In recent decades, energy drinks have gained widespread popularity and have taken a steady place in the diet of the population, especially among teenagers and young adults, due to the public perception of their ability to increase mental and physical performance.
The "Heratsi Analytical" Center referred to the cases of poisoning from alcohol-containing energy drinks that are currently causing concern.
The "Heratsi" center notes that during 2025, the "Neonatal and pediatric resuscitation, toxicology and anesthesiology" clinic of the "Muratsan" hospital complex provided medical assistance to 7 teenagers who were diagnosed with acute poisoning as a result of the use of alcoholic beverages. These types of energy drinks contain up to 9% alcohol, which, together with the rest of the ingredients, has a systemic toxic effect on a teenager's body. The mean age of the patients was 16 years, 5 were male and 2 were female. The combination of alcohol and energy drinks creates a complex and multisystemic hazard for the body, which is not limited to the sum of the effects of individual components, but leads to a significant increase in cardiotoxic, neurotoxic and behavioral risks.
EVs appeared on the markets of Europe and Asia as early as the 1960s and are currently widely distributed in almost all regions of the world. During the years 2004-2009, the increase of their sales volumes by more than 240% indicates the rapid and intensive expansion of the market. Aggressive marketing strategies and the wide availability of the product have contributed to the formation of persistent stereotypes in the public about their relative harmlessness. Meanwhile, the data of scientific research prove that EEs are complex multi-component mixtures with pronounced pharmacological effects.
A special and serious danger is the combined use of EE with alcohol, which is widespread among teenagers and young people. According to the data of toxicological centers, cases of poisoning caused by such a combination require hospitalization significantly more often and are accompanied by severe clinical manifestations: moderate and severe effects are reported in approximately 40% of cases. And the cases of severe poisoning among teenagers in RA in recent days once again emphasize the high relevance of this problem from the point of view of the national health system.
EEs belong to the group of functional foods, the biological effect of which is aimed at stimulating the central nervous system (CNS). Their main active ingredient is caffeine, the content of which in one 250-500 ml container can range from 50-505 mg, which significantly exceeds the amount found in traditional non-alcoholic drinks.
Caffeine acts as an antagonist of adenosine receptors in the brain. Adenosine is a substance produced in the body, which participates in the formation of fatigue and sleepiness. As a result of caffeine exposure, adenosine receptors are blocked, resulting in increased release of catecholamines (adrenaline, noradrenaline) and dopamine, neurotransmitters responsible for alertness, attention and a sense of activity, in the CNS.
As a result, there is an impression of increased energy and increased concentration, which, however, does not reflect the real functional state of the organism. fatigue is temporarily suppressed, while tension and overstimulation of the nervous system continue to accumulate.
In addition to caffeine, EEs contain a number of other biologically active components, including taurine, glucuronolactone, guarana, ginseng, and B vitamins. Taurine is an amino acid synthesized by the body, which participates in metabolic processes, as well as in the regulation of the activity of the cardiovascular system.
The content of taurine in EE can reach 2000-4000 mg/l, and its combination with caffeine is able to affect the electrophysiological properties of the myocardium by changing the function of calcium channels in cardiomyocytes. Calcium tubes are membrane structures of heart cells, which play a key role in controlling the frequency and rhythm of heart contractions.
Guarana is a raw material of vegetable origin, which is a natural source of methylxanthines: caffeine, theobromine and theophylline. The caffeine contained in guarana is often not included in the calculation of the total caffeine amount indicated on the product, so the actual stimulating effect of EE can significantly exceed the consumer's expectations, increasing the risk of overstimulation and unwanted physiological reactions.
The high sugar content in EE also creates an additional metabolic load for the body. its quantity in one container can reach 54-62g, which significantly exceeds the daily intake limit of free sugars recommended by WHO. A high dose of fast-digesting carbohydrates causes dramatic fluctuations in blood glucose and insulin levels, accompanied by a subjective feeling of a short-term increase in energy. However, this condition is often followed by a pronounced decrease in working capacity and deepening of fatigue.
The combined effect of caffeine and alcohol in children and adolescents who have not yet completed the development of the central nervous system can lead to long-term neurotoxic effects. Alcohol is a CNS depressant, slowing brain activity and reducing self-regulation and behavioral control mechanisms.
At the same time, caffeine and other stimulants contained in EE temporarily weaken or distort the sedative effects of alcohol, eliminating the subjective feelings of fatigue and sleepiness that under normal conditions play a protective role, signaling excessive alcohol consumption.
In this case, the concentration of alcohol in the blood, as well as disorders of cognitive functions, reduction of reaction speed, violations of the ability to make decisions and coordination of movements are preserved. As a result, the so-called phenomenon of "hidden drunkenness" or the state of "awake drunkard" is formed, when a person subjectively feels more sober and in control than in reality.
As a result of these effects, impairment of self-regulation and behavioral control mechanisms is often observed, accompanied by an increase in the frequency of risky behaviors, including involvement in conflict situations and driving under the influence of alcohol. The risk of injury and violence increases significantly. scientific studies document a more than two-fold increase in the probability of being injured, as well as a significant increase in the probability of becoming a victim of sexual violence or being involved in its implementation. Among young people, the combined use of alcohol and EE is associated with a four-fold increase in the frequency of conflict situations and a five-fold increase in alcohol-related injuries.
Long-term negative consequences are also recorded in the psychological and neuropsychological fields. The most frequent complaints are insomnia (34.5%), nervous tension and tremors (25.1%), as well as headaches (18.4%). High doses of caffeine lower the seizure threshold and may contribute to epileptic seizures, even in individuals without a previous diagnosis of epilepsy. Among mental disorders, increased stress level (35.4%), depressive symptoms (23%) and suicidal thoughts and attempts, the frequency of which reaches 19.8%, are most often reported.
The combined use of alcohol and EE also has a negative impact on the cardiovascular system. Caffeine activates the sympathetic nervous system, causing an increase in heart rate and blood pressure, while alcohol disrupts the electrical conduction of the heart muscle. The combined effect of these factors significantly increases the risk of developing heart rhythm disorders, including the possibility of severe, life-threatening arrhythmias. According to research data, in case of such use, palpitations are recorded in 26.2% of cases, chest pain in 10.3% of cases, and the prevalence of palpitations among adults can reach up to 56.6%.
Young people with undiagnosed congenital or functional cardiovascular disorders are a particularly vulnerable group. Cases of supraventricular tachycardia, atrial and ventricular fibrillation, spasm of coronary vessels, as well as myocardial infarction with ST segment elevation, which in some situations ended in sudden death, have been described in the medical literature.
The combined use of alcohol and EE can lead to irritation of the gastric mucosa, development of gastritis and erosive changes. Abdominal pain is observed in about 14.6% of cases, nausea and vomiting in 18.7% of cases, and in some cases the development of acute hepatitis and acute pancreatitis is described. The combined diuretic effect of caffeine and alcohol contributes to fluid loss, electrolyte imbalance, including hyponatremia and hypokalemia, and in severe cases can lead to the development of acute renal failure.
In many countries of the world, the relevant bodies of food quality and safety control have recognized the addition of caffeine in alcoholic beverages as dangerous and have banned the sale of ready-made alcoholic beverages. However, the practice of self-mixing is still widely used, and in our country such drinks are still available to the public, including teenagers.
"Thus, taking into account that the consumption of alcoholic beverages among children and young people continues to grow, this issue takes on special importance in the context of public health. Therefore, a systemic approach is needed to solve the problem, including increasing public awareness, limiting access to such products for minors, as well as the active involvement of the medical community in the process of forming a responsible and conscious attitude," the "Heratsi" center notes.
