1. Alcoholic Energy Drinks and Youth Alcohol Problems: An Overview James F. Mosher, JD Alcohol Policy Consultations October 12, 2010 Presentation at the California Department of Alcohol and Drug Programs’ Annual Training Conference, Sacramento, CA.

2. Alcoholic Energy Drinks (AEDs): What are they? Prepackaged beverages that combine alcohol with high levels of caffeine and other additives Contain between 4% and 12% alcohol in 8 oz. to 23.5 oz. cans

3. Added to Depressant Stimulant Alcoholic Energy Drinks: Impact on Adolescents

4. Caffeine Use Caffeine is “generally recognized as safe” by the US Food and Drug Administration as an additive to soda Minimum “safe” level of use in adolescents is unknown as studies are based on adults

5. Caffeine Use Disrupts sleep patterns Falsely stimulates the reward and reinforcement system of the brain.

6. Adolescent brains are still developing and are more vulnerable to these and other negative effects. (Temple, 2009)

7. Risk Taking and Caffeine Studies have found that energy drink consumption among college students and adolescents is associated with: Increase in impulsivity and sensation seeking Sexual risk taking Tobacco & illegal drug use Aggressive behavior Attention & conduct problems (Jones and Lejuez, 2005; Miller, 2008)

11. The Energy Drink Market: Youth Driven One in three teens are likely to use energy drinks compared to one in ten adults. Youth consumption is rapidly increasing.

12. Youth/Adult Energy Drink Consumers Mintel International Group 2007

13. Annual Sales of Energy Drinks U.S., Billions of Dollars [Projected] Source: xowill-team.com

14. Why are these potentially harmful? Joose is 12% alcohol in a 23.5 oz can  One can of Joose is similar in alcohol content to almost 5 shots, 5 bottles of beer or almost an entire bottle of wine with an unknown amount of caffeine

15. Alcohol + Energy Drinks = Increased Risk of Injury Stimulants cause a reduced subjective feeling of intoxication. Alcohol’s effects on motor skills, judgment, and mental acuity are not affected by stimulants S. E. Ferreira, Marco T. de Mello, S. Pompe´ ia,& M. L. Oliveira de Souza- Formigoni 2006.

16. The result: Increased risk taking and increased risk of injury – A “Wide Awake Drunk” Young, inexperienced drinkers are most likely to confuse the effects of mixing stimulants with alcohol. Alcohol + Energy Drinks = Increased Risk of Injury

17. College Students are at Particular Risk Students who mixed alcohol and energy drinks had double the risk of: Being hurt or injured; Requiring medical attention; Driving with an intoxicated driver; Being taken advantage of sexually; or Taking advantage of another sexually. (O’Brien, 2007)

18. Patrons leaving bars in a college community reporting consumption of caffeinated alcoholic beverages were: three times more likely to be highly intoxicated four times more likely to report an intention to drive than other drinking patrons. (Thombs, et. al, 2009)

19. Ventura County, CA car crash caused by a drunk driver who consumed Joose Alcoholic Energy Drink

20. “Total Marketing… combines all the key marketing elements into a single orchestrated thrust.” August Busch, III Promotion Place Product Price The 4 Ps of Total Marketing

21. Which of these energy drink brands contain alcohol? Blurred Lines Between Energy Drinks and AEDs

22. At One San Diego Middle School… Jovita Juarez, a Prevention Specialist, made a presentation to staff at the school about energy drinks. After the presentation, teachers checked the campus during lunch to see how popular the drinks were. They found that 12 of the 43 students with energy drinks were drinking alcohol (Oct 2007)

24. $2.39/16 oz = $.15/oz ($4.00/32 oz = $.125/oz) $2.59/23.5 oz = $.11/oz Price Comparison: Energy Drinks vs. AEDs

25. AEDs: Mixing Energy Drinks with Alcohol +

26. “Perfect Mix”