In the wake of regulatory threats against the makers of alcoholic energy drinks, some are calling for further scrutiny of nonalcoholic energy drinks promoted as mixers for alcohol. 

Last year, after the Food and Drug Administration and Federal Trade Commission told the four biggest manufacturers of alcoholic energy drinks the caffeine in their beverages was an unsafe additive, and that their marketing might be unfair and deceptive, the companies agreed to reformulate. 

Of course, that did nothing to stop people — especially young people — from adding alcohol to energy drinks as they’ve always done, but did call into question whether the practice should be encouraged in advertising and promotions.

“If marketing a product that combines caffeine and alcohol is illegally deceptive, then promoting a drink as a mixer is equally deceptive,” said Michele Simon, research and policy director at the Marin Institute, an alcohol industry watchdog.

In Simon’s view, “A company that is promoting a highly caffeinated drink to be mixed with alcohol is certainly engaged in unethical business practices and deceptive illegal business practices,” Simon added, because the potential risks aren’t being disclosed.

“You aren’t telling someone you could get seriously injured, injure someone else, or die,” Simon said. “You’re withholding relevant information.”

While it is not within the FDA’s jurisdiction to regulate whether alcohol should be mixed with energy drinks, Simon thinks the FTC could pursue the issue because of the way energy drink companies advertise and promote their drinks as mixers.

“Monster and Red Bull are promoting [the mixing of alcohol and energy drinks] and the FTC could absolutely go after this,” she said, adding that she’s not trying to dictate what issues should be a priority for the FTC.

Other countries have, however, taken steps to alert consumers about potential risks. Canada and Sweden have issued warnings about the dangers of mixing alcohol with energy drinks and, in light of evidence that caffeinated beverages may negatively affect the health of children and young adults, some countries prohibit the sale of energy drinks outright.

Earlier this year, in a commentary in the Journal of the American Medical Association, two researchers called the FDA/FTC pressure on the makers of caffeinated alcoholic beverages “a welcome response to an increasing public health risk.”

But they warned that regular nonalcoholic energy drinks may be just as dangerous as the premixed alcohol brands, and said mixing alcohol with energy drinks is both widespread and dangerous.

“The practice of mixing energy drinks with alcohol […] has been linked consistently to drinking high volumes of alcohol per drinking session and subsequent serious alcohol-related consequences such as sexual assault and driving while intoxicated,” the researchers wrote.

Energy drink companies regularly encourage students on college campuses to mix their products with alcohol, said Patricia Maarhuis, coordinator at Washington State University’s Alcohol and Drug Counseling and Prevention Services program.

For example, she said, energy drink companies employ students at WSU to promote their products on campus, which includes throwing parties where energy drinks are handed out to students who are encouraged to bring their own alcohol. 

In marketing energy drinks to young people, manufacturers often suggest the beverages can enhance attention and endurance.  And some people think they can consume more alcohol if it’s mixed into energy drinks, because they think the caffeine will offset the effects of the alcohol. 

However, a recent study by the Boston University School of Public Health and Brown University’s Center for Alcohol and Addiction Studies, published in the journal Addiction, found that energy drinks made no difference in stopping the depressant effects of alcohol, including impaired driving performance, shortened attention span, and slowed reaction times.

Regulators should scrutinize advertising practices regarding the safety of mixing alcohol with energy drinks, the study recommended.

In a second study, researchers at Northern Kentucky University found that students who drank Red Bull with vodka said they felt more alert than students who drank straight vodka, but they were just as inebriated.  That study, published online in Alcoholism: Clinical and Experimental Research, emphasized the concern that drinkers stimulated by caffeine when energy drinks are mixed with alcohol sometimes don’t know when to stop.

Asked for a response, Red Bull emailed a statement about mixing its energy drink with alcohol.

“Some consumers do like to mix [Red Bull] with different types of alcohol,” the statement said. “Red Bull Energy Drink …  may be mixed with alcohol as long as people drink responsibly and understand that alcohol consumption might impair their mental and physical activities.”

And Red Bull is not designed to counter the depressant effects of alcohol, the company said.

“Everyone knows that the excessive and irresponsible consumption of alcohol can have adverse effects on human health and behavior. But it should be clear that this is due to the alcoholic drink, not the mixer.”