Caffeinated Booze: Bad News for Bad Brews

The writing would seem to be on the wall for Four Loko and other beverages that combine alcohol and caffeine, as the FDA considers an outright ban of the combination. Anyone who is for sanity and safety in marketing should read it and cheer, not weep.

Combining alcohol and caffeine is -- in one word -- crazy. Don't do it! It has an excellent chance of hurting you, and a fairly good chance of killing you. Recent news reports feature tragic victims of this deadly duo. As the companies and federal authorities decide what to do, you can make up your own mind to steer clear of this bad brew.

As I suspect everyone knows, alcohol is a central nervous system depressant. It is certainly possible to drink enough alcohol for it to be lethal, and people have. But the depressant effect tends to limit the damage, because people fall asleep or pass out before they reach a truly lethal level of intake. Alcohol is more likely to kill by impairing judgment, and responses behind the wheel of a car. But here, too, the intrinsically sedating effects of alcohol help limit these incident, which are horribly too numerous as is.

Caffeine, of course, is a central nervous system stimulant. We use it to help stay awake and alert, and it exerts just this effect even as you drink alcohol. But caffeine does nothing at all to combat the deleterious effects of alcohol on judgment, inhibition, reflexes and coordination. You get just as drunk while getting jazzed on caffeine -- you simply stay awake and stimulated longer, so you wind up drinking more.

This combination would be bad enough if it required alternating booze and java. But the commercial products at the center of the current scandal combine highly concentrated alcohol -- the equivalent of five beers in a single can -- with a full mug of coffee's worth of caffeine. Before the can is set down, you are inebriated, but too wired on caffeine to know it.

It's hard to imagine any argument for such products -- except that selling them makes money for someone. So does selling heroin and cocaine, which are also very bad ideas.

It's also hard to imagine anyone objecting to a ban of such products, although the strong "keep the government out of my business" sentiment that runs through our society suggests that some will find cause to do so. In response to any objections, I can only ask: Where would you draw the line? Should the government stay out of the crack, heroin, and angel dust business as well, and simply let the peddling of such wares take their place in a free market economy? If there is any line at all over which dangerous products that generate unscrupulous profits at the cost of human life should be banned -- caffeinated alcoholic beverages are over it.

Combining caffeine and alcohol is, indeed, crazy. It can be lethally crazy, so it's a mistake you may not get to make twice. So don't make it even once. I recall a poster I had hanging on my dorm room in college that read: "Good judgment comes from experience, and experience comes from poor judgment." We do all need to learn by trying. But unfortunately bad judgment that kills you does not lead to good judgment -- it leads only to whatever final judgment we are destined to face, and the anguish of those left behind.

Please don't go there. No need to wait for the FDA. This stuff is crazy -- ban it yourself.

Dr. David L. Katz