Letter to the Editor in Regard to Peacock, Bruno, and Martin (2012): “The Subjective Physiological, Psychological, and Behavioral Risk‐Taking Consequences of Alcohol and Energy Drink Co‐Ingestion”

Department of Behavioral and Community Health , University of North Texas Health Science Center, Fort Worth, Texas.
Alcoholism Clinical and Experimental Research (Impact Factor: 3.21). 07/2013; 37(12). DOI: 10.1111/acer.12186
Source: PubMed
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    ABSTRACT: AimsAlcohol mixed with energy drinks (AmED) is a relatively new consumption trend generating increasing concern regarding potential adverse effects. Despite the political and health imperative, there has been no systematic and independent synthesis of the literature to determine whether AmED offers additional harms relative to alcohol. The aim of this study was to review the evidence about whether co-consumption of energy drinks and alcohol, relative to alcohol alone, alters: (i) physiological, psychological, cognitive, and psychomotor outcomes, (ii) hazardous drinking practices, and (iii) risk-taking behaviour.Methods Pubmed, PsycInfo, and Embase databases were searched up until May 2013 for articles outlining descriptive, observational analytic, and human experimental studies which compared target outcomes for AmED versus alcohol consumers (between-subjects), or AmED versus alcohol consumption (within-subjects). Odds ratios were calculated for target outcomes following screening, data extraction, and quality assessment.ResultsData were extracted from 19 articles. Analyses typically revealed increased odds of self-reported stimulation-based outcomes and decreased odds of sedation-based physiological and psychological outcomes relative to when alcohol was consumed alone, as indicated by rigorous cross-sectional descriptive research. These findings typically have not been reflected in experimental research, possibly due to the low doses administered relative to typical self-reported ‘real-life’ intake. AmED consumers generally report more hazardous alcohol consumption patterns and greater engagement in risk-taking behaviour than alcohol consumers. While most studies had equivocal findings, two studies showed lower odds of risk-taking behaviour for AmED relative to alcohol drinking sessions but limitations with respect to the outcome measures used restrict conclusions in regards to the behavioural outcomes of AmED use.Conclusions Mixing alcohol with energy drinks may exert a dual effect, increasing stimulation-based effects and reducing sedation-based outcomes; the clinical severity and dose threshold has not been established. At this stage it is unclear whether these changes in the nature of intoxication translate into greater alcohol intake and risk-taking behaviour.
    Addiction 05/2014; 109(10). DOI:10.1111/add.12622 · 4.74 Impact Factor
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    ABSTRACT: Emerging evidence indicates that consumers of alcohol mixed with energy drink (AmED) self-report lower odds of risk-taking after consuming AmED versus alcohol alone. However, these studies have been criticized for failing to control for relative frequency of AmED versus alcohol-only consumption sessions. These studies also do not account for quantity of consumption and general alcohol-related risk-taking propensity. The aims of the present study were to (i) compare rates of risk-taking in AmED versus alcohol sessions among consumers with matched frequency of use and (ii) identify consumption and person characteristics associated with risk-taking behavior in AmED sessions. Data were extracted from 2 Australian community samples and 1 New Zealand community sample of AmED consumers (n = 1,291). One-fifth (21%; n = 273) reported matched frequency of AmED and alcohol use. The majority (55%) of matched-frequency participants consumed AmED and alcohol monthly or less. The matched-frequency sample reported significantly lower odds of engaging in 18 of 25 assessed risk behaviors in AmED versus alcohol sessions. Similar rates of engagement were evident across session type for the remaining behaviors, the majority of which were low prevalence (reported by <15%). Regression modeling indicated that risk-taking in AmED sessions was primarily associated with risk-taking in alcohol sessions, with increased average energy drink (ED) intake associated with certain risk behaviors (e.g., being physically hurt, not using contraception, and driving while over the legal alcohol limit). Bivariate analyses from a matched-frequency sample align with past research showing lower odds of risk-taking behavior after AmED versus alcohol consumption for the same individuals. Multivariate analyses showed that risk-taking in alcohol sessions had the strongest association with risk-taking in AmED sessions. However, hypotheses of increased risk-taking post-AmED consumption were partly supported: Greater ED intake was associated with increased likelihood of specific behaviors, including drink-driving, sexual behavior, and aggressive behaviors in the matched-frequency sample after controlling for alcohol intake and risk-taking in alcohol sessions. These findings highlight the need to consider both personal characteristics and beverage effects in harm reduction strategies for AmED consumers. Copyright © 2015 by the Research Society on Alcoholism.
    Alcoholism Clinical and Experimental Research 04/2015; 39(5). DOI:10.1111/acer.12700 · 3.21 Impact Factor
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    ABSTRACT: Background In response to concern about whether mixing caffeinated energy drinks with alcohol (AED) increases alcohol consumption and related harm, and the role of industry in this debate, we conducted a comprehensive review of the research evidence on the effects of AED and documented industry involvement in this research. Method A systematic review of 6 databases. Studies must have examined the effect of consuming alcohol with energy drinks (ED) or caffeine on alcohol-related outcomes. Results 62 studies were identified; 29 were experiments, 9 had industry ties (8 with Red Bull GmbH). Young adults who consumed AED drank more alcohol and experienced more alcohol-related harm than other drinkers. There was insufficient evidence to conclude that AED led to increased alcohol consumption or altered the nature of alcohol-related harm. However, AED consumers reported that AED increased stimulation and alertness, offset fatigue from drinking, and facilitated drinking. Experimental research also found that combining ED or caffeine with alcohol increased stimulation and alertness, offset alcohol-related fatigue and increased the desire to keep drinking. It did not change BAC, perceived intoxication, perceived impairment and it did not reverse alcohol-induced impairment on simple psychomotor tasks. Combining ED/caffeine with alcohol reduced alcohol-induced impairment on some but not all aspects of complex tasks. Although few in number, studies with industry ties presented contrary evidence. Conclusion A growing body of evidence suggests that AED may facilitate drinking and related harms via its effects on intoxication but a causal link needs to be confirmed. The influence of industry involvement in this area of research needs to be monitored.
    Drug and Alcohol Dependence 04/2015; In press. DOI:10.1016/j.drugalcdep.2015.01.047 · 3.42 Impact Factor