Are energy drinks unique mixers in terms of their effects on alcohol consumption and negative alcohol-related consequences?

International Journal of General Medicine Dovepress open access to scientific and medical research ORIGINAL RESEARCH International Journal of General Medicine downloaded from https://www.dovepress.com/ by 37.59.46.207 on 12-Jul-2018 For personal use only. Open Access Full Text Article Are energy drinks unique mixers in terms of their effects on alcohol consumption and negative alcohol-related consequences? This article was published in the following Dove Press journal: International Journal of General Medicine Sean J Johnson 1 Chris Alford 1 Karina Stewart 2 Joris C Verster 3–5 1 Department of Health and Social Sciences, Psychological Sciences Research Group, University of the West of England, 2Department of Applied Sciences, Biomedical and Analytical Sciences, University of the West of England, Bristol, UK; 3Division of Pharmacology, Utrecht University, Utrecht 4Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; 5Center for Human Psychopharmacology, Swinburne University, Melbourne, VIC, Australia Introduction: Previous research has suggested that consuming alcohol mixed with energy drinks (AMED) increases overall alcohol consumption. However, there is limited research examining whether energy drinks are unique in their effects when mixed with alcohol, when compared with alcohol mixed with other caffeinated mixers (AOCM). Therefore, the aim of this survey was to investigate alcohol consumption on AMED occasions, to that on other occasions when the same individuals consumed AOCM or alcohol only (AO). Methods: A UK-wide online student survey collected data on the frequency of alcohol consumption and quantity consumed, as well as the number of negative alcohol-related consequences reported on AO, AMED and AOCM occasions (N=250). Results: Within-subjects analysis revealed that there were no significant differences in the number of alcoholic drinks consumed on a standard and a heavy drinking session between AMED and AOCM drinking occasions. However, the number of standard mixers typically consumed was significantly lower on AMED occasions compared with AOCM occasions. In addition, when consuming AMED, students reported significantly fewer days consuming 5 or more alcohol drinks, fewer days mixing drinks, and fewer days being drunk, compared with when consuming AOCM. There were no significant differences in the number of reported negative alcohol-related consequences on AMED occasions to AOCM occasions. Of importance, alcohol consumption and negative alcohol-related consequences were significantly less on both AMED and AOCM occasions compared with AO occasions. Conclusion: The findings that heavy alcohol consumption occurs significantly less often on AMED occasions compared with AOCM occasions is in opposition to some earlier claims implying that greatest alcohol consumption occurs with AMED. The overall greatest alcohol consumption and associated negative consequences were clearly associated with AO occasions. Negative consequences for AMED and AOCM drinking occasions were similar, suggesting that energy drink was comparable with AOCM in this regard. Keywords: alcohol, energy drinks, caffeine, alcohol consumption, consequences Introduction Correspondence: Sean J Johnson Department of Health and Social Sciences, Psychological Sciences Research Group, University of the West of England Coldharbour Lane, Frenchay Campus, BS16 1QY, Stoke Gifford, Bristol, UK Tel +44 117 328 3812 Email 15 submit your manuscript | www.dovepress.com International Journal of General Medicine 2018:11 15–23 Dovepress © 2018 Johnson et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms. php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). http://dx.doi.org/10.2147/IJGM.S143476 Powered by TCPDF (www.tcpdf.org) Despite a recent report that alcohol consumption is declining among young adults in the UK,1 it remains a significant issue among UK university students. For example, university students have been reported to drink more than their non-university peers and the general population,2,3 with 65% of female and 76% of male UK students reporting at least 1 episode of binge drinking in the previous 2 weeks.4 This is further highlighted by 41% of UK students reporting drinking alcohol with the deliberate intention of getting drunk at least once a week.5 International Journal of General Medicine downloaded from https://www.dovepress.com/ by 37.59.46.207 on 12-Jul-2018 For personal use only. Johnson et al In the short-term, this excessive alcohol consumption leads to a decrease in academic performance6 and an increased susceptibility to alcohol-related harms such as anti-social behavior,7 driving while intoxicated8 and engaging in unsafe sexual practices.9 It may also lead to acute intoxication and alcohol poisoning, resulting in hospital admission.10 Long-term consequences include health-related problems and an increased risk of dependency later in life.11 Hence, this excessive alcohol consumption practice not only has an impact on the student concerned, but also has wide-ranging social, health and economic implications and thus presents a serious public health problem. Given the extent of this problem, in recent years, much research has concentrated on trying to understand the factors that may be driving this excessive consumption. One factor that has been linked to problematic student alcohol consumption is the rise in popularity of alcohol mixed with energy drinks (AMED) among this age group. A substantial body of survey research has consistently found that those who mix alcohol with energy drinks consume significantly more alcohol more often and in higher quantities and experience more negative alcohol-related consequences12–16 than those who consume alcohol alone. Early explanations for these observed differences focused on the idea that the stimulant effects of caffeine counteract the sedative effects of alcohol, leaving consumers feeling subjectively less intoxicated and therefore more likely to consume further quantities of alcohol and engage in riskier behaviors.17 However, evidence that AMED consumption reduces perception of intoxication is lacking, with a recent systematic review and meta-analysis concluding that “consuming alcohol with caffeinated beverages does not impair judgement of subjective intoxication”.18 More recently, some researchers19 have questioned the exclusive focus on energy drinks as a unique mixer when co (...truncated)