Nov. 30--While Texas regulatory officials are adding their own pressure to three federal agencies' crackdown on cans of caffeinated alcohol, Houston doctors are still worried about the unconstrained mixing of the two drinks at clubs and bars.
The Texas Alcoholic Beverage Commission this month asked vendors to cease distributing the products and remove them from store shelves. The request followed Food and Drug Administration, Treasury Department and Federal Trade Commission warnings to companies that make the beverages that they're unsafe and illegal.
"It's great that public officials are moving to discourage these canned products, but the mixing of the drinks is still very prevalent in bars and clubs," said Dr. John Higgins, a Houston cardiologist. "It's a very risky combination."
Higgins, a professor at the University of Texas Medical School at Houston and the director of exercise physiology at the Memorial Hermann Sports Medicine Institute, recently released results of a study on the dangers from excessive consumption of just energy beverages, let alone such beverages mixed with alcohol.
His study found the combination, popular among young people in recent years, can impair cognitive and heart function.
'Blackout in a can'
The pre-mixed drinks, sometimes called "blackout in a can," have caused a series of recent high-profile incidents.
Dozens of students at Central Washington University and Ramapo College in New Jersey, many of them unconscious, were rushed to hospital emergency rooms with alcohol poisoning after consuming cans of Four Loko, the most popular product.
In addition, numerous fatal car crashes have been attributed to the drinks, one involving a North Texas high school student.
ER doctors at Memorial Hermann and Ben Taub General Hospital said they're not aware of mass blackouts or fatalities from caffeinated drinks here. But Higgins said he knows of local cases in which abnormal heartbeats tied to such drinking brought young people to the ER.
Medical experts say the mixture creates "wide-awake drunks," people unaware how intoxicated they are and able to consume more drinks before passing out. Higgins said the mixture's opposite effects -- "like pushing on the brakes and accelerator at the same time" -- are hard on the central nervous system.
The cans, which contain as much as 12 percent alcohol and 200 mg of caffeine, pack a much stronger punch than, say, a rum and Coke.
Consuming a single can of Four Loko, for instance, has been compared to drinking five cans of beer and a cup of coffee, enough to give a small woman a blood-alcohol level about twice the legal limit.
'A responsible manner'
Houston bar staff contrast that with the Red Bull and vodka and other caffeinated drinks they mix.
"The difference is that bartenders serve in a responsible manner," said Cameron Giamalva, manager of The Lot on Washington. "The levels of alcohol and energy drinks are much smaller and bartenders know when to cut someone off who has had too much."
But Higgins' study, published in the November issue of Mayo Clinic Proceedings, recounts one tragic result of the combination at a Miami nightclub.
Cleveland Browns receiver Donte Stallworth told police that after four shots of tequila and a can of Red Bull he didn't feel drunk in the hours before he struck and killed a pedestrian with his car. He later pleaded guilty to DUI manslaughter charges and was suspended for the 2009 season.
Giamalva said alcohol spiked with caffeine is very popular at The Lot -- "maybe one of every five drinks ordered" -- as people look "to stay in the game while they drink."
TABC's focus
Carolyn Beck, spokeswoman for the Texas Alcoholic Beverage Commission, said the mixing of caffeinated distilled spirits has not been a subject of conversation at the agency.
She said the agency is focused on the canned drinks, which, brightly packaged, fruit-flavored and cheap, are marketed at young consumers -- and typically consumed by underage customers. A federal ban on cans of caffeinated alcohol is expected in 2011.
She said the TABC has received assurances from a significant number of vendors that they will cooperate with the request to halt sales of the canned drinks.
Higgins said more research is needed on the long-term effects of alcohol and energy beverages, especially since the beverages also include vitamins, amino acids and herbs whose interactions with caffeine and alcohol aren't well understood.
His study found the energy beverages alone raise one's blood pressure and heart rate and recommended no more than a can a day.
todd.ackerman@chron.com
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