Reports of caffeine poisoning from ‘energy drink’ consumption are increasing in Australia, particularly among adolescents. A new study is calling for greater regulation of the labelling and sale of energy drinks, and for teenagers to be better educated about their hazards.
Telephone calls to an Australian poisons information centre about energy drinks ‘overdose’ increased from 12 in 2004 to 65 in 2010. Most of these calls – 217 out of 297 in total – were about recreational exposure, defined as ‘intentional ingestion for the purpose of gaining euphoria or other psychotropic effect’.
The most commonly reported symptoms were:
- heart palpitations or tachycardia
- tremors and shaking
- agitation and restlessness
- gastrointestinal upset.
Symptoms were occasionally reported even at manufacturer-recommended amounts of energy drink consumption. Twenty-one callers reported signs of serious toxicity such as hallucinations, seizures, and cardiac ischaemia. At least 128 people required emergency department attendance.
The median age of people affected was 17 years, and 57% were male. The number of drinks consumed in one session varied greatly (median, 5 units; range, 1 to 80 units). Co-ingestion of other substances was recorded for 46% of recreational users, the most popular: alcohol and other caffeine-containing products.
The main active constituents of energy drinks include varying amounts of caffeine, guarana extract, taurine and ginseng. The report says that “manufacturers pitch their product to athletes, students and people in professions that require sustained alertness. These drinks are also commonly consumed at dance parties, which require sustained energy for prolonged activity into late hours. In this setting, they may also be combined with alcohol and recreational drugs such as ecstasy or other amphetamines.”
The authors claim that adolescents are particularly attracted to energy drinks because of “effective product marketing, peer influence and a lack of knowledge of the potential harmful effects”.
The report states that: “In 2009, the energy drink industry spent nearly $15 million on marketing alone in Australia. Value growth in the convenience sector had increased by 20% as compared with 10% for carbonated beverages on the whole. The target population for these types of drinks clearly includes adolescents and young adults, as well as professionals. Consumers are likely to be unaware of the variation in chemical composition and caffeine dosage in energy drinks, and with little or no warnings on products, the potential for overdose and poisoning remains ever-present.”
The study was undertaken by Naren Gunja, Medical Director and Toxicologist at the NSW Poisons Information Centre (NPIC), and Jared Brown, Senior Poisons Specialist (Research and Audit) at NPIC.