Many have had those days,
following a stressful week of exams, where they are exhausted yet still want
to go out and have an alcoholic beverage. Some may think mixing alcohol with
caffeine or energy drinks will promote alertness and stamina when drinking, but
research suggests otherwise. It seems to be a common misconception that alcohol
and caffeine will prevent or lessen the negative effects of alcohol
consumption.
In general, drugs and their
rewarding symptoms work through activation of the median forebrain bundle,
which includes the nucleus accumbens (NA) and the ventral tegmental area (VTA).
This is called the reward pathway. Alcohol works through the activation of GABA
(an inhibitory neurotransmitter) to further decrease neuron activity, thus
resulting in decreased reaction times.
Alcohol also weakens glutamate’s stimulatory effects in the NA and VTA
(2). Because of its effects, alcohol is called a depressant (depresses the
nervous system). Caffeine is a stimulant that works in the reward pathway by
blocking an inhibitory neurotransmitter called adenosine. By blocking this
inhibitory neurotransmitter, caffeine allows for more neuron stimulation (1). Knowing
this, it seems that mixing a depressant with a stimulant will balance out,
right? Wrong, research suggests that consuming alcohol with caffeine or energy
drinks is not any better than alcohol without caffeine, when it comes to
driving or attention/reaction time performance.
In
comparing the effects of alcohol without caffeine and caffeinated alcoholic
beverages between participants on simulated driving and
attention/reaction times, one study found there was no difference in reaction
times, attention and driving between the groups (Howland et al. 2010). Furthermore, people’s expectations that
caffeine has reversal effects have been shown to result in further
impairment than in people who did not expect caffeine to counteract alcohol
(Fillmore, Roach, and Rice 2002). With this said, it is evident that the
“beneficial” effects of drinking alcohol with caffeine can actually lead to
further impairment if one expects the caffeine to counteract the alcohol. Though caffeine may make one “feel” more
alert and less impaired it has not been proven to reverse the depressant effects
of alcohol.
Fillmore MT, Roach EL, Rice JT. 2002. Does Caffeine
Counteract Alcohol-Induced Impairment? The Ironic Effects of Expectancy.
Journal of Studies on Alcohol. 63(6):745-754
Howland J, Rohsenow DJ, Arnedt TJ, Bliss CA, Hunt SK, Vehige
Calise T, Heeren T, Winter M, Littlefield C, Gottlieb DJ. 2010. The
acute effects of caffeinated versus non-caffeinated
alcoholic beverage on driving performance and
attention/reaction time. Addiction. 106: 335–3.
This is a really interesting post, Dominique! It is so relevant to today's young-adult crowd. Just this weekend, I was at a wedding, and I saw one of the other people in attendance ordering a "Vodka Monster". I thought to myself "gross!", but then I found out that it's actually a pretty common drink for people to order. I did a little further research to find out more about the possible negative effects of the alcohol/caffeine combo. According to Dr. David Weldy at the University of Toledo College of Medicine, the reason that this combination is considered dangerous is primarily because the energy drink is carbonated and dilutes the alcohol, increasing the rate of absorption of the alcohol. Additionally, the person is kept awake longer, which allows them to drink more alcohol than they would have originally (because they probably would have otherwise gone home and gone to bed). This could be really bad when one considers how low the Therapeutic Index is for alcohol (it's easy to reach toxic levels of alcohol in the bloodstream relative to some other drugs). If people aren't careful, they could drink themselves to the point of alcohol poisoning without thinking they were even close. Studies demonstrating the negative effects of caffeine drinks mixed with alcohol would be good to spread around to the greater population, especially to parents, because these drinks are becoming more and more popular, and they could be putting young students and adults, alike, at risk. Weldy says that manufacturers are starting to pick up on the trend and are selling pre-mixed energy/alcohol drinks. I figure the more we can prevent harmful effects of alcohol, the better.
ReplyDeleteReference:
Weldy, D. (2010). Risks of alcoholic energy drinks for youth. Journal of the American Board of Family Medicine, 23: 555-558. doi:
10.3122/jabfm.2010.04.090261
Dominque, this post was very interesting. I know a lot of college students use Redbull as a way to "keep the night going" and mix it with alcohol. It was interesting to see a physiological view behind the danger of mixing the two. It also made me think about how Redbull is not the only substance college students are mixing with alcohol. My senior year of college, my roommate came home to find a student that none of us knew, passed out on our porch. She immediately called 911. After they revived him two times on our porch he was taken to the ER. About a week later she got a call from the police detective reporting that the student had passed away and his mother wanted to come thank her for calling 911 on his behalf. Turn out he had taken Adderall as his choice of "energizer" that night and mixed it with copious amounts of alcohol.
ReplyDeleteYour post sparked me to research the effects of Adderall and alcohol. Like caffeine, Adderall is also a stimulant (Me 2009). Adderall targets the prefrontal cortex of the brain (PFC), accumbens, and the medial septum. It makes sense that it targets the PFC because the PFC is associated with attention and decision-making (Fitzgerald and Bronstein 2013). The accumbens has shown involvement in processing "rewards" and the medial septum is linked to arousal and movement (Fitzgerald and Bronstein 2013). Adderall boosts dopamine and norepinephrine neurotransmitter levels in the brain (Fitzgerald and Bronstein 2013). Dopamine has been shown to play a role in memory function and norepinephrine has been shown to play roles in attentiveness. Unlike caffeine, students are obtaining Adderall without a prescription and are often unaware of the risks involved with mixing it with alcohol. Adderall allows for the effects of alcohol to essentially be masked just like caffeine. It makes sense how the student who passed away was able to drink so much alcohol that night. By taking Adderall, you lose your ability to tell whether or not you have drank too much. Therefore, alcohol poisoning is at great risk. Adderall is able to essentially "shut off" the warning signs of alcohol poisoning (Me 2009). I feel it is important to bring to the forefront the dangers of mixing not only caffeine, but Adderall with alcohol. It was extremely frightening seeing a student's life being fought for on my porch. I do not know if the student was aware of the dangerous effects of Adderall and alcohol, but I would hate for more lives to be lost because of unawareness.
References:
Me M. Dec 2009. Why Adderall and alcohol do not mix. Health Central. http://www.healthcentral.com/adhd/c/849319/99292/adderall-alcohol-mix/2.
Fitzgerald KT, Bronstein AC. Feb 2013. Adderall® (Amphetamine-Dextroamphetamine) Toxicity. Topics in Companion Animal Medicine. 28.1:2-7.
http://www.ncbi.nlm.nih.gov/pubmed/23796480