Energy drinks and drinking more alcohol

They may make you feel like you can stay out all night but mixing alcohol mixed with energy drinks can be a dangerous combination. Energy drinks can mask the effects of alcohol, and make you 'wide awake drunk', so you may underestimate how you’re feeling and end up drinking more alcohol than you normally would.

Mixing alcohol and energy drinks can mean you consume more sugar, calories and caffeine than drinking alcohol by itself. You could also experience increased physical and psychological side effects from drinking this combination.

Popularity of energy drinks has increased in recent years. Since 2008, sales have increased by between 5.3 and 13.6% in the UK (1). At the same time, mixing spirits and liqueurs with them has become increasingly popular.

It’s common to see bars, pubs and clubs promoting these drink combinations, and you can buy energy drinks and bottles of alcohol separately in supermarkets and off-licences to mix at home. But recent research has found that mixing energy drinks with alcohol could be more risky than drinking alcohol on its own, or with a more traditional mixer.

We took a look at the research and talked with our medical experts to find out the facts about alcohol and energy drinks. When you combine a lot of the two, we discovered that you:

  • Can drink more alcohol, become ‘wide awake drunk’
  • Are likely to experience increased physical and psychological side effects, such as heart palpitations, problems sleeping, feeling tense or agitated (4)
  • Can consume large amounts of caffeine, which in this quantity, can cause anxiety and panic attacks
  • Increase your chances of developing short and long-term health problems (5).

Why you’ll drink more alcohol

Drinking energy drinks with alcohol can trick your brain and lead to a state researchers have called ‘wide awake drunk’ (6). Of course, this is why many people mix them – so they can stay awake longer and drink more alcohol.

But, though you might feel alert when you combine the drinks, your body is still experiencing the effects of alcohol (7). That means you can end up drinking more without realising that your judgement, balance and coordination are being affected. So, you’re more likely to risk doing things that you wouldn’t normally do, like getting into a fight or crossing the road when there’s a car nearby (8).

“Wide awake drunk’ means you’re alert but you underestimate how much you’re drinking and don’t know the alcohol is still affecting your thinking and ability to react in an emergency,” says London-based GP Sarah Jarvis. “It creates a false sense of security which can be dangerous.”

The combination has this effect because alcohol and energy drinks work in different ways. Alcohol is a depressant which means it slows down the brain’s functions and can act as a sedative – drink a lot and you might slur your words, have slower reflexes and feel sleepy. The caffeine in energy drinks, on the other hand, is a stimulant (9). If you mix the two, you’ll feel the stimulant effects of the caffeine more strongly, masking the interference caused by alcohol to reaction time, memory and other processes in the brain (10).

“This makes mixing alcoholic drinks with energy drinks a very risky thing to do, and a worrying trend,” says Professor Paul Wallace, Drinkaware’s Chief Medical Advisor.

Lasting physical and psychological side effects

Evidence shows that if you combine alcohol and energy drinks you can experience physical and psychological side effects – more so than if you drank alcohol on its own. This includes heart palpitations, problems sleeping, feeling tense or agitated (11). This is a result of the high volume of caffeine in energy drinks.

“Caffeine is a long lasting drug,” says Professor Jonathan Chick, a Consultant Psychiatrist. “In high quantities, it increases the heart rate and so does alcohol. And although alcohol sends you to sleep, it can cause you to wake up in the night. So people who consume both may well expect to have a doubling of their mid to late night insomnia.”

Caffeine in energy drinks

Young people are particularly susceptible to caffeine which is not good for you in excess. Drink a lot of it, and you can feel very anxious and experience panic attacks. Energy drinks are packed with caffeine. There’s usually about 80 milligrams (mg) of caffeine in a small 250ml leading brand can – the same as three cans of cola or a mug of instant coffee (12).

Medical experts suggest children, or other people sensitive to caffeine, should only consume caffeine in moderation. Pregnant women are advised not to have more than 200mg of caffeine a day, roughly two mugs of instant coffee or one filter coffee (12). 

“With a large amount of caffeine in a single drink, it’s frightening to think how many times this could be exceeded if someone is combining alcohol and energy drinks on a night out,” says Dr Jarvis.

Calories and sugar in alcohol and energy drinks

Combined with the large amount of calories in alcohol, the high sugar content in many energy drinks can mean you can put on weight if you drink them regularly. Putting on weight and drinking alcohol can increase your risk of developing type 2 diabetes. When you mix alcohol and energy drinks, the high sugar content you consume also adds to this risk (13).

A small can of energy drink contains up to 30g (14) so just one energy drink can be about half of your daily sugar allowance. Alcohol can also be calorific, with a 50ml measure of the liqueur typically mixed with energy drinks containing 126 calories. 

Find out more about the symptoms of diabetes and how alcohol can be a contributory factor.

Advice

More research and larger studies are needed to establish the impact of mixing alcohol and caffeine. Energy drinks are still relatively new so research into them alone is limited, but reports link them to seizures, mania, stroke and sudden death. Some countries are restricting the sale and marketing of energy drinks because of health c

oncerns like these (17).

If you’re combining alcohol with energy drinks, be aware that you might drink more than you thought you would and that the alcohol is still having an effect even though you might not be able to feel it much.

“The more alcohol you drink, the higher your risk of developing long-term health harms associated with alcohol, which include increased chances of developing cancer, liver disease and stroke,” says Professor Wallace. “So people need to be particularly careful of an alcohol combination that encourages them to drink more.”

Alcohol and energy drinks – top tips:

While we don’t recommend mixing alcohol and energy drinks, if you do decide to drink them together, it is possible to reduce the risk of short and long term harms by: 

1. Tracking how much you’re drinking. You can easily drink more than you realise when you combine alcohol and energy drinks. Try not to drink more than one over the course of a night. And keep a careful track of the number of units you’re drinking to avoid exceeding the low risk unit guidelines. 
2. Keeping tabs on your friends. You’re more likely to take risks when you combine these drinks so keep an eye on your friends as well as yourself.
3. Eating. A full stomach helps to slow down the rate your body absorbs alcohol, so it won’t go to your head so quickly. Starchy food like pasta or potatoes are the best foods to eat before or during your night out.
4. Keeping check of caffeine and sugar content. Energy drinks contain high amounts of both which can have an effect on your health, including your weight and mood. So if you have access to the information about the calorie, sugar and caffeine contents of the drinks you are drinking, try not to exceed the daily allowance

5. Avoiding drinking them before going to bedAlcohol and energy drinks can both cause insomnia so avoid drinking them if you know you’ll be heading home soon.

References

(1) British Soft Drinks Association, ‘Changing tastes. The UK Soft Drinks Annual Report 2015’, London, 2013. Available at:

http://www.britishsoftdrinks.com/write/MediaUploads/Publications/BSDA_Annual_Report_2015.pdf 
(2) Megan E. Patrick and Jennifer L. Maggs, ‘Energy Drinks and Alcohol: Links to Alcohol Behaviors and Consequences Across 56 Days, Journal of Adolescent Health, 3 December 2013. Available at
http://www.jahonline.org/article/S1054-139X(13)00511-9/abstract
(4) Amy Peacock, Raimondo Bruno, and Frances H. Martin, ‘The Subjective Physiological, Psychological, and Behavioural Risk-Taking Consequences of Alcohol and Energy Drink Co-Ingestion, Alcoholism: Clinical and experimental research, vol. 36, no. 11, November 2012. Available at:
http://www.ncbi.nlm.nih.gov/pubmed/22897756
(7) (8) Angela S. Attwood, ‘Alcohol and caffeine Caffeinated Alcohol Beverages: A Public Health Concern’, Alcohol and Alcoholism, vol. 47, no. 4, pp. 370–371, 2012 doi: Advance Access Publication 29 May 2012. Available at:
http://www.ncbi.nlm.nih.gov/pubmed/22645036
(9) A Zwyghuizen-Doorenbos, TA Roehrs, L Lipschutz ,V Roth Timms, ‘Effects of caffeine on alertness’, Psychopharmacology (Berl). 1990, vol. 100, no. 1, pp.36-9. Available at:
http://www.ncbi.nlm.nih.gov/pubmed/2296626
(10) Angela S. Attwood, ‘Alcohol and caffeine Caffeinated Alcohol Beverages: A Public Health Concern’, Alcohol and Alcoholism, vol. 47, no. 4, pp. 370–371, 2012 doi: Advance Access Publication 29 May 2012.
http://alcalc.oxfordjournals.org/content/47/4/370.full.pdf
(11) Amy Peacock, Raimondo Bruno, and Frances H. Martin, ‘The Subjective Physiological, Psychological, and Behavioural Risk-Taking Consequences of Alcohol and Energy Drink Co-Ingestion’, Alcoholism: Clinical and experimental research, vol. 36, no. 11 November 2012. Available at:
http://www.ncbi.nlm.nih.gov/pubmed/22897756
(12) Food Standards Agency, ‘High caffeine energy drinks and other foods containing caffeine’, accessed 30/01/2015. Available at:
http://www.food.gov.uk/policy-advice/additivesbranch/energydrinks#.UtwAMhDFLIU
(13) Scientific Advisory Committee on Nutrition, Carbohydrates and Health (2015). Available here:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/445503/SACN_Carbohydrates_and_Health.pdf
(14) Seifert, S.M., Schaechter, J.L., Hershorin, E.R. and Lipshultz, S.E., 2011. Health effects of energy drinks on children, adolescents, and young adults.Pediatrics, 127(3), pp.511-528. Available at:
http://pediatrics.aappublications.org/content/pediatrics/127/3/511.full.pdf
(7) Seifert, S.M., Schaechter, J.L., Hershorin, E.R. and Lipshultz, S.E., 2011. Health effects of energy drinks on children, adolescents, and young adults.Pediatrics, 127(3), pp.511-528. Available at:
http://pediatrics.aappublications.org/content/pediatrics/127/3/511.full.pdf