By Thomas Biancaniello, MD
On December 2nd the New York State Office of Alcoholism and Substance Abuse Services and the Department of Health issued a joint Health Advisory on Caffeinated Alcoholic Beverages identifying their use as a serious public health concern. Recent headlines in the newspapers and stories in the media have focused on their use in binge drinking particularly in college age students. A rash of visits to emergency rooms by college students raised the media attention. Some colleges and universities have banned these drinks from their campuses. These premixed drinks may contain other stimulants such as guarana, taurine, ginseng, or choline. Combining stimulants with alcohol can mask the effects of the alcohol resulting in impaired judgment and the protective effect of sleepiness, which can serve to protect from the overconsumption of alcohol that in the extreme can lead to serious health impairment or death. Alcohol can cause respiratory depression, unconsciousness, vomiting and aspiration and death.
Caffeinated beverages especially when combined with other stimulants and drugs such as cocaine may precipitate cardiac rhythm disorders which may directly result in death or impair cardiac function which may cause permanent injury to the heart, brain and other vital organs. Frequently individuals indulging in recreational drugs do not consider the harm in combinations or these drugs. Furthermore, the content and quantity of substances in illicit drugs is frequently unknown. This further increases the danger and risk.
While the news reports have focused on college students, we have already seen significant harm to younger students on Long Island. Not surprising, high school and junior high school students who may be drinking or using illicit drugs are also at risk for these combinations. Parents need to be vigilant – sometimes the sleepover is not just for staying up all night with friends.
While the government has focused attention on the manufacturers, one needs to remember the ingenuity of adolescents and substance abusers who have no problem mixing their own concoctions. High caffeine containing beverages are sold legally and underage drinkers seem not to have much trouble obtaining the alcohol to mix in. We are all aware of the dangers of access to prescription drugs in the medicine cabinets. We have also seen some of the over the counter medications withdrawn from the market because of their potential for abuse or for extraction of dangerous substances from them by amateur chemists.
In medicine we say there are no safe drugs. As parents we need to educate our children to the dangers of substances, even those that sold in local stores.