If a recent letter from the Food and Drug Administration has the effect that Mary O'Brien is hoping for, Outliers would guess that she won't celebrate with a Jägerbomb.
O'Brien is an emergency physician and associate professor of emergency medicine and public health sciences with Wake Forest University Baptist Medical Center, Winston-Salem, N.C. Treating a student there who was extremely intoxicated, O'Brien asked him what he had been drinking. He responded that he had been drinking Jägerbombs—a shot of the German liqueur Jägermeister dropped in a glass of Red Bull energy drink. “I didn't know what that was,” O'Brien says.
So O'Brien began researching the effects of mixing caffeine and alcohol. She led a survey of nearly 4,300 students at 10 colleges in North Carolina, finding that students who mixed caffeine and alcohol drank more and for longer periods of time. Moreover, they were twice as likely to ride with a drunk driver, commit or fall victim to sexual assault or require medical attention, O'Brien says—and that's after accounting for the increased amount that they drank, she says.
The biggest problem for “mixers,” as O'Brien calls them, seems to be that they don't “feel” as drunk as they really are, she says, so they aren't as cautious as they might be if they felt it more.
O'Brien and several other scientists wrote to three attorneys general in September pointing out these findings and other studies. Earlier this month, the FDA wrote to nearly 30 companies that make alcoholic beverages with caffeine, such as Joose, Four Loko and Liquid Charge. The FDA demanded that the manufacturers disclose any studies that they have done that show that caffeine is safe to mix with alcohol. It is highly unlikely that such studies exist, O'Brien says, because it's impossible to design an ethical experiment that would reproduce the real-life conditions of mixers. If the companies can't or won't produce evidence that their products are safe, they'll have to pull them from the market, O'Brien says.
Even so, highly caffeinated, nonalcoholic beverages such as energy drinks can still be mixed with alcohol, so O'Brien says the effort to educate drinkers, especially younger ones, is vital.