Alcohol and energy drink use among adolescents seeking emergency department care

• Combined alcohol/energy drink consumers are likely to engage in risky behaviors.
• Combined users had the highest alcohol use severity.
• Common motives for combining were hiding the alcohol flavor and liking the taste.

Emergency department (ED) visits due to energy drinks rose drastically from 2007 to 2011. Consuming alcohol mixed with energy drinks by young people is particularly concerning. Among youth (aged 14–20 years) in the ED reporting past-year alcohol use, we assessed frequency, reasons, and medical consequences of consuming alcohol and energy drinks in the same beverage or on the same occasion, and relationships with other risk behaviors. The sample included 439 youth (Mage = 18.6 years, SD = 1.4; 41% male; 73% Caucasian): those who drank alcohol, but not energy drinks (Non-Users; 41%, n = 178), those who drank alcohol and energy drinks on separate occasions (Separate; 23%, n = 103), and those who combined alcohol and energy drinks in the same beverage or on the same occasion (Combined; 36%, n = 158). Common reasons for combining energy drinks and alcohol were hiding the flavor of alcohol (39%) and liking the taste (36%). Common consequences were feeling jittery (71%) and trouble sleeping (46%). Combined users had the highest rates of risk behaviors (e.g., drug use, sexual risk behaviors, driving after drinking) and alcohol use severity. Multinomial logistic regression indicated that men, those who had sex after substance use, those who had used drugs, and those with higher alcohol severity were more likely to be Combined users than Non-Users. Those with higher alcohol severity were also more likely to be Combined users than Separate users. Combining energy drinks and alcohol is associated with higher rates of other risk behaviors among young drinkers. Future studies are needed to determine longitudinal relationships of energy drink use on substance use problem trajectories.