Jersey and Washington.) But why does mixing caffeine and alcohol have such adverse effects on our bodies and minds in the first place? How does it increase the potential for disastrous consequences?
A Bad Combination for the Body and the Brain
Caffeine and alcohol have opposite effects on the body’s central nervous system. The former makes you energetic and slightly manic, while the latter makes you sleepy. Putting both of these in your body at the same time greatly confuses your system and throws nerve messages out of whack, thereby leading to even poorer coordination and motor skills, as well as dizziness, difficulty breathing, and cardiovascular issues. People with heart problems should be especially wary of imbibing Red Bull cocktails and other caffeinated alcoholic beverages, but there have been instances in which people without preexisting conditions have suffered heart ailments as well. In October 2010, ABC News reported on a nineteen-year-old man in Philadelphia who had a heart attack after combining alcohol and caffeine. According to the doctor, he didn’t show any other signs of a poor heart.
Other than sending your nervous system conflicting messages, mixing alcohol and caffeine has an even more troubling effect on the average drinker’s judgment and behavior. Various studies show a link between drinking beverages like Four Loko or Joose (another fruity malt-liquor concoction) and a higher likelihood of both getting in a car with a drunk driver and being a drunk driver. One study published in a 2010 edition of Addictive Behaviors surveyed 802 people leaving bars and tested their blood alcohol levels. Of that group, the ones who reported drinking alcohol-and–energy drink cocktails were three times more likely to leave the bar “highly intoxicated” than the other participants were. Even scarier, that subgroup was four times more likely to get behind the wheel afterward.
The appeal of combining alcohol with stimulating mixers isn’t really in the taste, but in the effect itself. It’s a way to circumvent the sleepiness that alcohol usually induces, and as a result, people can drink more without feeling as drunk as they might otherwise. But therein lies one of the mixture’s most dangerous attributes, because those people are that drunk—they just don’t realize it because the caffeine keeps them wide-eyed and supposedly alert. One 2006 study, published in Alcoholism: Clinical and Experimental Research, disproved the theory that caffeine somehow cancels out alcohol’s negative effects. After studying twenty-six volunteers who drank alcohol, Red Bull, or a combination of the two, researchers concluded that the combination only made volunteers think they were more coordinated and alert. Objectively, their motor coordination and reaction times were just as bad as the alcohol-only drinkers’.
Ending the Party on a Sour Note
After Four Loko came under fire, the company argued that there were many other kinds of alcohol at the parties, and that the students didn’t drink only Four Loko. While that’s true, it’s also true that drinking a highly alcoholic and caffeinated beverage is different from downing gin and tonics or shots of tequila. In the latter instances, the drinker will eventually get tired and go to bed (or pass out) when her body decides it’s had enough. Drinking something like Four Loko takes that defense mechanism out of the equation. Instead, partiers can drink more than they would normally and not realize how drunk they really are, because they still feel awake. That’s why they’re more likely to drive under the influence or engage in similar risky behavior: caffeinated alcoholic beverages give them an inflated—and potentially dangerous—sense of self-control.
The aforementioned New Jersey college (Ramapo College) banned drinks like Four Loko after the recent emergency room incidents. The FDA had already threatened to ban them in November 2009, telling the companies that produce them to prove that they’re safe. There hasn’t been any regulating action since then, though the FDA says that companies are responding. The outcome’s still undetermined, but one thing’s for sure: the popularity of Four Loko and the like is still on the rise. A 2006 study out of Wake Forest University found that 24 percent of college students who had drunk in the preceding month had consumed alcohol mixed with an energy drink at least once. The Wall Street Journal reported in August 2009 that sales of Four Loko and its sister brand rose 2,680 percent in a year’s time.
Perhaps the present negative attention surrounding Four Loko will make people think twice about mixing Red Bull and vodka or reaching for a can of Joose. Clearly, the buzz such beverages provide is not one our bodies want or need. Sure, these drinks help you party longer, but if the party ends at the hospital, sleeping it off sounds much more preferable.