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Hot Topic: Four Loko

What it is

This caffeinated malt beverage (also known as an "alcoholic energy drink") contains 12% alcohol— nearly 3 times the alcohol content of beer. In other words, drinking a whole 23.5 oz can is the equivalent of having almost 5 shots or 5 beers. It also contains a ton of caffeine and sugar. Some Four Loko fans say they like the drink because it gives them an interesting "alert-but-relaxed feeling." 

Four Loko is certainly not the only option for those seeking an alcoholic energy drink. Another is the popular "Joose" (18-19 proof, also in a 23 oz can). Some people prefer to mix their own, combining alcohol with their choice of energy drinks (e.g., Red Bull, Rock Star, Jolt, Monster, and Amp).

A can of Four Loko or a Red Bull & vodka may make you feel like you can "dance all night," but they are not without their problems.   

The problems

There is no general consensus (among health professionals and the scientific research community) that the use of caffeine in alcoholic beverages has been demonstrated to be safe. On the contrary, the consumption of caffeinated alcoholic beverages has been associated with increased risk of serious injury to oneself and to others, as the result of driving while intoxicated, sexual assault, and other dangerous behaviors. Here are some of the issues: 

  • Because of their sweet flavor, (Four Loko contains 660 calories and 60 grams of sugar in one 23.5 oz can) drinks like this can go down pretty quickly, which means that people tend to drink them faster than beer. The speed of consumption, combined with the high alcohol content, make them a risky choice for many drinkers.
  • Because of the caffeine in the drink, the usual “you’ve had enough” signals won't come through, or will be somewhat masked, making it easy to think you could drink even more. Users of the drinks report feelinig more alert and less aware of the effects of alcohol … at first. Five beers in a sitting is a lot of alcohol for anyone, but, if you are a relatively small woman, about 120 pounds, and you drink that can in about an hour, your BAC will be up around a .18, which is over twice the legal limit of too drunk to drive (.08 BAC). Normally, at a .18 BAC, most of us would feel pretty messed up—stumbling, staggering, slurred speech.
  • Alcohol and caffeine are both diuretics, increasing the risk of dehydration; dehydration slows the body’s ability to process alcohol, affecting balance, coordination, body temperature, speed of sobering up
  • Because caffeine has no effect on blood alcohol concentration, people often feel the full effect of the alcohol after the caffeine has worn off

IN SUMMERY: Drinkers of the caffeinated energy drinks may feel more competent than they really are, and may make decisions to drive under the influence or take other behavioral risks; this may result in more injuries, fights, blackouts, an unwanted hook-up, or even alcohol poisoning, which can be fatal.

If you drink Four Loko

To be on the safe side, consider these strategies: 

  • Learn about caffeinated energy drinks and their typical effects on the human body, so you can make choices to reduce the associated harms. (See links, below.)
  • Consider the amount of alcohol that is right for you: How do you know? Take into account your gender, weight, and overall state of mind. A BAC (blood alcohol concentration) calculator can help make sure your BAC stays at or below a .06. This is especially important when using caffeinated alcoholic beverages, as the way you feel at first may not be a trustworthy gauge of how much alcohol you’ve consumed.
  • Drink less. Pour the equivalent amount of a glass of wine, (a 5oz serving).  
  • Drink it slowly, as you would a glass of wine. Sip it for at least 20 minutes so that you can start to feel the effects of the first serving before you go on to that second serving.  
  • Consider filling up your cup with water before you go on to that second serving. It will help with the hangover the next day, cut down on the empty calories from the alcohol, and allow you to check in with how you really feel before going on to that next drink. 
  • If you are with a friend who has had too much to drink, don’t hesitate to call 911 for medical assistance. It is always better to be on the safe side when it comes to alcohol poisoning.  

More information

The following links provide additional information about research related to alcoholic energy drinks:

 Four Loko

Risks may outweigh perceived benefit.