Alcohol & Caffeine - A Dangerous Combination

Drinks mixing high alcohol and caffeine content pose a great risk to teens and young adults

Concern over a controversial beverage concoction of caffeine and booze, that some experts say may not even be legal, could be posing a new health threat for the drinks' biggest fans: college-age people. The drinks—with names like Joose, Torque and Four Loko-- come in large cans covered with colorful graphics that experts and some students say make the alcoholic beverages hard to tell apart from non-alcoholic ones. The drinks sell for about three dollars each.

Four Loko comes in a 23.5 ounce can that contains 2.82 ounces of alcohol, or 12 percent. Experts say you'd have to drink almost six cans of Bud Light beer, or 67.2 ounces, to get the same amount of alcohol. The drinks also come with a jolt. The fruit punch-flavored Four Loko has 156 milligrams of caffeine. An eight ounce cup of coffee, by comparison, has about 100 milligrams of caffeine. "This is a dangerous product from what we've seen," Dr. McNamara said. "It doesn't have to be chronic use. I think it could happen to somebody on a first time use."

Doctor Mary Claire O'Brien of Wake Forest University led a recent study on the effects of combining alcohol and caffeine. She found that compared to college students who drink only alcohol, students who drink booze mixed with energy drinks are twice as likely to be injured, require medical attention or ride with an intoxicated driver. Those students are also more than twice as likely to take advantage of someone sexually.

O'Brien said mixing a depressant like alcohol with a caffeine stimulant is akin to stepping on the gas and brake of a car at the same time. "They can't tell that they're drunk," said O'Brien, an associate professor of emergency medicine and public health. "What this behavior gets is a wide awake drunk."

As the alcohol-caffeine concoctions -- sometimes dubbed "cocaine in a can" -- are becoming more popular on college campuses, officials are taking notice. Attorneys general in several states are investigating whether the drinks are being marketed to underage drinkers. One New Jersey college banned the drinks this month after 23 students were hospitalized with alcohol-related problems. At least some of them reportedly drank Four Loko.

A Food and Drug Administration spokesman told ABC News that determining whether drinks like Joose and Four Loko are legal is a high priority for the federal agency. The FDA says food additive regulations currently do not allow mixing caffeine with booze. Drink manufacturers maintain their products contain ingredients that are "generally recognized as safe" but now the FDA wants them to prove it.

Last year the agency sent 27 letters to drink makers seeking more information. 19 companies responded. "FDA intends to evaluate the information submitted by the manufacturers and other available scientific evidence as soon as possible in order to determine whether caffeine can be safely and lawfully added to alcoholic beverages," spokesman Michael Herndon said in an email. Herndon said the timing of any FDA decision to regulate the drinks is difficult to predict. Until then, the drinks will continue to be sold. If the agency determines the drinks are illegal or should be regulated, sanctions against the manufacturers could range from a warning letter to having their products seized.