Caffeinated Cocktails: Get Wired, Get Drunk, Get Injured
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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.
26
26
Alcohol
26
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”
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
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
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)
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?