Thousands of ER Visits Tied to Energy Drinks

Thousands of ER visits have been linked to energy drinks, according to a new report from the Substance Abuse and Mental Health Services Administration. The large amounts of caffeine in energy drinks could be putting consumers of these drinks at risk for caffeine intoxication, which can lead to nervousness, anxiety, restlessness, insomnia, gastrointestinal upset, tremors, rapid heartbeat, and overdose.

The new report revealed an increase of more than 10-fold in ER visits associated with energy drinks from 2005 through 2009, said WebMD. In 2005, 1,128 ER visits were linked to the popular drinks versus 13,114 in 2009, with a high of over 16,000 ER visits in 2008. The American Beverage Association fired back with a statement arguing that the report is misleading.

While 44% of cases involved energy drinks drunk in combination with alcohol or other drugs, the report indicated that most ER patients told physicians they had only consumed energy drinks. “There’s been quite a bit of attention paid to those energy drinks that have alcohol with them. What we found was that there are actually more visits for those energy drinks that don’t have alcohol,” said Albert Woodward, PhD, director of the Drug Abuse Warning Network (DAWN) at the Substance Abuse and Mental Health Services Administration in Rockville, Maryland, said WebMD. DAWN reports, including this one, are published periodically.

may think that the alcohol-caffeine drinks are dangerous, but they may not have any idea that the caffeine-only drinks are also potentially problematic,” Woodward said. Experts who study energy drinks said the findings are concerning. “I do a lot of my research on combining alcohol and energy drinks and I know that’s really risky, but energy drinks by themselves, it’s been quite in debate whether they’re really all that dangerous,” since they’re touting as containing caffeine equivalent to that in a cup of coffee, said Cecile Marczinski, PhD, an assistant professor of psychology at Northern Kentucky University, wrote WebMD.

Marczinski noted that manufacturers are not required to report a drink’s total caffeine, only what is added, so there could be significantly more caffeine from, for instance, guarana, a stimulant herb, said WebMD. “The caffeine in these drinks could be vastly underestimated,” she told WebMD. Marczinski said the drinks are more dangerous than coffee because they are packaged in large containers, so several servings can be consumed in one sitting. They are also very sweet and served cold, and are replace water or sports drinks, she told WebMD. “So it is easier, I think, to consume more of an energy drink than any other caffeinated food or product,” Marczinski added.

We’ve noted that while the U.S. Food & Drug Administration (FDA) has no “hard limit” on caffeine in soft drinks regulated as foods, the agency considers caffeine safe in soft drinks if it makes up 0.02% or less of the product, measured by weight. That translates to 71 milligrams in a 12-ounce container, according to a prior Johns Hopkins study, which revealed that Red Bull had 80 milligrams of caffeine per drink; Rockstar, 160; No Fear, 174; Wired X505, 505; Fixx, 500; and Cocaine Energy Drink, 280.

ER doctors said the symptoms referred to in the report were likely similar to those seen in a typical caffeine overdose. “Those symptoms include a fast heart rate, elevated blood pressure, maybe a fever, agitation, moodiness, confusion, and perhaps difficulty with fine motor control,” Tamara R. Kuittinen, MD, director of medical education in the department of emergency medicine at Lenox Hill Hospital in New York City, told WebMD.

Effects can be exacerbated if the person is taking another medication or abusing drugs. This report revealed that of those who received ER treatment, 27% were taking another pharmaceutical; 16% had consumed alcohol, and 10% had used illegal drugs, said WebMD. The caffeine in energy drinks can hide feelings of intoxication; earlier studies have found that people mixing energy drinks and alcohol in social situations are three times likelier to leave very drunk and are four times likelier to drive drunk, said WebMD.

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