Case series: intoxication from alcoholic “energy” drink

August 23, 2011, 10:26 pm

★★☆☆☆

Adolescents and Young Adults Presenting to the Emergency Department Intoxicated From a Caffeinated Alcoholic Beverage: A Case Series. Cleary K et al. Ann Emerg Med 08 Aug 2011 [Epub ahead of print]

Abstract

Before it was reformulated by the manufacturer, Four Loko — a popular caffeinated alcoholic beverage — contained alcohol, caffeine, guarana, and taurine. Because the product contains up to 12% alcohol by volume and comes in 23.5 oz containers, one can has an alcoholic content approximately equal to four 12-oz regular beers. Marketed with colorful packaging and fruit flavors, these drinks are widely used by adolescents and young adults. Many observers had expressed concern that the combination of alcohol and caffeine could increase toxicity and the potential risks of consuming Four Loko and other similar beverages. In November 2010, the manufacturer removed caffeine from the product.

Because of the re-formulation, this article is somewhat out of date, demonstrating again that traditional medical literature is too cumbersome to keep up with the rapid pace of developments in many aspects of toxicology, especially when it come to recreational drugs used by young people. The authors, from NYU and the New York City Poison Control Center, identified 11 patients seen in their pediatric emergency department over a 4 month period with intoxication related to consumption of Four Loko. (By the way, their peds ER sees patients up to 25 years of age.)

Alcohol levels tested in five patients ranged from 103 to 366 mg/dL. (The paper says these were blood alcohol levels, but virtually every hospital measures serum levels, so I wonder if that’s what we’re dealing with here.) All patients had altered mental status. No respiratory depression was documented.

There are additional data and demographic information in the article, but since the cases are highly selected and involved intoxication from a product formulation no longer available, nothing of clinical relevance can be gleaned from them.

Related posts:

The New York Times on Four Loko

New Jersey college bans alcoholic “energy” drink Four Loko

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