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Are Energy Drinks Safe?

The use of high energy drinks has become a multibillion dollar business over the last several years with the greatest consumption by athletes, teens and young adults. While some athletes use them as performance enhancers, they are primarily used by adolescents and young adults to keep pace with their hectic lifestyles which include school, sports, extracurricular activities, jobs and social activities. The college application process has gotten so competitive that getting good grades and high SAT scores are no longer a safe bet that you will get into a good college. High school students need to develop their resumes with numerous activities in order to be competitive in the application process. For college students there are the academic rigors that require them to pull “all nighters” while studying for final exams. As a result young people have turned more and more to these high energy products to keep pace with their busy schedules. 

The main ingredients in these drinks are sugar and caffeine. Caffeine works by blocking the effects of adenosine, a brain chemical involved in sleep. When caffeine blocks adenosine, it causes neurons in the brain to fire. Thinking the body is in an emergency, the pituitary gland initiates the body's "fight or flight" response by releasing adrenaline. This hormone makes the heart beat faster and the eyes dilate. It also causes the liver to release extra sugar into the bloodstream for energy. Caffeine affects the levels of dopamine, a chemical in the brain's pleasure center. All of these physical responses make you feel as though you have more energy. Some of the other ingredients can include:

  • Ephedrine - A stimulant that works on the central nervous system. It is a common ingredient in weight-loss products and decongestants, but there have been concerns about its effects on the heart.
  • Taurine - A natural amino acid produced by the body that helps regulate heart beat and muscle contractions. Many health experts aren't sure what effect it has as a drink additive (and the rumor that taurine comes from bull testicles is false).
  • Ginseng - A root believed by some to have several medicinal properties, including reducing stress and boosting energy levels.
  • B-vitamins - A group of vitamins that can convert sugar to energy and improve muscle tone.
  • Guarana seed - A stimulant that comes from a small shrub native to Venezuela and Brazil.
  • Carnitine - An amino acid that plays a role in fatty acid metabolism.
  • Creatine - An organic acid that helps supply energy for muscle contractions.
  • Inositol - A member of the vitamin B complex (not a vitamin itself, because the human body can synthesize it) that helps relay messages within cells in the body.

·         Ginkgo biloba - Made from the seeds of the ginkgo biloba tree, thought to enhance memory.

Competition among the manufacturers who want to grab a share of this huge market has lead to products that push the outwards bounds of the caffeine amounts in their products. The main problem is that there are no limitations placed on the amount of caffeine that energy drinks contain. The FDA has set a standard for the amount of caffeine that cola type beverages can contain to 71 mg. per 12 ounce beverages. Many manufacturers avoid these limitations by classifying their products as dietary supplements which are not subject to FDA regulations. Some energy drinks can contain in excess of 500 mg of caffeine in one beverage. When you consider that a can of Coca Cola has about 34.5 mg of caffeine the disparity is astounding.

Significant amounts of intake of caffeine can lead to Caffeine Intoxication, a clinical syndrome which is listed in the Diagnostic and Statistics Manual (DSM-IV-R)  published by the American Psychiatric Association categorizes Caffeine Intoxication as:

A.  Recent consumption of caffeine, usually in excess of 250 mg (e.g., more than 2-3 cups of brewed coffee).

B.  Five (or more) of the following signs, developing during or shortly after, caffeine use:

(1)   Restlessness

(2)   Nervousness

(3)   Excitement

(4)   Insomnia

(5)   Flushed face

(6)   Diuresis (increased urine discharge)

(7)   Gastrointestinal disturbance

(8)   Muscle twitching

(9)   Rambling flow of thought and speech

(10) Tachycardia (excessively rapid heartbeat) or heart cardiac arrhythmia (irregular heart      

        beat)  

(11) Periods of inexhaustibility

(12) Psychomotor agitation

C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder (e.g., an Anxiety Disorder).

 

An extensive study by John’s Hopkins University published in Drug and Alcohol Dependence in September has brought significant attention of the use of energy drinks among young people. Rolland Griffiths, PhD, one of the authors of the article worries that these high energy drinks advertise their products as performance enhancers and stimulants – a marketing strategy that may put young people at risk for abusing even stronger stimulants such as the prescription drugs amphetamine and methylphenidate (Ritalin). A 2008 study of 1,253 college students found that energy drink consumption significantly predicted subsequent non-medical prescription stimulant use, raising the concern that energy drinks might serve as "gateway" products to more serious drugs of abuse. Potentially feeding that "transition" market, Griffiths says, are other energy drinks with alluring names such as the powdered energy drink additive "Blow" (which is sold in "vials" and resembles cocaine powder) and the "Cocaine" energy drink. Both of these products use the language of the illegal drug trade. 

A study of 795 undergraduates by scientist Kathleen E. Miller at the University at Buffalo's Research Institute on Addictions found that students who consumed energy drinks six or more days a month were much more likely to engage in a wide variety of risky behaviors than people who didn’t use energy drinks. White energy drinkers were about three times more likely to smoke cigarettes or abuse prescription drugs. Both whites and non-whites were more likely to have been involved in a serious fight in the year before the survey. 

Another problem with energy drinks is that they have become popular as mixers for alcoholic beverages, often in an effort to counteract drowsiness so that you can drink more alcohol. The combination of large amounts of caffeine and alcohol is especially dangerous, since alcohol by itself is known to trigger fast heart rhythms. Brown University’s Student Services Health website warns their students of the dangers of mixing alcohol with energy drinks:

  • Since energy drinks are stimulants and alcohol is a depressant, the combination of effects may be dangerous. The stimulant effects can mask how intoxicated you are and prevent you from realizing how much alcohol you have consumed. Fatigue is one of the ways the body normally tells someone that they've had enough to drink.
  • The stimulant effect can give the person the impression they aren't impaired. No matter how alert you feel, your blood alcohol concentration (BAC) is the same as it would be without the energy drink. Once the stimulant effect wears off, the depressant effects of the alcohol will remain and could cause vomiting in your sleep or respiratory depression.
  • Both energy drinks and alcohol are very dehydrating (the caffeine in energy drinks is a diuretic). Dehydration can hinder your body's ability to metabolize alcohol and will increase the toxicity, and therefore the hangover, the next day.

Moderate use of caffeine is generally considered safe for most people who do not have underlying health conditions. Taken in moderate doses, it can make the person who uses it temporarily feel better, think more clearly and work harder. But when you start to exceed doses of 300mg or more it can have serious consequences for you health especially if you are mixing it with alcohol. You should also check with your doctor if you are taking medication. High doses of caffeine can increase the side effects of certain medications.

Teens often abuse prescription drugs because of the myth that these drugs provide a medically safe high.

It is estimated that major depressive disorder (MDD) affects about 5% of adolescents, and that between 10 - 15% of adolescents have some symptoms of depression at any one time.

Statistics show that giving a teen a credit card does not teach them to be financially responsible or to encourage self-restraint, but actually promotes a “spend now and deal with the consequences later” mindset.

Girls are more likely to intentionally abuse prescription drugs than boys.

The reality of excessive interest rates and fees that often accompany credit card use for teens, can put youngsters in a position where they are losing out on admission to graduate school, getting a job, or renting an apartment because of damaged credit history.

Less than 33% of teens with depression get help, yet 80% of teens with depression can be successfully treated if they seek help from a doctor or therapist.

Traffic crashes are the greatest single cause of death for all persons age 6-33, and about 45% of these fatalities are alcohol-related crashes.

About 6.2 million Americans get a new genital HPV infection each year.

30% of teens with depression also have a substance abuse problem.

Freshmen bring an average of $1,585.00 in credit card debt to college.

About a third of women who seek services related to unprotected sex, such as pregnancy testing or emergency contraception, do not receive STD counseling, testing, or treatment.

7-10% of college students will drop out of school because of credit problems.

Teens with untreated depression are more likely to engage in risky sexual behaviors, leading to higher rates of teen pregnancy and sexually transmitted diseases.

Most smokers begin smoking as teens, and the average age of initiation is 12.5 years of age.

People with manic symptoms and Bipolar Disorder II are at a significant risk of later developing an alcohol abuse or dependence problem.

Motor vehicle crashes are the leading cause of death for U.S. teens, accounting for 36% of all deaths in this age group.

While 93% of teenage women report that their first intercourse was voluntary, one-quarter of these young women report that it was unwanted. 7

A comprehensive review of pediatric trials conducted between 1988 and 2006 suggests that the benefits of antidepressant medications likely outweigh their risks to children and adolescents with major depressive and anxiety disorders.

Adolescents are more likely than young adults to become dependent on prescription medications.

At least 50% of sexually active men and women acquire genital HPV infection at some point in their lives.

Teens whose parents talk to them regularly about the dangers of drugs are 42% less likely to use drugs than those whose parents don’t, yet only 1 in 4 teens report having these conversations. 

The teen pregnancy rate in the United States is the highest of any industrialized democracy, nearly twice that of Great Britain and 10 times that of Japan. 4

Compared with other age groups, teens have the lowest rate of seat belt use, and male high school students are more likely than female students to rarely or never wear seat belts.

A national study of women ages 15-44 found that women were almost twice as likely to receive contraceptive services rather than STD services.

The teenage pregnancy rate in the U.S. is at its lowest level in thirty years, down 36% since its peak in 1990. Research suggests that both increased abstinence and positive changes in contraceptive practice are responsible these recent declines in teen pregnancy.

A sexually active teenager who does not use contraceptives has a 90% chance of becoming pregnant within one year. 8

In the United States, at least 5-10 million girls and women and 1 million boys and men are struggling with eating disorders. 11

Among male drivers between 15 and 20 years of age who were involved in fatal crashes in 2005, 38% were speeding at the time of the crash and 24% had been drinking.

Homicide is the second leading cause of death among 15- to 24-year-olds overall. 16

Every two minutes, somewhere in America, someone is sexually assaulted. 22

One in four teenage girls in the U.S. had at least one common sexually transmitted disease.

Suicide is the third leading cause of death among youths ages 15 to 20. 19

The highest Chlamydia rates occurred among women ages 15 to 19 and 20 to 24.

About 44% of rape victims are under age 18. Three out of every twenty victims (15%) are under age 12. 25

Each year, half of all HIV infections are among people under the age of 25.

Crash risk is particularly high during the first year that teenagers are eligible to drive.

One out of every six American women have been the victims of an attempted or completed rape in their lifetime. A total of 17.7 million women have been victims of these crimes. 23

Teen girls ages 15-19 have the highest Gonorrhea rate of any age group.

The motor vehicle death rate for male drivers and passengers ages 16-19 is more than one and half times that of their female counterparts.

More than four in 10 young women become pregnant at least once before they reach the age of 20 - nearly one million a year teen pregnancies a year 3

The presence of teen passengers increases the crash risk of unsupervised teen drivers; the risk increases with the number of teen passengers.

Smoking is the leading preventable cause of death in this country. More than 400,000 Americans die from tobacco-related causes each year, and most of them began using tobacco before the age of 18.

The risk of motor vehicle crashes is higher among 16- to 19-year-olds than among any other age group.

Underage drinking costs the U.S. more than $58 billion every year; enough to buy every public school student a state-of-the-art computer. 

At all levels of blood alcohol concentration (BAC), the risk of involvement in a motor vehicle crash is greater for teens than for older drivers.

Teens who drink are more likely to be victims of violent crimes and sexual assault, have serious problems in school, be involved in drinking-related traffic crashes, and develop problems with alcohol later in life.

Nearly all the poison deaths in the U.S. are attributed to drugs, and most drug poisonings result from the abuse of prescription and illegal drugs.

Alcohol kills 6.5 times more youth than all other illicit drugs combined.

Persons aged 15-24, who represent only 14% of the U.S. population, account for 30% ($19 billion) of the total costs of motor vehicle injuries among males and 28% ($7 billion) among females.

Among young people ages 12-17, prescription drugs have become the second most abused illegal drug, behind marijuana.

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