As the popularity of energy drinks have surged, so have ER visits due to hazardous side effects of these highly caffeinated beverages. Sold under such brand names as Red Bull, Monster, 5-Hour Energy and Full Throttle, energy beverages are a $5.4 billion market. But that demand for fast energy resulted in 13,114 ER visits linked to energy drinks in 2009, an astounding ten times the number for 2005, says a new report issued by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Energy drinks and "energy shots" are sold everywhere, it seems: in supermarkets, gas stations, even drugstores. Young athletes, truck drivers and college students buy them for a quick—but dangerous—pick-me-up, usually near the cashier’s station—no ID required. At least four documented caffeine-associated deaths have occurred in users of energy drinks, reports the Tucson Citizen. Here’s a closer look at the health hazards.
The age breakdown is telling; patients in nearly every age group reached for an energy drink last year. More than half of those ER patients were young adults (college age, 18 to 25), while another one-third were aged 26 to 39. Teens (age 12 to 17) and over-40 adults each accounted for 11 percent of the visits. Nearly two-thirds of the ER patients were men. In 16 percent of cases in which alcohol also was involved. And in another 10 percent of the ER visits, illegal drugs were taken along with the energy drinks. Some 27 percent of the ER patients were taking a drug of some kind, in many instances a stimulant such as Ritalin.
The dangers lie in the high levels of caffeine. According to a report in the Journal of the American Medical Association (JAMA), one ounce of cola contains up to 4.5 mg of caffeine, while coffee ranges from 12.8 to 25 mg per ounce, depending on how strong the brew. Yet an energy drink contains up to 35.7 mg per ounce, nearly three times the strength of some caffeinated coffees. The small "energy shot" drinks offer even more concentrated caffeine—between 90 mg and 171 mg of caffeine per ounce.
The consequences of ingesting all of that caffeine include elevated blood pressure, seizures, accelerated heart rate, liver damage, or even death. In pregnant women using energy drinks, late miscarriages, small fetus size and stillbirths have been reported. Since energy drinks are classified as supplements, they aren’t regulated by the FDA, which limits the caffeine content of cola drinks to 71 mg per 12 ounces. There’s no such restriction on energy drinks.
It’s a recipe for disaster: users of energy drinks and alcohol can underestimate their impairment, believing the caffeine has sobered them up, a feeling sometimes referred to as "wide-awake impairment." Studies show people who drink alcohol and energy drinks together are four times more likely to be drunk when they drive.
Students can easily confuse energy drinks with "sports drinks," and that has school athletic officials concerned. Infused with carbohydrates, minerals, electrolytes and flavorings, sports drinks can be useful during "prolonged, vigorous physical exercise," says the American Academy of Pediatrics (AAP), but they can contribute to obesity and tooth decay and shouldn’t be guzzled during normal physical activity. For moderate activity, water is the best and safest thirst-quencher.
Along with caffeine, energy drinks typically contain unregulated herbal stimulants like guarana and yerba mate, or less commonly, bitter organe and yohimbine, both of which can increase heart rate and interact with certain antidepressant medications, according to the National Institutes of Health. Often loaded with sugar, energy drinks offer little or no nutritional value and don’t improve sports performance.
In new guidelines released last May, the AAP came out against the use of caffeinated energy drinks by children and teens under any circumstances because of the stimulants in the drinks. They also recommended screening for sports and energy drinks during annual physical exams for athletes, stressing that it’s far better for students to hydrate themselves with water, before and during workouts and sports activities. Energy drinks may be particularly harmful to kids with such disorders as ADHD, diabetes or heart disorders.
SAMSHA Administrator Pamela Hyde warns that quick-fix energy drinks "carry great risks, especially in combination with other substances of abuse." For most healthy adults, according to the Mayo Clinic, moderate amounts of caffeine—200 to 300 mg. daily, or about two to four cups of coffee—aren’t harmful, while higher amounts can have unpleasant or even dangerous side effects. In general, the best ways to boost your energy level are to eat a healthy diet, exercise regularly, and sleep 7 to 8 hours a night.
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