FDA

NYT Message on Energy Drinks: Be Afraid! Safe As Coffee!

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A couple of weeks ago, I noted that the two prongs of New York Times reporter Barry Meier's journalistic crusade against energy drinks conflict with each other: In one story, he will warn that energy drinks contain so much caffeine that they might kill you, while in another he will debunk marketing claims about the supposedly energizing special ingredients in these products, saying all they really deliver is about as much caffeine as you get in a cup of coffee. Meier manages to hit both of these themes in two recent stories without noticing the contradiction.

Last week Meier noted a Drug Abuse Warning Network (DAWN) report on emergency room visits by people who had recently consumed energy drinks:

A rising number of patients, many of them young people, are being treated in emergency rooms for complications related to highly caffeinated energy drinks like Red Bull, Monster Energy and 5-Hour Energy, new federal data shows.

The number of annual hospital visits involving the drinks doubled from 2007 to 2011, the latest year for which data are available, according to a report by the Substance Abuse and Mental Health Services Administration.

In 2011, there were 20,783 reported emergency room visits in which an energy drink was cited as the primary cause of or a contributing factor to a health problem, compared with 10,068 in 2007. Such problems, which are typically linked to excessive caffeine consumption, can include anxiety, headaches, irregular heartbeats and heart attacks.

In two-fifths of these cases, the patients had consumed other drugs (typically alcohol or stimulants like Adderall or Ritalin) as well. Still, 20,783 sure sounds like a lot. How does that compare to emergency room visits by users of other psychoactive substances? Meier does not say, but this DAWN report shows that in 2010 there were 687,574 visits related to alcohol, 408,021 related to benzodiazepines (such as Valium), 115,739 related to hydrocodone (Vicodin), and 105,229 related to antidepressants. Even marijuana—which does not cause fatal overdoses and has so few serious side effects that the Drug Enforcement Administration's chief administrative law judge called it "one of the safest therapeutically active substances known to man"—clocked in at 461,028. In this context, 20,783 seems less impressive, especially given the size of the energy drink market. Survey data from 2008 indicated that more than a third of 18-to-24-year-olds were regular consumers of energy drinks, and the market has grown substantially since then (which helps explain why the number of hospital visits has risen). By comparison, less than a fifth of people in this age group report past-month marijuana use.

The point is not that marijuana is extremely dangerous but that the numbers Meier cites to pump up alarm about energy drinks actually make them look pretty benign. Similarly, Meier claims in the same article that the Food and Drug Administration has received "numerous reports of deaths and injuries in which the drinks were mentioned." How numerous? About two dozen a year for 5 Hour Energy, one of the leading brands, and about four for Monster Energy drinks, another product Meier says poses a deadly threat to consumers. By comparison, the FDA receives thousands of such reports (which do not prove a causal relationship) about aspirin each year and hundreds about coffee

Speaking of coffee, there it is in Meier's ninth paragraph:

Energy drink producers claim that their proprietary formulations provide consumers with a physical and mental edge. There is little scientific evidence, however, that the drinks provide anything more than a high dose of caffeine similar to that found in a strong cup of coffee.

In short, we should worry about dying from a caffeine overdose when we drink Red Bull, even though it contains less caffeine per ounce than coffee. The discombobulating juxtaposition of these two points is even more striking in the latest installment of Meier's never-ending exposé because it occurs in adjacent paragraphs:

In recent months, the Food and Drug Administration has begun examining the safety of energy drinks following reports of several deaths and numerous injuries potentially associated with the products. The number of annual hospital emergency visits involving the drinks doubled from 2007 to 2011, according to a federal report released last week.

In addition, claims by drink producers that their proprietary "energy" formulations provide consumers with a physical and mental edge are coming under scrutiny. There is little scientific evidence, researchers say, that the drinks provide anything more than a high dose of caffeine similar to that found in a cup of strong coffee.

Be afraid! Safe as coffee! Pick one, Barry.