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Do Energy Drinks Lead to Alcohol Abuse?

Most news headlines are focusing on the safety of alcoholic energy drinks like Four Loko, the maker of which announced on Tuesday, in the face of several statewide bans and the threat of a federal crackdown, that it would remove caffeine and other stimulants from its products. 
But it turns out, plain old booze-free energy drinks — like Red Bull and Monster — may also increase the risk of alcohol abuse among teens and college students, at least according to a new study by researchers at the University of Maryland and Johns Hopkins.
For the study, researchers examined the energy drink consumption and alcohol-drinking habits of 1,097 fourth-year students at a large public university that remains unnamed in the study. The data was collected as part of a four-year longitudinal study that the school conducted via anonymous computer survey to monitor student life. Researchers found that 10% of students reported being high-frequency energy drink consumers — downing energy drinks at least 52 days per year, and in some cases every day. About half were low-frequency drinkers, using energy drinks less than 52 days in the past year. The rest did not consume energy drinks at all.
Compared with the low-frequency group, those who consumed more energy drinks also drank alcohol more often — on 142 days versus 103 days in the past year. And when they drank, they drank more overall — 6.2 drinks a day versus 4.6 drinks.
These high-frequency energy drink consumers were also more likely to meet the criteria for alcohol dependence, as defined by the Diagnostic and Statistical Manual of Mental Disorders. Compared with students who abstained from using energy drinks, the high-frequency users were 2.4 times more likely to be considered alcohol dependent; compared with the low-frequency group, they were 86% more likely. The risk persisted even when the researchers controlled for factors that could independently increase drinking problems, such as having a "sensation-seeking" personality type, a family history of addiction, depression or involvement in fraternities and sororities. 
The relationship between energy-drink use and increased risk of alcohol abuse is not entirely clear, and the researchers acknowledge that causality may go in either direction: The possibility cannot be ruled out that heavy drinkers rely on energy drinks to help them function normally throughout the day, as a way of compensating for alcohol-related hangover effects. For example, a college student might use energy drinks to get through classes on the day after a drinking binge, and if chronic partying interferes with their study habits they might consume energy drinks to pull "all-nighters" before exams.