Concern is growing about the harms that may arise from heavy drinkers mixing alcohol with so called energy drinks to enable them to drink for longer and achieve higher levels of intoxication. On Friday and Saturday evenings, about 40% of people on Australian city streets are heavily intoxicated (breath alcohol concentrations (BAC) greater than 0.087 mg alcohol/100 ml) and nearly a quarter of these drinkers will have consumed more than two energy drinks.1 Data are lacking on energy drink use by alcohol drinkers in other countries but in samples, 73% of US college students2 and 85% of Italian college students3 reported consuming energy drinks mixed with alcohol in the past month.
Epidemiological studies show that drinkers who consume energy drinks are more likely to record a higher breath alcohol concentration than those who do not.4 They are also more likely to report drinking more alcohol5; engaging in aggressive acts1; being injured1 6; symptoms of alcohol dependence7; having driven while drunk or been a passenger in a car with an alcohol impaired driver1; and having taken sexual advantage of, or having been taken advantage of, by another person.
The role that energy drinks may play in facilitating intoxication is under-researched. Because of ethical concerns about people getting too drunk and drinking too many energy drinks, much of the research in laboratory settings has studied only the effects of combining low levels of alcohol intoxication (BAC less than 0.1 mg alcohol/100 ml) with a single energy drink (equivalent to a strong cup of coffee).
Some researchers doing these studies have concluded that we should not be concerned about the risks of combining alcohol and energy drinks. But evidence from these studies does not convincingly refute the hypothesis that more energy drinks consumed with more alcohol facilitates intoxication and increases the risk of alcohol related injuries and assaults.
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