A History of Caffeinated Alcoholic Beverages
Before 2010, a variety of pre-mixed caffeinated alcoholic beverages, often referred to as CABs, were popular, particularly among young adults. These products, such as Four Loko, Joose, and Sparks, combined a high alcohol content with caffeine and other stimulants like guarana and taurine. The combination was marketed as an energizing drink, but it created a dangerous phenomenon known as “wide-awake drunkenness,” where the stimulant effects of caffeine masked the depressant effects of alcohol.
The perception of alertness led individuals to consume more alcohol than they would have otherwise, increasing their risk of alcohol poisoning, binge drinking, and engaging in risky behaviors. Reports of hospitalizations and severe health incidents on college campuses led to increased public scrutiny and regulatory action. In response to mounting pressure and its own safety review, the FDA intervened, ending the era of mass-marketed CABs.
The FDA's 2010 Ruling and Its Impact
The FDA’s decision was a direct response to the public health concerns surrounding CABs. The agency issued warning letters to four companies, informing them that caffeine was an unsafe additive and that their products were subject to seizure under federal law. The ruling clarified that this prohibition applies specifically to the addition of caffeine to alcoholic beverages during production. It does not affect alcoholic drinks that contain caffeine naturally, such as coffee-flavored liqueurs, or beverages created by consumers or bartenders, such as an Irish coffee or a rum and coke.
This distinction is crucial. While the pre-mixed cans were removed from the market, people can still combine alcohol and caffeinated energy drinks themselves, a practice that the CDC has noted is still common, especially among college students. The health risks associated with this practice remain unchanged.
The Dangerous Synergy of Alcohol and Caffeine
Mixing alcohol and caffeine does not cancel out their opposing effects; rather, it creates a deceptive combination that can lead to dangerous overconsumption.
- Masked Intoxication: Caffeine is a central nervous system stimulant, while alcohol is a depressant. Caffeine can make a person feel less drunk than they actually are, delaying the natural signals of fatigue that would normally encourage them to stop drinking.
- Increased Binge Drinking: Feeling less impaired can lead people to drink for longer periods and consume higher quantities of alcohol. This dramatically increases the risk of binge drinking, which is defined by the NIAAA as consuming more than four drinks for men or three for women in about two hours.
- Higher Risk of Alcohol Poisoning: With the body's warning system compromised, drinkers are more likely to reach dangerously high blood alcohol concentrations. Symptoms of alcohol poisoning can include confusion, vomiting, seizures, and loss of consciousness, and it can be fatal if not treated.
- Cardiovascular Strain: Both substances affect the heart. Caffeine can increase blood pressure and heart rate, and when combined with alcohol, it can cause an irregular heartbeat. For individuals with pre-existing heart conditions, this can be particularly dangerous.
- Enhanced Dehydration: Alcohol and caffeine are both diuretics, meaning they cause increased urination. Together, they can rapidly lead to dehydration, which can cause headaches, fatigue, and muscle cramps.
Comparison Table: Pre-mixed CABs vs. Self-Mixed Cocktails
| Feature | Pre-Mixed Caffeinated Alcoholic Beverages (Before 2010) | Self-Mixed Cocktails (Today) |
|---|---|---|
| Caffeine Source | Added by the manufacturer as a stimulant during production. | Added by the consumer using separate ingredients (e.g., energy drinks, coffee). |
| Regulatory Status | Banned by the FDA as an unsafe food additive to malt liquor. | Unregulated by the FDA in terms of mixing, but manufacturers must adhere to labeling rules. |
| Caffeine Concentration | Often high and less controlled, sometimes equivalent to several cups of coffee per can. | Varies widely based on the specific caffeinated beverage and the ratio used by the consumer. |
| Risks | Historically linked to increased binge drinking and alcohol poisoning due to masked intoxication. | Still carries the same health risks (masking intoxication, cardiovascular strain) if not consumed responsibly. |
| Legality | Illegal to produce and market in the United States and Canada. | Legal to create and consume, but carries personal responsibility for safety and risks. |
Natural vs. Added Caffeine in Alcohol
As mentioned, the FDA ban specifically targets the added caffeine in beverages like the former Four Loko. This means that beverages with naturally occurring caffeine, like coffee-flavored liqueurs or certain types of beer brewed with coffee, are still legal. The key difference lies in the source and purpose of the caffeine. In a coffee liqueur, the caffeine is a natural component of the coffee extract used for flavor, not an additional stimulant intended to mask intoxication. This distinction underscores the regulatory focus on public health and the intentional marketing of high-risk beverages.
Conclusion: Personal Responsibility and Moderation
While pre-mixed caffeinated alcoholic drinks are a thing of the past in the U.S., the health risks they posed have not disappeared. The practice of mixing alcohol with energy drinks or coffee still carries the danger of consuming more alcohol than the body can safely handle. There is no official amount for how much caffeine is allowed in alcohol when mixing them yourself, emphasizing the need for personal responsibility.
The safest approach is to avoid mixing alcohol with caffeine. If you choose to do so, be extremely mindful of the quantities of both substances. Pay attention to your body's signals, and remember that feeling less intoxicated doesn't mean your blood alcohol level is lower. The stimulant from the caffeine will wear off, and the depressant effects of the alcohol will eventually set in, often with an intensified impact. Understanding the regulations and the science behind the dangers is the first step toward making safer and more informed choices about consumption. Learn more about the specific health effects of mixing alcohol and caffeine from the Centers for Disease Control and Prevention.
