2. Energy Drinks and Alcohol Presented by: Gary Seech

3. Objectives Identify common ingredients in energy drinks and energy drinks with alcohol Understand markets and marketing strategies Identify and Understand the risks associated with these beverages.

4. What Exactly Are We Talking About? Energy drinks like Monster, Redbull, etc. Energy drinks that are used as mixers or contain alcohol

5. Energy Drinks The first energy drink to come to the US was Jolt in 1985 and they became hugely popular with Red Bull in 1997 Eventually used as mixers in bars and nightclubs with the addition of alcohol And by 2002 alcoholic energy drinks were being sold with Sparks being one of the first

6. Common Ingredient Caffeine Guarana berry Taurine Ginseng Ginkgo Various other supplements and sometimes vitamins

7. Caffeine It is the most commonly used drug in the world It is a central nervous system stimulant. When taken in small doses it can increase alertness Act as a diuretic, removes water from our bodies

8. Health Concerns of Caffeine In larger doses: Reduce fine motor coordination Cause insomnia Headaches Nervousness Raises your blood pressure Increase heart rate Can cause dizziness

9. from “Energy Drinks Pose Serious Health Risks for Young People By Emma Hitt, PhD Health Concerns of Caffeine It can be deadly, about 170 mg of caffeine divided by a person’s body weight measured in kilograms is a lethal dose. http://www.energyfiend.com/death-by- caffeine http://www.energyfiend.com/death-by- caffeine “Of the 5448 US caffeine overdoses in 2007, 46% occurred in those younger than 19 years old.”

10. Guarana (Berry) Grows in Venezuela and Brazil Popular soft drink in Brazil, unique flavor Digestive problems, weight loss, mental clarity, energy

11. Gaurana.com Health Concerns of Guarana Increases heart rate and blood pressure Often mixed with other stimulants Can inhibit sleep Can cause nervousness

12. Health Concerns of Guarana Since guarana has the same chemical characteristic as caffeine, when the two are mixed, overdose can occur. Supplements are not regulated, since they are not considered “food or drug”

13. Taurine Taurine (2-aminoethanesulfonic acid) is a nonessential amino acid. It is the most abundant free amino acid in many tissues. Is found in all tissues but most heavily in the heart and brain. Many claims about the health benefits of taurine supplements have been made but there is little research to support the claims.

14. Ginseng No approval for ginseng in any food or beverage Side effects of ginseng may include nervousness, agitation, insomnia, diarrhea, headaches, high blood pressure, and heart palpitations http://altmedicine.about.com/od/ginseng/a/gin seng.htm http://altmedicine.about.com/od/ginseng/a/gin seng.htm because these are considered supplements and not “food or drugs” there is no regulation

15. Coffee Productserving sizecaffeine (mg) Coffee, brewed8 ounces135 G F international Coffee, orange cappuccino8 ounces102 Coffee, instant8 ounces95 G F international Coffee, Café Vienna8 ounces90 Maxwell house Cappuccino, Mocha8 ounces60-65 G F international Coffee, Swiss Mocha8 ounces55 Maxwell House Cappuccino, French Vanilla/ Irish Cream 8 ounces45-50 Maxwell House Cappuccino, Amaretto8 ounces25-30 G F international Coffee, Viennese chocolate Cafe8 ounces26

16. Tea Productserving sizecaffeine (mg) Tea, leaf or bag8 ounces50 Snapple Ice Tea16 oz bot.48 Lipton Ice Tea mix8 ounces25-45 Lipton Tea8 ounces35-40 Lipton Ice Tea16 oz bot.18-40 Nestea Ice Tea16 oz bot.34 Green Tea8 ounces30 Arizona Ice Tea16 oz bot.15-30 Guarana.com

17. Things to Consider… Classified as nutritional supplements, they avoid the 71 mg limit for caffeine per 12 oz set for sodas by the FDA. Caffeine from other additives like guarana, kola nut, and yerba mate can increase the amount of caffeine in these drinks to as much as 400 mg per container. Consider the daily recommended dose of caffeine for teens, “100 or 200 milligrams”. Adults, “200 to 300 milligrams”. from “Energy Drinks Pose Serious Health Risks for Young People” By Emma Hitt, PhD

18. Things to Consider… The number of emergency room visits involving energy drinks doubled from 2007 to 2011, reaching more than 20,000, according to a new government report. During that period, the popularity of energy drinks has surged on college campuses, and in bars and convenience stores, according to ABC News. About 42 percent of emergency room cases in 2011 involved energy drinks combined with alcohol or drugs such as Adderall or Ritalin.

19. While men are more likely to buy energy drinks than are women… …the number of Emergency room visits due to energy drink use has doubled for both sexes. …this appears to indicate that the use of energy drinks has increased for both men and women. Things to Consider…

20. Most emergency room visits were from people ages 18 to 25 …but the group that had the largest increase by percentage was the group over the age of 40.

21. One self survey indicated that 30-50% of children, teens and young adults regularly consumed energy drinks.

22. Cocaine in a Can Promotes drug use? Promotes drug use?

23. General Health Concerns As reported in Germany, Australia, and New Zealand, adverse outcomes associated with energy drinks include: Liver damage Kidney failure Respiratory failure Seizure Cardiac symptoms and death Just to name a few….. from “Energy Drinks Pose Serious Health Risks for Young People” By Emma Hitt, PhD

24. Who Is at Risk Medical conditions, heart problems, diabetes, high blood pressure etc. Workers who’s work environment is typically hot and requires physical exertion. Athletes (heat and physical activity) Sensitive to caffeine or have an adverse reaction to the other stimulants those with substance abuse problems, ADHA, Eating disorders

25. Examples Use at ¾ way house Worker on the line was experiencing chest pains Employee kept complaining of feeling “dizzy” and passed out at work. The language of energy drinks-slamming and shooting

26. Energy Drinks and Alcohol There are over 300+ recipes that mix alcohol and energy drinks. Some common drinks include… Lager bomb – Red bull & Lagermeister Vegas bomb – Rum, Schnapps and Red Bull Green Monster – Vodka & Monster

27. Energy Drinks and Alcohol Prepackaged beverages that combine alcohol with caffeine. They can include taurine, guarana, ginseng, and other ingredients commonly associated with nonalcoholic energy drinks.

28. Energy Drinks and Alcohol They have a higher alcohol content than an average beer and are less expensive Easy to obtain and conceal Difficult for parents/educators/law enforcement to tell the difference Marketing is targeted towards teens Sometimes called “Alco pops”, “Speedball in a can”, or “chick beer”

29. Can you tell the difference?

31. How to Tell the Difference? There are two things to look for… 1.“ALC/VOL” is printed on the can. 2.Surgeon General’s Warning printed on the packaging.

32. Another Drinking Game Two teams of three Relay race Winning team gets a free round

33. What Happens When Mix Them? Risk of dehydration, both act as diuretics The stimulants encourage greater consumption (counteract the depressant effects of alcohol), increasing the risk of heavy binge drinking. Energy drinks contain stimulants and alcohol is a depressant. Mixing the two sends conflicting messages to your nervous system which can cause cardiac related problems

34. Confusion for Consumers Energy drinks “dilute” the alcohol affect Understand the stimulant affect, but not how it impacts the affects of intoxication If it has less calories that orange juice and gives me more energy it’s better Don’t understand the high alcohol content

35. Research Much of the research shows that college students: Were twice as likely to be hurt or injured Twice as likely to require medical attention Twice as likely to ride with an intoxicated driver More than twice as likely to take advantage of someone else sexually Almost twice as likely to be taken advantage of sexually

36. Caffeine Gum? Original marketed for gum chewers over the age of 25, this product contains 40 mg of caffeine per serving (one piece)

37. Wrigley has pulled its gum, “Alert Energy” from stores due to pressure from the FDA. The FDA has been investigating the many products that contain caffeine currently on the market. Some products have been banned and there are new rules expected for the marketing of these products Caffeine Gum?

38. Other Caffeine Gum Products

39. Questions Discussion and Comments