It’s been almost two months since top federal regulators threatened to ban caffeinated alcoholic drinks, and manufacturers of these beverages have hardly blinked.

In a statement issued on November 13, 2009, the Food and Drug Administration (FDA) told nearly 30 manufacturers of the drinks that they had 30 days to prove combining alcohol and caffeine wasn’t dangerous or it would “take appropriate action to ensure that the products are removed from the marketplace.”  

Although officials did not specify how long such a determination would take, neither the FDA nor the targeted manufacturers have given any indication of what is being done to address these health concerns. As a result, caffeinated alcoholic beverages, which have been cited as “potential health and safety issues” by the FDA, remain on the market.

“The increasing popularity of consumption of caffeinated alcoholic beverages by college students and reports of potential health and safety issues necessitates that we look seriously at the scientific evidence as soon as possible,” said Dr. Joshua Sharfstein, principal deputy commissioner of food and drugs.

The agency’s threat came in response to a letter from 18 state attorneys general and 1 city attorney who expressed concern about the growing popularity and safety of alcoholic energy drinks.

According to experts and legislators, the health and safety concerns are extensive.

First, studies show that consumption of caffeinated alcoholic beverages in college students is associated with significantly increased heavy episodic drinking and episodes of weekly drunkenness. Studies also show that increased exposure to alcohol during the development stages of adolescence and young adulthood will increase the risk for alcohol-related problems later in life. This is significant because experts estimate that the combined use of caffeine and alcohol in U.S. college students is as high as 28 percent.

Second, caffeine may lead people to underestimate how drunk they are, giving drinkers a false sense of sobriety.  

“Being able to accurately perceive one’s level of intoxication is important,” the attorneys general said. “An inaccurate perception will increase the likelihood of engaging in high-risk behavior.” Associated consequences include driving while drunk, alcohol poisoning, inflicting injury to oneself or another person, and being taken advantage of sexually or vice versa.

Finally, experimental studies conducted to date have not established the safety of co-ingesting caffeine and alcohol.  Many who regularly consume caffeine and alcohol together may be unintentionally subjecting themselves to cardiovascular and neurological damage, the extent of which is unknown.

After pressure from attorneys general and experts alike, Anheuser-Busch eliminated caffeine and other additives from its flavored malt beverages, Tilt and Bud Extra, and MillerCoors similarly agreed to stop selling Sparks.

Although pressure from the attorneys general has yielded some desirable results, many companies, most notably United Brands, continue to produce caffeinated alcoholic drinks. This has led many states to introduce their own measures.  

Illinois Attorney General Lisa Madigan recently called on energy drink manufacturers to prove the safety of their products, and both Washington State and New Mexico recently proposed legislation banning alcoholic energy drinks in their respective states.

“If you’re going to sell a product in society, and if you know there are significant health problems from your product,” said New Mexico AG Gary King.  “You should step up to the table and address the social issues caused by your product.”

The FDA has a range of regulatory options if manufacturers fail to demonstrate the safety of their products, from the issuance of a warning letter to product seizure.

“It is the manufacturer’s continuing responsibility to ensure that the foods they market are in compliance with all applicable legal and regulatory requirements,” the FDA said in a press statement. “The FDA intends to exercise all options that are appropriate for the product in question.”

A call to the FDA was not immediately returned.