An article published in the journal Drug and Alcohol Dependence recommends that caffeinated energy drinks on the market have clear and prominent labels indicating the amount of caffeine contained in the drink. The researchers from Johns Hopkins University, after decades of research on how caffeine affects the body, say that consumers need to be more aware of potential health risks.

According to co-author Roland Griffiths, Ph.D., “The caffeine content of energy drinks varies over a 10-fold range, with some containing the equivalent of 14 cans of Coca-Cola, yet the caffeine amounts are often unlabeled and few include warnings about the potential health risks of caffeine intoxication.”

Americans purchase some $5.4 billion worth of energy drinks every year, and this figure is growing at about 55% every year. The target market includes teens and young adults who are exposed to advertising campaigns that focus on the performance-enhancing (stimulant) effects of energy drinks. There are fears that the marketing strategy also glorifies drug use.

Consumers are unlikely to realize the quantity of caffeine that they are ingesting unless producers use adequate, prominent labeling on their products. “It’s like drinking a serving of an alcoholic beverage and not knowing if its beer or scotch,” adds Griffiths.

Few people know of the clinical syndrome of caffeine intoxication, on that is accepted by authorities such as the Diagnostic and Statistical Manual of Mental Disorders and the World Health Organization’s International Classification of Diseases. Caffeine intoxication can lead to:

  • Nervousness
  • Anxiety
  • Restlessness
  • Insomnia
  • Gastrointestinal upset
  • Tremors
  • Tachycardia (rapid heartbeats)
  • Psychomotor agitation (restlessness and pacing)
  • Death (in rare cases)

According to the U.S. poison control centers, there have been reports of bad reactions from energy drink caffeine abuse. A 2007 survey of 496 college students revealed that over half (51%) consumed at least one energy drink in the previous month. Some 29% of these reported “weekly jolt and crash episodes,” and 19% said that the drinks caused heart palpitations. In addition, 27% of the students said that they consumed beverages that were a mixture of energy drinks and alcohol at least once in the previous month. “Alcohol adds another level of danger,” warns Griffiths, “because caffeine in high doses can give users a false sense of alertness that provides incentive to drive a car or in other ways put themselves in danger.”

For comparison purposes, it is interesting to note that a standard 12-ounce cola drink contains about 35 milligrams of caffeine, a 6-ounce cup of brewed coffee contains between 80 and 150 milligrams of caffeine, and energy drinks contain between 50 to over 500 milligrams of caffeine. Energy drinks are marketed as “dietary supplements,” and this enables them to avoid the limit that the Food and Drug Administration requires on the caffeine content of soft drinks – 71 milligrams for a 12-ounce can.

“It’s notable that over-the-counter caffeine-containing products require warning labels, yet energy drinks do not,” remarks study co-author Chad Reissig, Ph.D.

The authors conclude that: “Given that clinical pharmacology and epidemiological studies demonstrate an association of caffeine use with dependence on alcohol, nicotine, and other drugs, and one study showed that energy drink use predicts subsequent nonmedical use of prescription stimulants, further study of whether energy drink use serves as a gateway to other forms of drug dependence is warranted.”

“It is important for clinicians to be familiar with energy drinks and the potential health consequences associated with their use. Recognizing the features of caffeine intoxication, withdrawal, and dependence may be especially relevant when treating younger persons who may be more likely to consume energy drinks.”

Caffeinated energy drinks – A growing problem
Chad J. Reissiga, Eric C. Straina and Roland R. Griffiths
Drug and Alcohol Dependence (2008).
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Written by: Peter M Crosta