Have a Drink, Have a Heart Attack

Until last week, the main hazard of caffeinated alcoholic beverages such as Joose, Torque, and Four Loko was supposed to be that they keep you alert even when you're drunk, so that you underestimate your inebriation and are more inclined to engage in risky behavior. But now, thanks to the faux-sober reporting of ABC News, we know you also might drop dead from a heart attack the first time you try one of these drinks, even if you're a strapping 19-year-old:

Two weeks ago, an athletic, otherwise perfectly healthy 19-year-old man arrived at the emergency room at Temple University Hospital in Philadelphia.

"He had chest pains, he was sweaty, short of breath," said Dr. Robert McNamara, who heads the department of emergency medicine.

The patient was suffering a heart attack.

Tests, however, showed the man had none of the usual signs of an unhealthy heart or arteries.

The symptoms were extremely unusual for such a young person, said McNamara, who added they're typically seen in people who overdose on cocaine or speed. After further questioning, the patient admitted he'd been drinking a new type of beverage, which is growing in popularity, which combines high alcohol content with a large dose of caffeine.

"That was the only explanation we had," for the heart attack, said Dr. McNamara….

"This is a dangerous product from what we've seen," Dr. McNamara said. "It doesn't have to be chronic use. I think it could happen to somebody on a first time use."

Yet by ABC's own account, a 23.5-ounce can of Four Loko has 156 milligrams of caffeine—as much as a cup and a half of (pretty weak) coffee. Ounce by ounce, in fact, Four Loko has less caffeine than coffee: 6.6 mg per ounce, compared to 8.3 mg per ounce for McDonald's coffee, around 18 mg per ounce for store-bought drip coffee, and 50 mg per ounce for espresso. I cannot recall an ABC News story about the heart-attack risk posed by a 16-ounce Starbucks Grande Latte, which has as much caffeine as a can of Four Loko (or, assuming the combination of caffeine and alcohol is especially hazardous to the heart, the public health threat posed by Irish coffee).

ABC is also worried about the alcoholic content of Four Loko. At 12 percent, it is about as strong as wine. But it sounds scarier if you say, as ABC does, that "you'd have to drink almost six cans of Bud Light beer, or 67.2 ounces, to get the same amount of alcohol" as you get from a can of Four Loko. In truth, though, drinking six cans of Bud Light (or even one) sounds scary in any context.

For those who are still not convinced that caffeinated alcoholic beverages pose an intolerable threat to the youth of America, here's more (emphasis added):

One New Jersey college banned the drinks this month after 23 students were hospitalized with alcohol-related problems. At least some of them reportedly drank Four Loko.

"There's no redeeming social purpose to be served by having the beverage," Ramapao College President Peter Mercer told The Associated Press.

No social purpose to a beverage that loosens you up while stimulating you? I suspect all those drunk-yet-alert college students would disagree.

As ABC notes (and as I noted here a year ago), the FDA seems poised to ban buzzy booze, arguing that it has never explicitly authorized the combination of alcohol with caffeine. Fortunately for partiers who like to get up while they get down, the FDA has no jurisdiction over cocktails that feature, say, vodka and Red Bull, which has 50 percent more caffeine than Four Loko. 

I'm surprised ABC failed to point out that caffeine also can make you strangle your wife. But it gets points for calling Four Loko and similar products "cocaine in a can"—not to be confused with Cocaine in a can, which thanks to the FDA no longer exists.