Transcript Caffeinated Cocktails: Get Wired, Get Drunk, Get Injured

Caffeinated Cocktails: Energy Drink Consumption,
High-Risk Drinking and Alcohol-Related
Consequences Among College Students.
Mary Claire O’Brien, MD
NIDA/ODS Caffeine Symposium
July 8, 2009
Acknowledgements
Supported by Grants Number RO1 AA14007-2 and 2R01AA014007-06A1
from the National Institute on Alcohol Abuse and Alcoholism, and North
Carolina DHHS/ OJJDP EUDL Award Number 2004-AH-FX-0014.
Co-authors
 Thomas P. McCoy
 Scott D. Rhodes
 Ashley Wagoner
 Mark Wolfson
Presenter Disclosure
Mary Claire O’Brien, M.D.
The following personal financial relationships with
commercial interests relevant to this presentation
existed during the past 12 months:
“No relationships to disclose”
Yes!
It really is like the TV show.
Youth and alcohol
 Risk taking
 Independence seeking
 Experimentation
 Underage drinkers
consume almost 20%
of all alcohol in the
U.S.
 6th, 7th, and 8th
graders: 31.5%
reported drinking all
types of alcohol
 4 out of 5 college
students drink; ½
binge
 18-25 yr olds: highest
rate of binge drinking
among all U.S. adults
Study to Prevent Alcohol-Related Consequences
Among College Students (“SPARC”)
 Randomized group trial
 Community organizing approach
 Environmental strategies
 Availability (e.g. keg restrictions, compliance
checks, responsible beverage service policies…)
 Price/ marketing (e.g. regulation of “happy hours,”
limits on alcohol industry presence on campus…)
 Social norms (e.g. substance free housing,
parental notification…)
 Harm minimization (e.g. Safe Ride programs)
 PrincipaI investigator: Mark Wolfson, Ph.D.
SPARC: The Evaluation
College Drinking Survey (CDS)
 Resident Advisor Survey
 Alcohol Incident and Injury Reports
 Campus Police, Student Affairs, Campus Health,
Campus EMS
 Coalition Member Survey
 Environmental Strategies and
Implementation Survey (ESIS)
 Coalition Activity Tracking
Annual Consequences of College Drinking
 1,700 deaths
 599,000 injuries
 696,000 assaults
 97,000 sexual
assaults
 2.8 MILLION DWI
Hingson, 2005
Effects of Energy Drink Ingestion
on Alcohol Intoxication.
Ferreira SE, Tulio de Mello M, Pompeia S, Oliviera de SouzaFormigoni ML.
Alcoholism: Clinical and Experimental Research.
Vol 30, No 4, 2006: pp 598-605.
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Alcohol
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Energy drink
Breath alcohol concentration
Motor coordination
Visual reaction time
Feelings of intoxication
Alcohol
+ Energy drink
Results
 Alcohol alone:
 Dizzy, weak, tired, headache, trouble walking
 Alcohol + Energy drink:
 Same BAC
 Felt much less “intoxicated”
 NOTE!
 Performance on motor coordination and visual
reaction time were the same for both groups!
“Buzz Beer”
≠
Caffeinated liquor
“Mix-your-own”
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Jager Bomb
Liquid Viagra
Crunk Juice
Bullvodka
Irish Trash Can
Bull Blaster
Up All Night
Liquid Cocaine #6
Tucker Death Mix
Butt Plug
Dirty Gecko
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Panty Dropper Punch
Cherry Bomb Shot
Bazooka #2
Jacobo’s Melon Bomb
Touchdown
Canadian Bull
Flaming Liquid Cocaine
Blaster
 Flip Passion
 Raging Bull #2
 Heart Attack
2006 SPARC CDS
 Ten NC Universities
 Stratified random sample
 Email invitation to participate
 Web-based (secure URL)
 Anonymous
 Reminder emails to non-respondents
 307 items, with skip patterns (~20 min)
 Paypal® incentive
SPARC College Drinking Survey: Content
 Demographic variables
 Alcohol consumption behaviors
 Alcohol availability
 How obtained (e.g. where, from whom)
 Where consumed
 Attitudes about drinking (one’s own, perception of other
students’)
 Perceived campus drinking norms
 Knowledge of university policies
 Perception of enforcement (on campus, in the community)
 Consequences of one’s own drinking
 Consequences of other students’ drinking
 Sexual behaviors
 Other substance use behaviors
2006 Additional Goals
 Estimate the prevalence of mixing alcohol with
energy drinks (AmED) among past 30-day
drinkers
 Examine the association of AmED and high-risk
drinking
 Examine the association of AmED with alcoholrelated consequences, after adjusting for drinking
behaviors
2006 Sample characteristics
 N = 4,271
 Average age 20.4 ± 2.8 yrs
 61% Female
 78% Non-Hispanic White
 26% Fr; 25% So; 25% Jr; 20% Sr
 12% Greek society member or pledge
 22% intramural athlete; 5% varsity
 57% on-campus resident
2006 SPARC CDS
4,271 students
4,237 answered
drinking questions
(99.2%)
2,886 past 30-day
drinkers (68%)
697 past 30-day
AmED (24%)
AmED = Alcohol mixed
with energy drinks
1,385 non past 30-day
drinkers (32%)
Reasons given for consuming AmED
 To hide the flavor of the alcohol
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To drink more and not feel as drunk
To drink more and not look as drunk
To not get a hangover
“Because it was being served at a party”
 “Because it was the only mixer available”
 “Because that’s how you make Jagerbombs”
AmED more likely…
 Male (p < 0.001)
 White (p < 0.001)
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Intramural athletes (p < 0.001)
Greek society members or pledges (p < 0.01)
Younger (p<0.01)
Average age of first drink: 15.1 yrs
 (vs. 16.0 yrs for non-AmED; p <0.001)
 More drinking during last year of high school (p < 0.001)
 More non-medical use of prescription stimulants
(p < 0.001)
High-Risk Drinking
Drinking
Behavior
Typical # drinks
in single episode
# days with 5/4
heavy episodic
drinking past 30
days
# days drunk in
a typical week
Most # drinks
single episode
past 30 days
Non-AmED
N=2,189
(76%)
4.5  0.15
3.4  0.17
0.73  0.04
6.1  0.15
AmED
N=697
(24%)
b
95% CI
z statistic
p-value
5.8  0.17
1.4
(1.1,
1.6)
11.69
<0.001
6.4  0.23
2.9
(2.5,
3.3)
14.21
<0.001
1.4  0.05
0.70
(0.61,
0.79)
15.44
<0.001
8.3  0.19
2.2
(1.9,
2.5)
14.28
<0.001
Alcohol-Related Consequences
Consequence
Non-AmED
N=2,189
(76%)
AmED
N=697
(24%)
AOR
95% CI
z statistic
p-value
Was taken advantage of
sexually
3.7%
(2.9, 4.8)
6.4%
(4.7, 8.7)
1.77
(1.23,
2.55)
3.05
0.002
Took advantage of
another sexually
1.7%
(1.2, 2.4)
3.7%
(2.5, 5.4)
2.18
(1.34,
3.55)
3.13
0.002
Rode with a driver who
was under the influence
of alcohol
22.5%
(18.6, 26.9)
38.9%
(32.7,
45.6)
2.20
(1.81,
2.68)
7.83
<0.001
Was hurt or injured
5.9%
(4.8, 7.2)
12.3%
(9.9, 15.3)
2.25
(1.70,
2.96)
5.74
<0.001
Required medical
treatment
1.2%
(0.8, 1.8)
2.6%
(1.7, 4.1)
2.17
(1.24,
3.80)
2.70
0.007
“Buzz Beer”
≠
2007 SPARC CDS
3, 783 answered
drinking questions
(99.2%)
3,813 students
1,114 non-drinkers
(30%)
2,669 past 30-day
drinkers (70%)
704 past 30-day
AmED (26%)
59 Pre-mix only
(8.4%)
249 Pre-mix + MYO
(35.4%)
393 MYO only
(55.8%)
AmED = Alcohol mixed with energy drinks
Pre-mix = Pre-mixed alcoholic energy drinks (e.g. Sparks®, Tilt®)
MYO = Mix-your-own alcoholic energy drinks (e.g. Jagerbomb, Red Bull® and vodka)
AME: Availability
 BOUGHT IT THEMSELVES: 65.5%
 Of these, 48.3% were under age 21
(223 of 462)
 GIVEN THE ED FOR FREE: 13.4%
 Of these, 79.8% were under age 21
(75 of 94)
 SOMEONE ELSE BOUGHT FOR THEM: 13.9%
 Of these, 71.4% were under age 21
(80 of 112)
Questions?