Alcohol Mixed With Energy Drinks Consumption Research Articles

Relationship between energy drink consumption and sensation seeking in college students

Objective To investigate energy drink (ED) consumption and the relationship between ED consumption and sensation seeking among college students and to provide suggestions for management on ED consumption in the students. Methods Using stratified cluster sampling, we conducted a self-administered survey among 2 200 students of grade one to three recruited in two universities in a city with a self-desinged questionnaire and the Sensation Seeking Scale. Results Among the 2 064 students with eligible information, 1 034 (50.1%) and 511 (24.8%) reported having ED and alcohol mixed with energy drink (AmED) consumption during previous one month, with significantly higher ratios of ED and AmED consumption among the boy students than among the girl students (59.2% vs. 40.9%, χ2 = 69.222 and 30.5% vs. 19.0%; χ2 = 36.358; both P Conclusion A half of the college students consume ED and nearly a quarter of college students consume AmED; sensation seeking may be one of the motivations for the students' ED and AmED consumption.

The multiplicative effect of combining alcohol with energy drinks on adolescent gambling

PurposeThere has been increased concern about the negative effects of adolescents consuming a combination of alcohol mixed with energy drinks (AmED). To date, few studies have focused on AmED use and gambling. The present study analyzed the multiplicative effect of AmED consumption, compared to alcohol alone, on the likelihood of at-risk or problem gambling during adolescence. MethodsData from the ESPAD®Italia 2015 study, a cross-sectional survey conducted in a nationally representative sample of students (ages 15 to 19years) were used to examine the association between self-reported AmED use (≥6 times,≥10 times, and ≥20 times during the last month) and self-reported gambling severity. Multivariate models were used to calculate adjusted prevalence ratios to evaluate the association between alcohol use, AmED use, and gambling among a representative sample of adolescents who reported gambling in the last year and completed a gambling severity scale (n=4495). ResultsAmong the 19% students classed as at-risk and problem gamblers, 43.9% were classed as AmED consumers, while 23.6% were classed as alcohol consumers (i.e. did not mix alcohol with energy drinks). In multivariate analyses that controlled for covariates, AmED consumers were three times more likely to be at-risk and problem gamblers (OR=3.05) compared to non-consuming adolescents, while the effect became less pronounced with considering those who consumed alcohol without the addition of energy drinks (OR=1.37). ConclusionsThe present study clearly established that consuming AmED might pose a significantly greater risk of experiencing gambling-related problems among adolescents.

Direct Clinical Health Effects of the Consumption of Alcohol Mixed With Energy Drink in Dutch Adolescents

ABSTRACTThe direct clinical health effects of alcohol mixed with energy drinks (AmED) consumption are largely unknown. Using data from a nationwide questionnaire, two groups were compared: adolescents who consumed an energy drink at the event (ED+) and adolescents who did not (ED–). Blood alcohol concentration (BAC), duration of loss of consciousness, mean age, sex ratio, and habitual characteristics did not differ between the groups. In the ED+ group, more adolescents had lower education and drugs were used twice as often. Consumption of AmED with relatively low doses of caffeine does not lead to higher BAC in Dutch adolescents presenting to the hospital with alcohol intoxication.

Nature versus intensity of intoxication: Co-ingestion of alcohol and energy drinks and the effect on objective and subjective intoxication

BackgroundWe report a series of studies examining the effect of alcohol mixed with energy drinks (AmEDs) versus alcohol on objective intoxication (breath alcohol concentration; BrAC), intensity, and nature of intoxication. We also aimed to disentangle the role of energy drink (ED) ingredients in any effects. MethodThree within-subject double-blind placebo-controlled studies measured BrAC, subjective intoxication and impairment (‘intensity of intoxication’), stimulation and sedation (‘nature of intoxication’) following administration of ED, Cola, Caffeine+Sugar, and Placebo with alcohol (Study 1, n=18); ED, Caffeine-only, Sugar-only and Placebo with alcohol (Study 2, n=20); and ED and Placebo with alcohol (Study 3, n=27). ResultsSignificant moderate-to-large magnitude BrAC decrements and delayed time to peak BrAC were observed after ED administration versus Placebo. However, no meaningful BrAC differences between ED and other active conditions were observed in Study 1 and 2. After BrAC adjustment, moderate-to-large magnitude reductions in intoxication and impairment ratings were observed after ED versus Placebo on the ascending limb in all studies and at peak in Study 2 and 3. No meaningful differences were observed in intoxication and impairment ratings between ED and Caffeine+Sugar and Cola conditions (Study 1); ratings were lower after ED versus Sugar-only (Study 2). Stimulation and sedation ratings did not differ between ED and Placebo. ConclusionReductions in objective intoxication and perceived intensity of intoxication, but not nature of intoxication, were observed after AmED consumption. However, effects may be common to alcohol mixers containing sugars (objective intoxication) and caffeine (intensity of intoxication) and specific to a laboratory setting.

Combined use of alcohol and energy drinks: Dose relationship with self-reported physiological stimulation and sedation side effects

BackgroundNegative physiological stimulation and sedation side effects are experienced by a significant proportion of consumers who consume alcohol mixed with energy drinks (AmED). Few studies have compared the frequency of side effects between sessions of AmED and sessions of alcohol only within-subject, and none have explored a dose relationship. ObjectivesExplore the occurrence of self-reported physiological stimulant and sedative side effects between sessions of AmED and alcohol only, and at varying ED dosage levels within AmED sessions. MethodsA convenience sample of 2953 residents of New South Wales, Australia completed an online survey. N=731 AmED users reported daily caffeine intake, typical alcohol and AmED consumption, and past 12-month experience of physiological stimulation and sedation side effects during AmED and alcohol only sessions. Within-subject analyses compared occurrence of side effects between session types. Hierarchical binary logistic regression analyses explored the association of ED dose during AmED sessions with the experience of physiological side effects. ResultsThere were greater odds of most stimulant side effects, and lower odds of sedation side effects, during AmED sessions compared to alcohol only sessions. Compared to one ED, consumption of three or more EDs was significantly associated with the majority of both stimulant and alcohol intoxication side effects after controlling for demographics and consumption covariates. ConclusionsAmED is associated with perceived changes in physiological stimulant and sedation side effects of alcohol. Experience of side effects is positively associated with ED dosage. Future research should account for varying ED dosage, and reflect real world consumption levels.

Proportion as a metric of problematic alcohol-energy drink consumption in college students

ABSTRACTBackground: Alcohol mixed with energy drinks (AmED) is linked to deleterious drinking, particularly within college students. However, measurement and methodological concerns complicate a more thorough understanding of how AmED contributes to problematic alcohol consumption. This study examined AmED proportion (i.e., percentage of overall drinking events involving AmED consumption) as a metric for differentiating problematic alcohol use and tested the utility for explaining additional risk of alcohol-related problems beyond overall alcohol involvement. Methods: Self-report data were collected from a diverse sample of AmED consumers from two west-coast U.S. universities (N = 458; 60.1% female; 31.4% White). Participants were divided into three AmED proportion groups: low (25% or less of all drinking events), moderate (about 50%), or high (75% or more), and assessed for overall alcohol use and related consequences. Results: The groups did not differ on demographics or recent alcohol use. However, high proportion users reported significantly more alcohol-related problems than the low and moderate groups, even after controlling for overall alcohol involvement. However, proportion did not differentiate at-risk drinking as measured by cut-scores of the AUDIT. Conclusions: Findings provide support for proportion as metric for differentiating alcohol-related problems within AmED consumers. Implications for future research and interventions were discussed.

The right place at the right time: The social contexts of combined alcohol and energy drink use

Aims: Little is known about the social and functional aspects of alcohol mixed with energy drink (AmED) consumption. Using a functional substance use perspective and via the lens of social identity theory, this paper aims to explore the role of AmED consumption amongst the milieu of nightlife and party culture. Methods: Twenty-five regular AmED consumers aged 18–33 participated in semi-structured interviews. Qualitative thematic analysis of transcripts was undertaken, with a focus on the social contexts and perceived functions of AmED consumption, group dynamics and social identity. Findings: Three main themes were identified: (i) AmED use was restricted to specific social contexts, (ii) AmED use performed a social function and (iii) AmED users identified with a coherent and consistent social identity. AmED use was almost exclusively reported to occur within group drinking scenarios at parties and licensed venues, particularly nightclubs. AmED users identified with a clear and consistent social identity that was distinct from other alcohol consumers, typified by gregarious and extroverted behaviour. AmED use was seen to facilitate these ideals and strengthen group cohesion in appropriate contexts. Conclusions: Future efforts aiming to elicit changes in AmED consumption practices must account for the fundamental importance of social contexts to AmED use.

Alcohol mixed with energy drink: Use may be a consequence of heavy drinking

AimsIn recent years, studies have indicated that consumers of alcohol mixed with energy drink (AmED) are more likely to drink heavily and experience more negative consequences than consumers who avoid these beverages. Although researchers have identified a number of plausible hypotheses that explain how alcohol-energy drink co-ingestion could cause greater alcohol consumption, there has been no postulation about reverse causal relations. This paper identifies several plausible hypotheses for the observed associations between AmED consumption and greater alcohol consumption, and provides initial evidence for one such hypothesis suggesting that heavy drinking may be a determinant of AmED use. MethodData collected from 511bar patrons were used to examine the plausibility of one of the proposed hypotheses, i.e., AmED is an artifact of heavy drinking. Associations between the consumption of an assortment of alcoholic beverage types and total alcohol consumption were examined at the event-level, to assess whether AmED is uniquely related with greater alcohol consumption. ResultsIncreased alcohol consumption was associated with greater odds of consuming most alcoholic beverage types; this association was not unique to AmED. ConclusionsResults support the overlooked hypothesis that AmED use is an artifact of heavy drinking. Thus, AmED consumption may be a consequence or marker of heavier drinking. Much of the existing research on alcoholic beverage types is limited in its ability to implicate any specific type of drink, including AmED, as a cause of increased alcohol consumption and related harm. More rigorous study designs are needed to examine causal relationships.

Mixing alcohol with energy drink (AMED) and total alcohol consumption: a systematic review and meta-analysis.

It has been suggested that consuming alcohol mixed with energy drink (AMED) may increase total alcohol consumption. Aims of this systematic review and meta‐analysis were (i) to compare alcohol consumption of AMED consumers with alcohol only (AO) consumers (between‐group comparisons), and (ii) to examine if alcohol consumption of AMED consumers differs on AMED and AO occasions (within‐subject comparisons). A literature search identified fourteen studies. Meta‐analyses of between‐group comparisons of N = 5212 AMED consumers and N = 12 568 AO consumers revealed that on a typical single drinking episode AMED consumers drink significantly more alcohol than AO consumers (p = 0.0001, ES = 0.536, 95%CI: 0.349 to 0.724). Meta‐analyses of within‐subject comparisons among N = 2871 AMED consumers revealed no significant difference in overall alcohol consumption on a typical drinking episode between AMED and AO occasions (p = 0.465, ES = −0.052, 95%CI: −0.192 to 0.088). In conclusion, between‐group comparisons suggest that heavy alcohol consumption is one of the several phenotypical differences between AMED and AO consumers. Within‐subject comparisons revealed, however, that AMED consumption does not increase the total amount of alcohol consumed on a single drinking episode. © 2016 The Authors. Human Psychopharmacology: Clinical and Experimental Published by John Wiley & Sons Ltd

A survey of energy drink and alcohol mixed with energy drink consumption.

BackgroundEnergy drink consumption among youth is increasing despite recommendations by the American Academy of Pediatrics to eliminate consumption by youth. This study provides information on consumption of energy drinks and alcohol mixed with energy drinks (AmED) in a sample of Israeli youth and how consumer knowledge about the risks affects consumption rates.MethodsThe study was conducted in three Tel Aviv public schools, with a total enrollment of 1,253 students in grades 8 through 12. Among them, 802 students completed a 49-item questionnaire about energy drink and AmED consumption, for a 64 % response rate Non-responders included 451 students who were absent or refused to participate. All students in the same school were administered the questionnaire on the same day.ResultsEnergy drinks are popular among youth (84.2 % have ever drunk). More tenth through twelfth grade students consumed energy drinks than eighth and ninth grade students. Students who began drinking in elementary school (36.8 %) are at elevated risk for current energy drink (P < .001) and AmED (P = .002) use. Knowledge about amounts consumed and recommended allowances is associated with less consumption (OR 1.925; 95 %CI 1.18–3.14).DiscussionThe association between current AmED consumption and drinking ED at a young age is important. Boys and those who start drinking early have a greater risk of both ED and AmED consumption. The characteristics of early drinkers can help increase awareness of potential at-risk youth, such as junior and senior high school students with less educated or single parents.ConclusionsRisks posed by early use on later energy drink and AmED consumption are concerning. We suggest that parents should limit accessibility. Increased knowledge about acceptable and actual amounts of caffeine in a single product might decrease consumption.

Mode of daily caffeine consumption among adolescents and the practice of mixing alcohol with energy drinks: relationships to drunkenness.

Adolescent use of alcohol mixed with energy drinks (AmED) has recently received increased attention. Previous studies have established a strong link between AmED and drunkenness and suggest the importance of understanding associations with AmED use. In this study, we operationalized caffeine as daily consumption of coffee, tea, cola drinks, and energy drinks, and examined whether daily caffeine consumption relates to AmED use and drunkenness. We used multilevel structural equation modeling (SEM) with data from the 2013 Youth in Iceland cross-sectional survey among students, ages 16-17 years, who attended all of Iceland's 31 junior colleges (N = 5,784; 75% response rate; 51% girls). Our primary model fit the data very well with a comparative fit index of .994 and root mean square error of approximation of .042. Of the four daily caffeine consumption variables, coffee had the strongest relationship with AmED for both girls and boys, followed by energy drink consumption. The direct relationship between the daily caffeine consumption variables and drunkenness was generally weak for both genders, but the majority of the total relationship between all daily caffeine consumption variables and drunkenness was attributable to mediation through AmED. In our primary model, AmED consumption was also very strongly related to drunkenness (standardized βs = .74-.79). Caffeine use among adolescents ages 16-17 years is strongly related to increased consumption of AmED, irrespective of mode of caffeine consumption. AmED is strongly and positively associated with drunkenness on both individual and school levels.

Prevalence and Consequences of the Consumption of Alcohol Mixed with Energy Drinks: A Literature Review

Background: In recent years, the consumption of alcohol mixed with energy drinks (AmED) has become popular with young adults. The aim of this study was to provide a review of the empirical literature on the consumption of AmED, summarizing the research conducted with different methodologies. Method: A literature search was conducted with the terms “alcohol mixed energy drink” and “caffeinated alcoholic beverage” in databases such as MedLine/PubMed for the time period 2000–2013. The search revealed only 15 research articles. Therefore, a broader search was conducted with “energy drink,” and it was later filtered manually. This literature search yielded 31 research articles that were included in this review. Results: While energy drinks improve performance and increase feeling of alertness, this review suggests that energy drink consumption combined with alcohol might reduce perception of alcohol intoxication (labeled “wide-awake drunkenness”), or might lead to increased risk behavior or alcohol and drug use. Discussion: This review discusses the available scientific evidence obtained with different methodologies on the effects of mixing energy drinks with alcohol.

Commentary on Pennay et al. (2015): Measuring the effects of alcohol mixed with energy drinks on intoxication with real-world data.

Keywords: Alcohol; breath alcohol concentration; data collection via cellphones; energy drinks; hourly assessments; intoxication

Alcohol mixed with energy drinks are robustly associated with patterns of problematic alcohol consumption among young adult college students

BackgroundYoung adults are a population at great risk for problematic health behaviors. Alcohol mixed with energy drink (AmED) consumption is a relatively popular health risk behavior among young adults. AmED consumption continues to illustrate negative outcomes in the research literature, having been linked with other substance use, high-risk sexual behavior, and sexual victimization. Limited research to date has examined associations between AmED consumption and patterns of alcohol dependence. MethodsUndergraduate college students (n=757) filled out an online survey which assessed their drinking habits in the past week and month, including their consumption of AmED beverages, personality characteristics, substance use, and problematic alcohol consumption via the Alcohol Use Disorders Identification Test (AUDIT). ResultsA minority of participants reported AmED consumption in both the past month (11.6%) and past week (9.7%). Compared to their alcohol-only drinking counterparts, AmED consumers scored significantly higher on measures of impulsivity, and lower on anxiety sensitivity when compared to their alcohol-only drinking counterparts. In multivariate analyses, AmED consumption was robustly associated with patterns of alcohol dependence (AUDIT score≥8) among young adult college students, while controlling for energy drink use, alcohol use, personality factors, substance use, and demographic variables. ConclusionsAmED consumption in the past month is robustly associated with problematic alcohol consumption. The present study describes harmful outcomes associated with AmED consumption, and extends the literature on the combined effects of alcohol and energy drinks on young adult risk behaviors. Further research needs to address causal mechanisms for the AmED and problematic alcohol consumption relation.

Motives for mixing alcohol with energy drinks and other nonalcoholic beverages, and consequences for overall alcohol consumption.

IntroductionThe aim of this survey was to assess the motives for energy drink consumption, both alone and mixed with alcohol, and to determine whether negative or neutral motives for consuming alcohol mixed with energy drinks (AMED) have a differential effect on overall alcohol consumption.MethodsDemographics, alcohol and energy drink consumption-related questions, and motives for the consumption of energy drinks (alone or mixed with alcohol) were assessed. The motives to mix alcohol with energy drinks were compared with those for mixing alcohol with other nonalcoholic beverages.ResultsA total of 2,329 students who completed the study consumed energy drinks. The motives for consuming energy drinks (without alcohol) included “I like the taste” (58.6%), “To keep me awake” (54.3%), “It gives me energy” (44.3%), “It helps concentrating when studying” (33.9%), “It increases alertness” (28.8%), “It helps me concentrate better” (20.6%), and “It makes me less sleepy when driving” (14.2%). A total of 1,239 students reported occasionally consuming AMED (AMED group). The most frequent motives included “I like the taste” (81.1%), “I wanted to drink something else” (35.3%), and “To celebrate a special occasion” (14.6%). No relevant differences in motives were observed for using an energy drink or another nonalcoholic beverage as a mixer. A minority of students (21.6%) reported at least one negative motive to consume AMED. Despite these negative motives, students reported consuming significantly less alcohol on occasions when they consumed AMED compared to alcohol-only occasions.ConclusionThe majority of students who consume energy drinks (without alcohol) do so because they like the taste, or they consume these drinks to keep them awake and give them energy. AMED consumption is more frequently motivated by neutral as opposed to negative motives. No relevant differences in drinking motives and overall alcohol consumption were observed between the occasions when energy drinks or other nonalcoholic beverages were mixed with alcohol.

Are all alcohol and energy drink users the same? Examining individual variation in relation to alcohol mixed with energy drink use, risky drinking, and consequences.

Individuals who consume alcohol mixed with energy drinks (AmEDs) have been identified as higher-risk drinkers, as they are more prone to drink increased amounts of alcohol and experience more consequences compared with non-AmED users. The present study examined differential AmED use and alcohol consumption simultaneously as multidimensional risk behaviors among AmED users. Students who identified as drinkers and current AmED users (n = 195) completed a Web-based survey related to their AmED consumption and typical drinking patterns. Latent profile analysis was used to classify participants into distinct AmED user profiles. Profiles were then compared on AmED-based cognitive factors (e.g., expectancies, norms) and alcohol-related consequences. Four AmED user profiles emerged: moderate drinker, low proportion AmED users (ML); heavy drinker, low proportion AmED users (HL); moderate drinker, high proportion AmED users (MH); and heavy drinker, high proportion AmED users (HH). Membership in higher-proportion AmED groups was associated with more positive AmED expectancies and perceived norms. No significant differences were observed in the amount of consequences endorsed by HL and HHs; however, MHs experienced significantly more alcohol-related physical consequences than MLs. This suggests that increased use of AmEDs is associated with increased risk of experiencing alcohol-related consequences for moderate drinkers. Screening students for AmED use could be used as a novel, inexpensive tool to identify high-risk drinkers for targeted interventions aimed at reducing alcohol consumption and related problems.

The use of alcohol mixed with energy drinks and experiences of sexual victimization among male and female college students

Much research has documented negative associations with the consumption of alcohol mixed with energy drinks (AmED). To date, few research studies have examined the relation between AmED and sexual victimization. Furthermore, research on sexual victimization among men is less studied. The present study employed a sample of 253 men and 545 women to examine the differential associations between AmED consumption and sexual victimization as a function of gender. Results from this study suggest that AmED consumption is robustly associated with being sexually victimized among men, but not women. These results were robust while controlling for demographic factors and other substance use. Results add to the literature on sexual victimization by potentially identifying a new high-risk drinking behavior among males who have been sexually victimized.

The Effects of Alcohol Mixed With Energy Drinks (AmED) on Traffic Behaviors Among Brazilian College Students: A National Survey

Objective: Drinking alcohol mixed with energy drinks (AmED) may be contributing to hazardous drinking practices and risk-taking behaviors among college students. In this regard, this study aimed to assess the frequency of AmED consumption in a national sample of Brazilian college students and to estimate the risk that energy drinks pose on drinking and traffic behaviors. Method: A sample of 12,711 college students from across the country was asked to complete a research questionnaire on the use of drugs and other behaviors. Students who reported drinking in the previous 12 months (N = 8672) were divided into 2 groups: (a) those who reported drinking only alcohol (N = 4192) and (b) those who reported drinking AmED (N = 1119). The college students who reported the use of at least one illicit drug were excluded from data analysis. Descriptive and inferential analyses were subsequently carried out using the R library survey software 2.15.0. The null hypothesis was rejected at the level of P < .05. Results: AmED users are more likely to be hazardous drinkers. Being male, single, and involved with high-risk drinking behaviors are associated to AmED. After adjusting for demographic and drinking variables, the odds of being involved in high-risk traffic behaviors—for example, driving at high speed (odds ratio [OR] = 2.6; P < .001) and driving after binge drinking (OR = 2.8; P < .001)—were higher among AmED users than alcohol only users (AUs). Conclusion: The current findings are consistent with the results of previous studies. Drinking AmED may make college students more vulnerable to the occurrence of risky drinking and traffic behaviors. Educational campaigns targeted to young people should be developed warning them about the potential risks of mixing alcohol with energy drinks.

The Impact of Alcohol and Energy Drink Consumption on Intoxication and Risk-Taking Behavior

It has been argued that consuming alcohol mixed with energy drinks (AmED) causes a subjective underestimation of intoxication and an increased level of risk-taking behavior. To date, however, there is mixed support for AmED-induced reductions in perceived intoxication, and no objective assessment of risk-taking following AmED consumption. Consequently, the present study aimed to determine the effect of alcohol and energy drink (ED) consumption on subjective measures of intoxication and objective measures of risk-taking. Using a placebo-controlled, single-blind, cross-over design, participants (n = 28) attended 4 sessions in which they were administered, in counterbalanced order: 0.5 g/kg alcohol, 3.57 ml/kg ED, AmED, and a placebo beverage. Participants completed the Biphasic Alcohol Effects Scale and a Subjective Effects Scale at baseline and 30 and 125 minutes postbeverage administration; risk-taking was measured using the Balloon Analogue Risk Task (BART). Participants reported greater subjective intoxication, impairment, and sedation after active relative to placebo alcohol consumption, with no interactive AmED effects. However, a significant moderate magnitude increase in stimulation ratings was observed in the AmED relative to alcohol, ED, and placebo conditions. There was no independent effect of alcohol, or interactive effect with ED, on the BART. A significant, yet small magnitude, increase in risk-taking was evident in active relative to placebo ED conditions. The interactive effect of AmED appears restricted to perceived stimulation, with alcohol-induced increases in subjective intoxication occurring regardless of presence or absence of ED. Engagement in risk-taking behavior was only increased by ED consumption; however, this effect was only of small magnitude; at these doses, alcohol consumption, with or without EDs, did not affect risk-taking. Further research assessing the dose-dependent effects of AmED on objectively measured risk-taking behavior could clarify whether the ED effect increases with higher doses and whether an interactive effect is observed with higher alcohol doses.

The Alcohol Mixed with Energy Drink Debate: Masking the Facts! A Commentary on “Mixing an Energy Drink with an Alcoholic Beverage Increases Motivation for More Alcohol in College Students” by Marczinski and Colleagues (in press)

The Alcohol Mixed with Energy Drink Debate: Masking the Facts! A Commentary on “Mixing an Energy Drink with an Alcoholic Beverage Increases Motivation for More Alcohol in College Students” by Marczinski and Colleagues (in press)