'High' risk? A systematic review of the acute outcomes of mixing alcohol with energy drinks

Alcohol mixed with energy drinks (AmED) is a relatively new consumption trend generating increasing concern regarding potential adverse effects. Despite the political and health imperative, there has been no systematic and independent synthesis of the literature to determine whether or not AmED offers additional harms relative to alcohol. The aim of this study was to review the evidence about whether co-consumption of energy drinks and alcohol, relative to alcohol alone, alters: (i) physiological, psychological, cognitive and psychomotor outcomes; (ii) hazardous drinking practices; and (iii) risk-taking behaviour.

Gender stereotypes and drinking cognitions as indicators of moderate and high risk drinking among young women and men

The study examined differences in gender stereotypes, restrained drinking and self-efficacy for alcohol refusal between moderate and high risk drinkers among a university sample of 301 women and 118 men. Both female and male high risk drinkers displayed a response conflict, typified by high scores on restrained drinking but low scores on self-efficacy. This pattern of response conflict was more pronounced for high risk drinking women, who also identified poorly with feminine traits (e.g. ‘nurturing’, ‘love children’, ‘appreciative’). The findings are discussed in relation to society's double standard that accepts intoxication in men but condemns it in women.

It blasted me into space : intoxication and an ethics of pleasure

O'Malley and Valverde point out that in the 21st century, pleasure is a warrantable motive for drug and alcohol use only when it is attached to the idea of moderation. This presents a problem for those researchers who wish to theorise about those individuals who use drugs deliberately to induce intoxication. This paper uses unconventional means to come to an understanding of intoxication, it uses the stories of interviewed former heroin addicts, published autobiographies, biographies and even some fictional accounts to come to an understanding of the. difficulties of dealing with intoxication and the drug-using subject, it also uses the accounts that Michel Foucault gave about his own use of drugs and its relationship to an ethics of pleasure and resistance. The article uses theories of risk and edgework to understand the underlying meanings of intoxication to many drug users.

Patron offending and intoxication in night time entertainment districts (POINTED) : a study protocol

Risky alcohol consumption is the subject of considerable community concern in Australia and internationally, particularly the risky drinking practices of young people consuming alcohol in the night-time economy. This study will determine some of the factors and correlates associated with alcohol-related risk-taking, offending and harm in and around licensed venues and night-time entertainment precincts across five Australian cities (three metropolitan and two regional). The primary aim of the study is to measure levels of pre-drinking, drinking in venues, intoxication, illicit drug use and potentially harmful drinking practices (such as mixing with energy drinks) of patrons in entertainment areas, and relating this to offending, risky behaviour and harms experienced. The study will also investigate the effects of license type, trading hours, duration of drinking episodes and geographical location on intoxication, offending, risk-taking and experience of harm. Data collection involves patron interviews (incorporating breathalysing and drug testing) with 7500 people attending licensed venues. Intensive venue observations (n=112) will also be undertaken in a range of venues, including pubs, bars and nightclubs. The information gathered through this study will inform prevention and enforcement approaches of policy makers, police and venue staff.

Reducing intoxication among bar patrons: some lessons from prevention of drinking and driving

Intoxication in and around licensed premises continues to be common, despite widespread training in the responsible service of alcohol and laws prohibiting service to intoxicated individuals. However, research suggests that training and the existence of laws are unlikely to have an impact on intoxication without enforcement, and evidence from a number of countries indicates that laws prohibiting service to intoxicated individuals are rarely enforced. Enforcement is currently hampered by the lack of a standardized validated measure for defining intoxication clearly, a systematic approach to enforcement and the political will to address intoxication. We argue that adoption of key principles from successful interventions to prevent driving while intoxicated could be used to develop a model of consistent and sustainable enforcement. These principles include: applying validated and widely accepted criteria for defining when a person is ‘intoxicated’; adopting a structure of enforceable consequences for violations; implementing procedures of unbiased enforcement; using publicity to ensure that there is a perceived high risk of being caught and punished; and developing the political will to support ongoing enforcement. Research can play a critical role in this process by: developing and validating criteria for defining intoxication based on observable behaviour; documenting the harms arising from intoxication, including risk curves associated with different levels of intoxication; estimating the policing, medical and social costs from intoxicated bar patrons; and conducting studies of the cost-effectiveness of different interventions to reduce intoxication.

'Wide-awake drunkenness'? Investigating the association between alcohol intoxication and stimulant use in the night-time economy

Aims: We tested whether patrons of the night-time economy who had co-consumed energy drinks or illicit stimulants with alcohol had higher blood alcohol concentration (BAC) levels than patrons who had consumed only alcohol. Design: Street intercept surveys (n=4227) were undertaken between 9 p.m. and 5 a.m. over a period of 7 months. Setting: Interviews were undertaken with patrons walking through entertainment precincts, queuing to enter venues or exiting venues in five Australian cities. Participants: The response rate was 92.1%; more than half the study sample was male (60.2%) and the median age was 23 years (range 18-72). Measurements: Data were collected on demographics, length of drinking session, venue types visited, types and quantity of alcohol consumed and other substance use. A BAC reading was recorded and a subsample of participants was tested for other drug use. Findings: Compared with the total sample (0.068%), illicit stimulant consumers (0.080%; P=0.004) and energy drink consumers (0.074%; P<0.001) had a significantly higher median BAC reading, and were more likely to engage in pre-drinking (65.6, 82.1 and 77.6%, respectively, P<0.001) and longer drinking sessions (4, 5 and 4.5 hours, respectively, P<0.001). However, stimulant use was not associated independently with higher BAC in the final multivariable model (illicit stimulants P=0.198; energy drinks P=0.112). Interaction analyses showed that stimulant users had a higher BAC in the initial stages of the drinking session, but not after 4-6 hours. Conclusions: While stimulant use does not predict BAC in and of itself, stimulants users are more likely to engage in prolonged sessions of heavy alcohol consumption and a range of risk-taking behaviours on a night out, which may explain higher levels of BAC among stimulants users, at least in the initial stages of the drinking session.

Demographic risk factors for alcohol-related aggression in and around licensed venues

AIMS: Few studies have examined the role of gender and both area-level and individual socio-economic status (SES) as independent predictors of alcohol-related aggression (ARA) in and around licensed venues. METHODS: The aim of the present study was to investigate the relationship between gender, area-level SES and individual SES (operationalised as occupational category) and ARA in and around licensed venues. The sample comprised 697 men and 649 women aged 16-47, who completed a patron intercept survey as part of a larger study assessing trends in harm and stakeholders' views surrounding local community level interventions in dealing with alcohol-related problems in the night-time economy. RESULTS: Binary logistic regression analyses showed that age, gender, occupational category, area-level SES and level of intoxication at time of interview were all significant predictors of involvement in ARA. Being male doubled the odds of involvement in ARA, while age was a protective factor. Blue collar workers had more than double the odds of ARA involvement of professionals, while those living in the most socio-economically disadvantaged areas were over twice as likely to report experiencing ARA compared to those living in the most advantaged areas. However, assessment of the predictive model by gender revealed that effects of age, occupational category and area-level SES were restricted to male participants, with greater intoxication no longer predictive. CONCLUSIONS: ARA among patrons was significantly more likely to occur among men, those in blue collar occupations, and individuals living in low SES areas, suggesting both individual and area-level disadvantage may play a role in ARA.