Alcohol Mixed With Energy Drinks Use Research Articles

Factors influencing young people's use of alcohol mixed with energy drinks

A growing evidence base demonstrates the negative health outcomes associated with the consumption of energy drinks (ED) and alcohol mixed with energy drinks (AMED), especially among young people. Work to date has focused on the physiological effects of ED and AMED use and the motivations associated with consumption, typically among college students. The present study adopted an exploratory, qualitative approach with a community sample of 18–21 year olds to identify relevant barriers, motivators, and facilitators to AMED use and to explicate the decision-making processes involved. The sensitisation method was used to collect data from a cohort of 60 young adult drinkers over a period of six months via individual interviews, focus groups, and introspections. The findings indicate that there may be a general understanding of the negative consequences of AMED use, and that these consequences can constitute barriers that serve to discourage frequent consumption among young people. This outcome suggests the potential application of positive deviance and social norms approaches in interventions designed to reduce AMED use among this population segment. The results are promising in the identification of a large number of concerns among young adults relating to AMED use. These concerns can constitute the focus of future communications with this target group. The results are likely to have relevance to other countries, such as the US and the UK, that share similar alcohol cultures and where energy drinks have achieved comparable market penetration rates.

Typology of alcohol mixed with energy drink consumers: motivations for use.

Previous research on alcohol mixed with energy drinks (AmED) has shown that use is typically driven by hedonistic, social, functional, and intoxication-related motives, with differential associations with alcohol-related harm across these constructs. There has been no research looking at whether there are subgroups of consumers based on patterns of motivations. Consequently, the aims were to determine the typology of motivations for AmED use among a community sample and to identify correlates of subgroup membership. In addition, we aimed to determine whether this structure of motivations applied to a university student sample. Data were used from an Australian community sample (n=731) and an Australian university student sample (n=594) who were identified as AmED consumers when completing an online survey about their alcohol and ED use. Participants reported their level of agreement with 14 motivations for AmED use; latent classes of AmED consumers were identified based on patterns of motivation endorsement using latent class analysis. A 4-class model was selected using data from the community sample: (i) taste consumers (31%): endorsed pleasurable taste; (ii) energy-seeking consumers (24%): endorsed functional and taste motives; (iii) hedonistic consumers (33%): endorse pleasure and sensation-seeking motives, as well as functional and taste motives; and (iv) intoxication-related consumers (12%): endorsed motives related to feeling in control of intoxication, as well as hedonistic, functional, and taste motives. The consumer subgroups typically did not differ on demographics, other drug use, alcohol and ED use, and AmED risk taking. The patterns of motivations for the 4-class model were similar for the university student sample. This study indicated the existence of 4 subgroups of AmED consumers based on their patterns of motivations for AmED use consistently structured across the community and university student sample. These findings lend support to the growing conceptualization of AmED consumers as a heterogeneous group in regard to motivations for use, with a hierarchical and cumulative class order in regard to the number of types of motivation for AmED use. Prospective research may endeavor to link session-specific motives and outcomes, as it is apparent that primary consumption motives may be fluid between sessions.

Longitudinal patterns of alcohol mixed with energy drink use among college students and their associations with risky drinking and problems.

The consumption of alcohol mixed with energy drinks (AmEDs) is a form of risky drinking among college students, a population already in danger of heavy drinking and associated consequences. The goals of the current longitudinal study were to (a) identify types of AmED users between the first and second year of college and (b) examine differences among these groups in rates of highrisk drinking and consequences over time. A random sample of college student drinkers (n = 1,710; 57.7% female) completed baseline and 6-month follow-up measures assessing alcohol-related behaviors. AmED use was endorsed by 40% of participants during the course of the study. As anticipated, four distinct groups of AmED users were identified (nonusers, initiators, discontinuers, and continuous users) and were significantly different from one another on drinking and consequence outcomes. Further, significant Time × Group interaction effects were observed for drinking and overall consequences. Generally, across all outcomes and time points, nonusers reported the lowest rates of drinking and consequences, whereas continuous users consistently reported the highest rates of drinking and consequences. Students who initiated AmED use during the course of the study also reported anabrupt increase in alcohol use and reported consequences. Findings suggest students who consistently engage in and initiate AmED use also engage in riskier drinking behaviors and experience higher rates of consequences. Interventions that specifically target AmED use may be warranted and have the potential to reduce alcohol-related consequences.

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.

Alcohol Mixed With Energy Drink Use Among U.S. 12th-Grade Students: Prevalence, Correlates, and Associations With Unsafe Driving

PurposeThe consumption of alcohol mixed with energy drinks (AmED) is a risky drinking behavior, most commonly studied using college samples. We know little about rates of AmED use and its associations with other risk behaviors, including unsafe driving, among high school students. This study examined the prevalence and correlates of AmED use among high school seniors in the United States. MethodsNationally representative analytic samples included 6,498 12th-grade students who completed Monitoring the Future surveys in 2012 and 2013. Focal measures included AmED use, sociodemographic characteristics, academic and social factors, other substance use, and unsafe driving (i.e., tickets/warnings and accidents) after alcohol consumption. ResultsApproximately one in four students (24.8%) reported AmED use during the past 12 months. Rates of AmED use were highest among males and white students. Using multivariable logistic regression models controlling for sociodemographic characteristics, results indicate that students who cut class, spent more evenings out for fun and recreation, and reported binge drinking, marijuana use, and illicit drug use had a greater likelihood of AmED use. AmED use was also associated with greater odds of alcohol-related unsafe driving, even after controlling for sociodemographic, academic, and social factors and other substance use. ConclusionsAmED use among 12th-grade students is common and associated with certain sociodemographic, academic, social, and substance use factors. AmED use is also related to alcohol-related unsafe driving, which is a serious public health concern.

Young adults who mix alcohol with energy drinks: Typology of risk-taking behaviour

IntroductionContrary to predictions, several studies have shown that people who consume alcohol mixed with energy drinks (AmED) display low odds of risk-taking during AmED versus alcohol drinking sessions. However, these results are based on treating AmED consumers as a homogeneous group. The aim of the present study was to determine typologies of AmED risk-taking behaviour amongst consumers, as well as identifying correlates of AmED risk-taking class membership. MethodsAmED consumers (N=403) completed an online survey where they reported whether they had engaged in risk behaviours in the preceding six months during AmED and alcohol drinking sessions. Latent class models were estimated based on AmED risk-taking data; univariate multinomial logistic regression was conducted to determine correlates of class membership. ResultsA 3-class model was selected based on fit and parsimony, identifying: 1) Low risk-taking consumers (38%): low probability of any AmED risk behaviours; 2) disinhibited intake consumers (48%): high probability of drinking and spending more than intended; and 3) high risk-taking consumers (14%): high probability of most AmED risk behaviours assessed. The latter two groups had significantly higher odds of being male and reporting hazardous alcohol use, more frequent AmED use, greater alcohol and ED intake in AmED sessions, and higher trait impulsivity scores. The latter two groups also reported significantly greater odds of risk-taking behaviours regardless of whether consuming alcohol only or AmED. ConclusionsAmED consumers are not a homogeneous group in regard to their risk-taking behaviours post-consumption. High likelihood of risk-taking behaviour in AmED sessions, as well as elevated risk-taking in alcohol drinking sessions, highlights the need for targeted harm minimisation policies and programmes for a significant minority of consumers.

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

Use of alcohol mixed with energy drinks as a predictor of alcohol-related consequences two years later.

This study examines the use of alcohol mixed with energy drinks (AmED) as a predictor of alcohol problems and alcohol-related consequences and accidents two years later in a college student sample. Longitudinal data on AmED use, alcohol consequences, and alcohol problems were collected from the fall of students' second year of college to the fall of their fourth year (N = 620, 49% male). After we controlled for demographic indicators and heavy episodic drinking, AmED use was a consistent predictor of negative alcohol-related outcomes 2 years later. Compared with no AmED use, both infrequent (i.e., one to three times per month) and frequent (i.e., one or more times per week) AmED use were associated with an increased risk of negative alcohol consequences and harmful/hazardous alcohol use (≥8 on Alcohol Use Disorders Identification Test [AUDIT]). Frequent AmED use was also associated with serious alcohol problems ≥16 on AUDIT) and an increased risk of alcohol-related accidents in the subsequent 2 years. Prospective risks of alcohol consequences related to AmED use suggest a continued need for research and policy to address the surveillance, etiology, and prevention of AmED use.

Combined alcohol and energy drink use: hedonistic motives, adenosine, and alcohol dependence.

Consumption of alcohol mixed with energy drinks (AmED) has been associated with both short- and long-term risks beyond those observed with alcohol alone. AmED use has been associated with heavy episodic (binge) drinking, risky behaviors, and risk of alcohol dependence. Laboratory research has demonstrated that AmED beverages lead to greater motivation to drink versus the same amount of alcohol consumed alone. However, the reason consumers find AmED beverages particularly appealing has been unclear. A recent report by Droste and colleagues (Alcohol Clin Exp Res 2014; 38:2087-2095) is the first study to investigate motivations related to AmED consumption and to determine which motives predict AmED consumption patterns, experience of drinking-related harms, and risk of alcohol dependence. The findings of this study significantly enhance our understanding of why AmED consumption is related to the risk of alcohol dependence and change our understanding of why consumers choose AmED beverages. The authors report that hedonistic motives strongly predicted AmED use and the harms associated with use. While intoxication-reduction motives predicted self-reported accidents and injuries, these motives did not predict AmED consumption patterns and risk of dependence. The risk of alcohol dependence may arise from repeated experiences when drinking alcohol is more pleasurable when energy drinks are consumed with the alcohol. This commentary will focus on why energy drinks might increase the rewarding properties of alcohol in social drinkers. In addition, discussion is provided explaining why more research on the neurotransmitter, adenosine, may actually inform us about the mechanisms contributing to the development of alcohol dependence.

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.

Is alcohol mixed with energy drinks consumption associated with susceptibility to smoking?

ObjectiveThis paper examines whether adolescent students in Canada who have never smoked but who drink alcohol mixed with energy drinks (AmED) are more susceptible to smoking than those who do not consume AmED. MethodsA nationally representative sample of 15,875 never-smoking students in grades 9 to 12 from the 2010–2011 Canadian Youth Smoking Survey is used. The association between AmED and susceptibility to smoking is examined using a logistic regression. ResultsAbout 28% of the never-smoking adolescents in grades 9 to 12 are susceptible to smoking, and 13% report using AmED. Results of the adjusted logistic regression analysis show a statistically significant positive association between consuming AmED and susceptibility to smoking. Never-smoking students who reported using AmED are more susceptible to smoking when compared with those who have not consumed AmED (OR=1.89; 95% CI=1.71–2.10). Similar results are obtained when the analysis is stratified by gender. ConclusionsThe consumption of AmED is associated with higher odds of smoking susceptibility among Canadian adolescents. AmED use could be a potential marker for smoking susceptibility among never-smoking adolescents.

Alcohol mixed with energy drinks: Are there associated negative consequences beyond hazardous drinking in college students?

ObjectiveThe consumption of alcohol mixed with energy drinks (AmED) is prevalent among college students as is hazardous drinking, a drinking pattern that places one at risk for alcohol-related harm. The present study, therefore, examined associations between AmED use, hazardous drinking, and alcohol-related consequences in college students. MethodsBased on a probability sample conducted in 2010, participants were 606 undergraduate students aged 18–25. AmED consumption included lifetime and past year use. Hazardous drinking and alcohol-related consequences were measured during the past year. Point prevalence was used to estimate rates of AmED use, and chi-square, ANOVA, and logistic regression were used to examine associations between AmED use, hazardous drinking, and alcohol-related consequences. ResultsLifetime and past year AmED use prevalence rates were 75.2% and 64.7%, respectively. Hazardous drinkers who engaged in AmED use were significantly more likely than past year hazardous drinkers who did not engage in AmED use to have had unprotected sex (OR=2.35, CI 1.27–4.32). ConclusionsAmED use appears to be highly prevalent among college students, and AmED use may confer additional risk for unprotected sex beyond hazardous drinking. Unprotected sex has implications for public health, and students who drink hazardously and consume AmED may be at greater risk.

Patterns of use and motivations for consuming alcohol mixed with energy drinks.

Use of alcohol mixed with energy drinks (AmED) is an increasingly prevalent trend. However, recent research has suggested that AmED use may result in increased alcohol consumption and engagement in risk behavior postingestion. Although the majority of research has been focused on AmED use outcomes, there is a current paucity of data on the patterns of AmED use and motives for consumption. Four hundred and three participants from an Australian community sample (n = 244 women) ages 18-35 who had consumed alcohol mixed simultaneously with energy drinks (ED) in the preceding 6 months completed an online survey regarding use of EDs, alcohol, and AmED. Although AmED sessions occurred relatively infrequently compared to alcohol sessions, the alcohol and ED quantity consumed in AmED sessions was significantly greater than recommended intake. Reports of AmED use context indicated that participants typically consumed AmED while engaging in heavy drinking in public venues. However, the primary motives for AmED use related to the situational context of use, functional and hedonistic outcomes, as well as the pleasurable taste; few participants reported using AmED to increase alcohol intake, to mask intoxication, to hide alcohol's flavor, or to simulate an illicit drug "high." AmED users may be coingesting in a context and at a quantity that enhances the possibility of risky alcohol outcomes, despite predominantly consuming AmED for the taste and the functional and hedonistic outcomes. Strong endorsement of motives relating to ease of access and low cost price suggests that alcohol policy reform in relation to licensing restrictions may be necessary to minimize the risk of harm.

Alcohol Mixed with Energy Drinks: Consumption Patterns and Motivations for Use in U.S. College Students

Binge drinking in college students is widespread and known to cause significant harms and health hazards for the drinker. One factor that may be exacerbating hazardous drinking in young people is the new popular trend of consuming alcohol mixed with energy drinks (AmED). However, rates of AmED use and motivations for AmED consumption in college students have not been well established. In this study, 706 undergraduate college students from a university in the United States participated in a web-based survey that queried self-reported alcohol, energy drink, and AmED use. In addition, motivations for using AmEDs were assessed. The results indicated that for all participants, 81% reported that they have tried at least one energy drink in the past and 36% reported consumption of at least one energy drink in the past 2 weeks. Alcohol consumption patterns were similar to findings from U.S. national surveys of college drinking, as 37% of respondents were classified as binge drinkers and 23% abstained from drinking. In the whole sample (including the alcohol abstainers), 44% reported trying AmED at least once and 9% reported AmED consumption at least once in the past 2 weeks. 78% of respondents agreed with the statement that AmEDs appeal to underage drinkers. When AmED users were asked about various motivations for consuming AmEDs, users reported that they consumed these beverages to get drunk and reduce sedation compared to alcohol alone. In conclusion, the consumption of AmEDs is common in U.S. college students. Motivations for using AmEDs include the reduction of the sedative effects of alcohol, an important interoceptive cue that one should stop drinking.

Drinking patterns and risk behaviors associated with combined alcohol and energy drink consumption in college drinkers

Objective In recent years the consumption of alcohol mixed with energy drinks (AmED) has become popular in young adults in North America. There have been few studies into the drinking patterns and risk behaviors that accompany this new form of alcoholic beverage consumption and more information is required to support harm reduction and prevention efforts. This paper goes beyond previous research by investigating risk behaviors associated with AmED use while (1) controlling for risk-taking propensity, (2) examining a range of outcomes (e.g. stimulant drug use), and (3) replicating previous findings in a Canadian sample. Method In winter 2009/10, a web-based survey was completed by 465 students (56% female) attending a university in Western Canada. Regression analyses were used to investigate whether consumption of AmED is associated with heavy drinking, stimulant drug use, and alcohol-related consequences. Results A total of 105 students (23%) reported consuming AmED in the past 30 days. These students were more likely to be heavier drinkers, than non-AmED users after controlling for risk-taking propensity. More frequent AmED drinkers had twice the odds of experiencing one or more negative consequences from AmED use (e.g. drinking and driving, being hurt or injured), compared to less frequent drinkers after controlling for risk-taking propensity and drinking behavior. Conclusions Students who consume AmED are at increased risk for harms. Therefore, consuming AmED should be considered “high-risk drinking” for university students and efforts should be made to discourage combined consumption.