ER doctors report on effects of caffeinated alcoholic beverages on minors

A team of emergency room doctors in New York City describes 11 cases of young people who wound up in the ER after drinking Four Loko in a report published in the latest Annals of Emergency Medicine.  The median age of the teenagers was 16.4 years.  The report starts with:

Premixed caffeinated alcoholic beverages such as Four Loko are promoted for their ability to mask alcohol’s effects and intensify the intoxication. Their brightly colored packaging, low cost, and retail placement mean that they are marketed like a sports or energy drink, appealing to a young consumer. These young drinkers may engage in high-risk behaviors that place them or others in danger, resulting in severe societal consequences. 

Four Loko is a top-selling caffeinated alcoholic beverage in the United States. Its popularity followed the surge in energy drink sales during the last several years, largely because of consumer marketing of caffeine’s stimulant and recreational effects. Since early 2011, caffeine has been removed as an ingredient of Four Loko because of governmental warnings.  Retail and Internet supplies of the original formulation exist, although manufacturing and distribution have halted . . . The combined use of caffeine and alcohol is increasing, especially among adolescents and college students, leading to increased alcohol related injury.

The report goes on to describe the 11 cases of adolescents who were brought the the ER under the influence of Four Loko and then concludes with a discussion that includes:

Adolescents and young adults who are naive to the effects of alcohol and caffeine may be at higher risk from these combination beverages . . . More than 35% of our patients had blood alcohol levels greater than twice the legal limit. This population is inherently immature, and intoxication with caffeine and alcohol can increase risk-taking behavior. Alcohol and caffeine combinations have been associated with higher rates of alcohol-related consequences, such as medical treatment, sexual assault, drunk driving, and injury.