Why Caffeinated Alcohol Drinks Are So Risky

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"Blackout in a can." That's what kids call the fruity caffeinated-alcohol drinks that offer a cheap, fast way to get drunk and party all night. As safety concerns grow, so does the pressure to pull these potent products from store shelves. Oklahoma, Washington, Utah, and Michigan recently banned the drinks. Beverage retailers in Indiana are lobbying their state to do the same; Pennsylvania has asked state-run liquor stores to voluntarily stop selling them. Meanwhile, pressure is mounting on the FDA to finish its yearlong investigation into the drinks' safety.

While there have always been drinks that mix caffeine and alcohol, health experts say these pre-mixed cocktails are much more dangerous than rum and Coke or even Red Bull and vodka. The cans may be the size of two 12-ounce beers, but they deliver a much stronger punch. "Some, like Four Loko, are 12 percent alcohol and have something in the range of 200mg of caffeine," says Bruce Goldberger, a forensic toxicologist at the University of Florida. "That's the equivalent of five to six beers and four to five colas in one can." A 110-pound woman who downs a single can will have a blood-alcohol level twice the national intoxication standard, he says.

Brightly packaged and fruit-flavored, the beverages resemble sports drinks and attract young customers. They're also big and cheap: a 23.5-ounce can of Joose sells for less than $3. "When you're broke and want to get drunk, this is a cheap way to do it," says one Loyola of Chicago student who asked not to be identified.

The high caffeine levels prevent drinkers from falling asleep, overriding the body's natural defense against excessive alcohol consumption. Because they're "wide-awake drunk," Goldberger says, consumers don't realize how intoxicated they are. Studies reveal drinkers of caffeinated alcohol are more likely to engage in "risky behavior, like drunk driving and sexual assaults," he says.

The megadose of caffeine creates additional problems. Dr. Richard O'Brien, an emergency physician in Scranton, Pa., says he's seen an increase in drunken kids "coming in saying their hearts are pounding out of their chests." To date, he adds, "everyone I've seen drinking this stuff has been under 21."

Joose's Michael Mikhail, a father of teens, says his products are marketed only to adults. Phusion Projects LLC, which makes Four Loko, was not available for comment, but has sent letters to college presidents, offering to partner with them on alcohol education. But critics like O'Brien question how anyone can promote responsible drinking of a product like Four Loko. "Kids who buy it aren't drinking for social convention," he says. "They're on an intoxication quest."