Caffeinated Energy Drinks – A Growing Problem

Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
Drug and alcohol dependence (Impact Factor: 3.42). 10/2008; 99(1-3):1-10. DOI: 10.1016/j.drugalcdep.2008.08.001
Source: PubMed


Since the introduction of Red Bull in Austria in 1987 and in the United States in 1997, the energy drink market has grown exponentially. Hundreds of different brands are now marketed, with caffeine content ranging from a modest 50 mg to an alarming 505 mg per can or bottle. Regulation of energy drinks, including content labeling and health warnings differs across countries, with some of the most lax regulatory requirements in the U.S. The absence of regulatory oversight has resulted in aggressive marketing of energy drinks, targeted primarily toward young males, for psychoactive, performance-enhancing and stimulant drug effects. There are increasing reports of caffeine intoxication from energy drinks, and it seems likely that problems with caffeine dependence and withdrawal will also increase. In children and adolescents who are not habitual caffeine users, vulnerability to caffeine intoxication may be markedly increased due to an absence of pharmacological tolerance. Genetic factors may also contribute to an individual's vulnerability to caffeine-related disorders including caffeine intoxication, dependence, and withdrawal. The combined use of caffeine and alcohol is increasing sharply, and studies suggest that such combined use may increase the rate of alcohol-related injury. Several studies suggest that energy drinks may serve as a gateway to other forms of drug dependence. Regulatory implications concerning labeling and advertising, and the clinical implications for children and adolescents are discussed.

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    • "Consuming multiple energy drinks over a short period as brief as only a few hours may cause caffeine intoxication resulting in heart palpitations, hypertension, nausea and vomiting, convulsions, psychosis, and in some rare cases, even death (Gunja & Brown, 2012; Trabulo, 2011; Winston et al., 2005). Research suggests that energy drinks pose a public health risk and may be linked to other substance use problems (Arria et al., 2011; Azagba, Langille, & Asbridge, 2014; Breda et al., 2014; Hamilton, Boak, Ilie, & Mann, 2013; Reissig et al., 2009; Terry-McElrath et al., 2014). "
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    ABSTRACT: Background: Energy drinks are popular beverages that can have adverse long-term health effects when consumed by children and adolescents. This study sought to determine if the age of first energy drink use in a U.S. military population is predictive of the maximum number of energy drinks consumed during a single day and/or single occasion (operationally defined as a couple of hours; e.g., a night out, during studying or sport session). Method: Student U.S. naval aviator and naval flight officers who reported past-year use of energy drinks (N. =. 239) were surveyed to determine various measures of energy drink consumption. Results: Age of first consumption was predictive of the maximum number of energy drinks consumed during a single occasion within the past year. Within this sample, the age range between 13 and 16. years appeared to be a critical period with results indicating that people who began consuming energy drinks during this period were 4.88 times more likely to consume high quantities (four or more) of energy drinks during a single occasion when compared to those who started consuming energy drinks between the ages of 20-23. Likewise, persons who began to consume energy drinks between the ages of 13-16 are 2.48 times more likely to consume high quantities of energy drinks during a single occasion than those who started between the ages of 17-19. There was no difference between 17 and 19. year olds and 20-23. year olds. Age of first use was not correlated to daily average intake or daily maximal intake of energy drinks. Conclusions: A lower age of first energy drink use suggests higher risk of single-occasion heavy episodic consumption in this military population. Researchers should further explore the relationship of early onset energy drink consumption and potential future health risks.
    Full-text · Article · Dec 2015
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    • "It has been associated with a four-factor structure in secondary school children labelled Junk Food, Caffeinated Soft Drinks/Gum, Healthy Foods, and Hot Caffeinated Beverages (see Richards et al., 2015b). Because caffeine content is known to vary considerably between energy drink products (Reissig et al., 2009), participants were asked to state the brand names of those that they consumed. This measure was included in order to increase the accuracy of estimating caffeine consumption. "
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    ABSTRACT: Previous research suggests that effects of caffeine on behaviour are positive unless one is investigating sensitive groups or ingestion of large amounts. Children are a potentially sensitive subgroup, and especially so considering the high levels of caffeine currently found in energy drinks. The present study used data from the Cornish Academies Project to investigate associations between caffeine (both its total consumption, and that derived separately from energy drinks, cola, tea, and coffee) and single-item measures of stress, anxiety, and depression, in a large cohort of secondary school children from the South West of England. After adjusting for additional dietary, demographic, and lifestyle covariates, positive associations between total weekly caffeine intake and anxiety and depression remained significant, and the effects differed between males and females. Initially, effects were also observed in relation to caffeine consumed specifically from coffee. However, coffee was found to be the major contributor to high overall caffeine intake, providing explanation as to why effects relating to this source were also apparent. Findings from the current study increase our knowledge regarding associations between caffeine intake and stress, anxiety, and depression in secondary school children, though the cross-sectional nature of the research made it impossible to infer causality.
    Full-text · Article · Oct 2015 · Journal of Psychopharmacology
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    • "The use of amphetamine-related drugs is often combined with beverages containing a high 90 quantity of caffeine in order to amplify their stimulant actions and reduce their side effects 91 (Mohamed et al., 2011; Reissig et al., 2009). Although caffeine use is safe (Ascherio et al., 92 2001; Fredholm et al., 1999; Schwarzschild et al., 2003), caffeinated energy drinks have 93 widespread popularity, and their use might influence the adverse effects of other substances 94 which are taken concomitantly (Mohamed et al., 2011; Morelli and Simola, 2011; Simola et 95 al., 2006). "
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    ABSTRACT: Amphetamine-related drugs, such as 3,4-methylenedioxymethamphetamine (MDMA) and methamphetamine (METH) are popular recreational psychostimulants. Several preclinical studies have demonstrated that, besides having the potential for abuse, amphetamine-related drugs may also elicit neurotoxic and neuroinflammatory effects. The neurotoxic potentials of MDMA and METH to dopaminergic and serotonergic neurons have been clearly demonstrated in both rodents and non-human primates. This review summarizes the species-specific cellular and molecular mechanisms involved in MDMA and METH-mediated neurotoxic and neuroinflammatory effects, along with the most important behavioral changes elicited by these substances in experimental animals and humans. Emphasis is placed on the neuropsychological and neurological consequences associated with the neuronal damage. Moreover, we point out the gap in our knowledge and the need for developing appropriate therapeutic strategies to manage the neurological problems associated with amphetamine-related drug abuse.
    Full-text · Article · Oct 2015 · Progress in Neurobiology
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