What is the prevalence of caffeine toxicity in the US?

Updated: Oct 24, 2020
  • Author: David Yew, MD; Chief Editor: Michael A Miller, MD  more...
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Caffeine poisoning is a relatively common toxicologic emergency in the United States, and the number of cases has steadily increased in the past decade. The Substance Abuse and Mental Health Services Administration (SAMHSA) reported a jump in the number of emergency department visits involving energy drinks, increasing roughly 10-fold from 2005 (1128 visits) to 2008 and 2009 (16,053 and 13,114 visits, respectively). More than half of the visits made by patients age 18-25 years involved the combination of energy drinks with alcohol or other drugs. [15]  Between 2007 and 2011 the number of energy drink related visits to the emergency room doubled. [16]

The American Association of Poison Control Centers (AAPCC) reported 1592 single exposures to caffeine-containing energy drinks in 2018, with six major outcomes but no deaths. The AAPCC also reported 2849 single exposures to caffeine as a street drug, with 21 major outcomes and two deaths. [17]

Caffeinated alcoholic beverages were a public health concern because caffeine can mask some sensory cues that people might normally rely on to determine their level of intoxication. The US Food and Drug Administration (FDA) banned their sales in 2010. [7]  In spite of the ban, mixing alcohol with energy drinks is still common practice and popular. In 2015, 13.0% of students in grades 8, 10, and 12 and 33.5% of young adults aged 19 to 28 reported consuming alcohol mixed with energy drinks at least once in the past year. Furthermore, the CDC reports that drinkers aged 15 to 23 who mix alcohol with energy drinks are 4 times more likely to binge drink at high intensity. [18]  It is very important for the physician to inquire about co-ingestion of caffeine-containing drinks when obtaining a history for possible drug overdose or alcohol poisoning.

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