The Next Student Health Problem?

Three beers, a can of Red Bull and a large espresso: no big deal, many college students might say. Three beers, a can of Red Bull and a large espresso times three or four, and they still might tell you they're not intoxicated.

Therein lies the danger of caffeinated alcoholic beverages, whose popularity has grown in recent years among college-aged drinkers, drawing the attention of concerned health officials, politicians and college administrators. Experts say that even one is a recipe for disaster, and so do officials at Ramapo College: they banned alcoholic energy drinks on campus this month.

Peter Mercer, president of the New Jersey college, said students referred to the above concoction when describing the effects of drinks such as Four Loko, which is particularly popular around the campus. Four Loko is one of a few flashy, canned drinks that take the mixing out of the equation, making it that much easier for students to get dangerously intoxicated, faster. Mercer said concerned students told him the inexpensive 23-ounce, 12-percent alcohol energy drinks were "all of a sudden very popular," and Four Loko was involved in a couple of incidents of excessive drinking. Since the start of fall semester, 23 people have been hospitalized with alcohol intoxication.

Mercer called Four Loko a "cynical product" whose only purpose is to get the drinker intoxicated quickly. Others agree: Glen L. Sherman, co-chair of the Alcohol and Other Drug Knowledge Community for NASPA: Student Affairs Administrators in Higher Education, said the drinks are dangerous because of their apparent targeting of underage student consumers and their high alcohol content -- drinking one can of Four Loko is the approximate equivalent of drinking four beers, according to an informational page NASPA recently posted on its website.

"These beverages are of great concern to us," Sherman wrote in an e-mail. "Each campus must decide what specific steps make sense to best educate students about and try to protect them from these risks, and to encourage students to make good decisions when they are confronted by them."

Ramapo's ban is part of a "multi-pronged approach" addressing excessive alcohol consumption, Mercer said. Other measures the college has taken include increasing after-hours security measures in residence halls, tightening visitor policies and holding student focus groups.

Those additional steps may be crucial for the ban to have even a shot at success. Kathleen E. Miller, a research scientist at the Research Institute on Addictions at the State University of New York at Buffalo, has studied college students' use of energy drinks, both with and without alcohol. She said that if the college can't ban drinks like Red Bull and vodka from local bars, it won't be able to stop consumption of caffeinated alcoholic beverages. But the college can send a signal.

"A college ban will make people take a second look and maybe they'll be more aware of what they're drinking," Miller said. "It's inherently potentially dangerous to mix caffeine and alcohol because you're sending your body mixed signals." The caffeine stimulates the system while the alcohol depresses it, making students feel less drunk than they actually are.

Through her research, Miller found that students who consume energy drinks with or without alcohol are more likely to engage in risky behavior like drug use, smoking or binge drinking. That doesn't necessarily mean the energy drinks cause the behavior, but there is a correlation. Energy drink consumption "isn't necessarily a gateway behavior, but it is what you might call a red-flag behavior," she said.

In a June 2008 study published in the Journal of American College Health, Miller found that 26 percent of surveyed public university undergraduates reported consuming energy drinks mixed with alcohol in the past month, while about half said they'd done so more than once.

Efforts at Ramapo have curbed and will continue to curb consumption of alcoholic energy drinks, Mercer said, but "it's unrealistic to assume that it'll be totally eliminated." That's not stopping him from trying, though: At the next meeting of the New Jersey Presidents' Council, Mercer plans to make his case to other college and university presidents. "The risk for their students is just as high as the risk for mine," he said. "I'll tell them what I've done and hope that they may want to follow suit." States such as New Jersey and New Mexico are considering banning the drinks entirely.

The drinks are also on the federal government's radar. Last November, the Food and Drug Administration threatened to ban the drinks if manufacturers could not prove they were safe for consumption. No regulations have been issued yet, but an FDA press officer, Michael L. Herndon, told Inside Higher Ed on Friday that the agency has received 19 responses from 27 manufacturers and distributors, and plans to evaluate those submissions and other scientific evidence "as soon as possible in order to determine whether caffeine can be safely and lawfully added to alcoholic beverages." Herndon said the decision is a high priority but "could take some time."

But Mercer doesn't need FDA regulations to deem the drinks unsafe, especially when it comes to students. "I don't accept that it's a rite of passage to collegiate life that people put themselves at risk," he said. "I can't accept that."