Alcohol mixed with energy drinks: Is there an evidence-base for future policy reform and regulation?

Transcription

1 Alcohol mixed with energy drinks: Is there an evidence-base for future policy reform and regulation? Amy Peacock & Raimondo Bruno School of Medicine (Psychology) Faculty of Health University of Tasmania

2 Alcohol Mixed with Energy Drinks (AmED)

3 What are the theorised potential harms of AmED? 1. Wide-awake drunkenness : The stimulant (energy drink) masks the effects of the depressant (alcohol) 2. The consumer underestimates their level of intoxication 3. Increased likelihood of risk-taking

4 Who is concerned about AmED?

5 What are the current Australian regulations regarding AmED? Australia New Zealand Food Standards Code: Maximum recommended daily intake of two standard 250mL EDs (160mg caffeine) per day No national response in regards to regulation of the sale, marketing, and supply of AmED Lack of research assessing relative harms of AmED versus alcohol 63% of articles included in a recent review of AmED harms were published between January, 2011 and May, 2013

6 What are the potential theorised harms of AmED? 1. Wide-awake drunkenness : The stimulant (energy drink) masks the effects of the depressant (alcohol) 2. The consumer underestimates their level of intoxication 3. Increased likelihood of risk-taking

7 1. Wide-awake drunkenness : Do the stimulant effects of the ED mask the depressant effects of alcohol?

8 What side-effects do AmED consumers report? Peacock et al. (2013). ACER.

9 Peacock et al. (2013). ACER.

10 Peacock et al. (2013). ACER.

11 What side-effects do AmED consumers report? + ~.050% BAC Peacock et al. (2013). ACER.

12 What are the potential theorised harms of AmED? 1. Wide-awake drunkenness : The stimulant (energy drink) masks the effects of the depressant (alcohol) 2. The consumer underestimates their level of intoxication 3. Increased likelihood of risk-taking

13 2. Misperception of Intoxication: Does the consumer underestimate their level of intoxication after drinking AmED relative to alcohol?

14 How do people rate their level of intoxication? % BAC Study Marczinski (2011) Marczinski (2012) Marczinski (2013) Peacock (2013) Intoxication Rating after AmED compared to Alcohol No change No change No change No change Peacock et al. (in press). Addiction.

15 How do people rate their level of intoxication? % BAC Study Marczinski (2011) Marczinski (2012) Marczinski (2013) Peacock (2013) Intoxication Rating after AmED compared to Alcohol No change No change No change No change Peacock et al. (in press). Addiction.

16 How do people rate their level of intoxication? +

17 How do people rate their level of intoxication? +

18 How do people rate their level of intoxication? versus

19 What are the potential theorised harms of AmED? 1. Wide-awake drunkenness : The stimulant (energy drink) masks the effects of the depressant (alcohol) 2. The consumer underestimates their level of intoxication? 3. Increased likelihood of risk-taking

20 3. AmED Increased Risk-taking: Does the consumer report increased risk-taking after drinking AmED relative to alcohol?

21 Is risk-taking more likely after AmED vs alcohol? De Haan (2012) Peacock (2013) Drove a motor vehicle after drinking Did not use contraception Spent more money than planned Gambled Verbally fought Physically fought = Asked to leave a drinking establishment Drank more alcohol than planned Used illegal drugs Passed out = Physically hurt or injured Required medical treatment lower odds of behaviour after AmED vs alcohol; = equal odds of behaviour after AmED vs alcohol Peacock et al. (in press). Addiction.

22 Is risk-taking more likely after AmED vs alcohol?

23 Is risk-taking more likely after AmED vs alcohol?

24 What are the potential harms of AmED? 1. Wide-awake drunkenness : The stimulant (energy drink) masks the effects of the depressant (alcohol) 2. The consumer underestimates their level of intoxication? 3. Increased likelihood of risk-taking?

25 Where to now? Implications for research 1. AmED wide-awake drunkenness 2. AmED underestimation of intoxication 3. AmED-increased risk-taking 1. Effect of real world doses (generalisable to real-life) 2. Rating of intoxication in natural drinking environments (generalisable to real-life) 1. Assessment of risk-taking whilst intoxicated (avoid recall bias) 2. Objective assessment of risktaking (avoid self-report bias)

26 Where to now? Implications for health promotion and legislation Development of guidelines specific to AmED built on current recommended alcohol and ED intake guidelines? Guidelines regarding advertisements or promotions for non-standard sized drinks or receptacles that encourage rapid drinking? Warnings on packaging of EDs that allow consumers to purchase over the recommended daily intake? Targeted advertising in licensed venues? Education in schools?

27 What can we do right now? Increase awareness of maximum recommended daily ED intake guidelines (i.e., no more than two 250mL ED per day) Increase consumer awareness regarding their other substance intake while consuming AmED (i.e., co-ingesting other caffeine products and stimulant products)

28 For further information: Lubman, D., Peacock, A., Droste, N. et al. (2013). Alcohol and energy drinks in NSW. Available at: ublications/publications/alcohol-andenergy-drinks-in-nsw.pdf Queries: Phone: