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Four Loko Consumers: Underage, Unwise and Unwell

Armen Hareyan's picture
Four Loko

Over a four-month period in one New York City hospital, 11 patients intoxicated by the caffeinated alcoholic beverage Four Loko™ were brought to the emergency department by ambulance, 10 of whom were under the legal drinking age of 21. The case series is described in a paper published online today in Annals of Emergency Medicine ("Adolescents and Young Adults Presenting to the Emergency Department Intoxicated from a Caffeinated Alcoholic Beverage: A Case Series").

"One of these kids had fallen onto subway tracks, a potentially deadly scenario," said lead study author Deborah Levine, MD, of Bellevue Hospital Center in New York. "Five of them were found unconscious in public areas, alone and at night. The combination of alcohol, caffeine and youth clearly has great potential to cause harm."

More male patients negatively affected by Four Loko drink

The majority of the cases occurred during October, 2010. Most patients were male (63.6 percent) and under the age of 18 (96 percent). Patients ranged in age from 13 to 24. Almost half were found in potentially hazardous situations and one patient was found unconscious at school. Two patients were admitted to the hospital from the emergency department.

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The combined effect of caffeine with alcohol results in decreased perception of intoxication by increasing alertness and decreasing awareness of physical impairment, commonly referred to as the "wide-awake drunk." Four Loko™ was marketed toward young consumers, but in late 2010 its manufacturers agreed to remove caffeine from the beverage. However, there are other caffeinated alcohol drinks on the market.

"More than one-third of our patients had blood alcohol levels more than twice the legal limit," said another study author Kelly Clear, MD, also of Bellevue Hospital Center in New York. "Young people think they are going to live forever. In fact, immaturity can lead these young drinkers to suffer from assaults, injury and death."

Written by Julie Lloyd
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, a national medical society.

Image source of Four Loko: Wikipedia