Mixing stimulants with alcohol may pose a health risk.
Body Text A young crowd packs tightly into an east Sacramento bar, where the jukebox is playing "Brown Eyed Girl" and the beer is flowing liberally.
Behind the bar, amid beer taps and bottles lining the wall at the Limelight Bar and Cafe, glows a backlit purple sign heralding night life's latest libation.
The sign is for Red Bull, one of several nonalcoholic "energy" drinks popularized in bars and nightclubs worldwide as mixers for hard alcohol. Young revelers are ordering "Bull blasters," SoBe with vodka, or Red Bull and Jaegermeister, a liqueur.
"Some people get an energy kick or boost from it," says 26-year-old Mark Hodge, after he and his friend, 31-year-old Paul Nozicka, guzzle pint glasses of Red Bull and double shots of Jaegermeister.
Counting on stimulants in energy drinks to keep them partying long into the night, young people are driving this burgeoning, multimillion-dollar industry. But mixed with alcohol, the stimulants may pose health risks, experts warn.
"The danger is an increased capacity to drink more than you normally would," said Steven Martin, a scientist at the Center for Drug and Alcohol Studies of the University of Delaware.
A waitress at the Blue Cue in Sacramento agrees. "I definitely think people drink more when they drink Red Bull," Adriana Landrum said, recalling patrons who ordered Red Bull mixers between rounds of beer.
Energy drinks with names such as Adrenaline Rush, Stamina and Rockstar are loaded with sugars and contain as much caffeine as a cup of coffee, which may mask a drinker's level of intoxication. Many also have herbal ingredients that the U.S. Food and Drug Administration has not approved as safe.
Each can, usually a little more than 8 fluid ounces, contains so much caffeine that some manufacturers label them with a warning to caffeine-sensitive people.
Mixing alcohol with energy drinks "sends a confused message to the brain. Alcohol is sedating, and caffeine makes you feel more stimulated. A more wide-awake drunk, but still a drunk," said Michelle Famula, director of the student health center at the University of California, Davis.
People who "perceive they are less intoxicated than they really are may engage in behaviors that they shouldn't," including driving under the influence of alcohol, said Cynthia Sass, a dietician at the University of South Florida and spokeswoman for the American Dietetic Association.
The Center for Science in the Public Interest in Washington, D.C., is beginning to gather information on the phenomenon of combining alcohol with energy drinks.
"One of our concerns is that (energy drink mixers) provide a false sense of security," as lots of caffeine may also disguise a drinker's inebriation from friends or bartenders who might otherwise intervene, said George Hacker, director of the alcohol policies project at the center.
The target audience's young age may also amplify the effects of the caffeinated beverages.
"Young people are not habitual caffeine drinkers, so the stimulatory effects are greater," said Liz Applegate, a sports nutritionist at UC Davis.
Yet the young crowd sipping Bull blasters or other combinations of energy drinks and alcohol disagree.
"You still know how drunk you are, (the caffeine) doesn't mask the effects of the alcohol," said Karl Yoder, 33, who prefers the fruity taste of SoBe's Adrenaline Rush over Red Bull.
Many drinks contain caffeine in several forms, including herbal additives such as guarana, a potent source of caffeine by itself. In addition, the drinks have other stimulants such as ginseng and ginkgo biloba, along with vitamins and additives, such as the amino acid taurine, which supposedly aid with energy release.
There is little or no scientific evidence that the additives confer any benefits, and the herbs might even be harmful for some people. Doctors are investigating a possible link between the deaths of three people in Sweden and the Red Bull cocktails they were drinking. However, there is currently no evidence connecting the drinks to the deaths.
Last month the FDA issued warnings to several food manufacturers, including Hansen Beverage Co., which is second only to Red Bull in energy drink sales, that the safety of certain herbal additives in some products has not been proven.
Energy drinks "contain a lot of different additives that are not regulated; some are really drugs," said Martin, the University of Delaware researcher.
The ingredients in energy drinks can be very seductive, Applegate said, and the association with drugs may even entice young people to keep drinking.
"It's like liquid crack," a 30-year-old bar patron remarked while drinking SoBe and vodka.
Some manufacturers target a young male crowd with television commercials, endorsements by athletes, advertising displays in bars and clubs, and slogans loaded with sexual innuendo.
Hacker, who studies the marketing of alcoholic beverages to young people, finds the advertising troublesome.
"The marketing needs to be examined really carefully," he said.
So far, that marketing has worked well. The energy drink industry earns an estimated $400 million annually, a figure that is likely to double within a year, according to John Sicher, editor of the Beverage Digest newsletter.
The marketing extends into bars and nightclubs, where company representatives push their beverages as mixers for alcohol, bar workers said.
"The rep comes around and tells us what people are making with (Red Bull)," said Keith Dehoff, a bartender at the Blue Cue.
Emmy Cortes, spokeswoman for Red Bull North America, said, "drink recipes are sometimes shared with bartenders by Red Bull employees. However, none of our advertising materials include Red Bull mixed with alcohol."
And Kristine Hinck, a spokeswoman for SoBe Beverages, said Adrenaline Rush "is intended as a nonalcoholic alternative drink."
But energy drink manufacturers recognize how their products are being used. Red Bull's Web site states that its product is safe in combination with alcohol, and Anheuser-Busch requires users to be at least 21 to view the Web site for its new energy drink, 180.
Many bars and nightclubs started carrying energy drinks about a year ago, and find themselves serving more every week. "It is definitely becoming more popular," said Dehoff, who estimates that Blue Cue sells about 150 cans per week.
At Polly Esther's nightclub, a fridge behind the bar sporting the drink logo is loaded with silver cans. "It's one of our most popular drinks," bartender Glenn Cucinotti said. "We go through a lot of them."
