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Keith Johnson, Deseret Morning News
Energy drinks such as Tilt contain alcohol, and their consumption by minors is a growing concern.

PROVO — Packed with caffeine, energy drinks are already a concern in some health-profession circles.

But now that alcohol has been added to some newer drinks on the market, a number of professionals are worried about additional health implications and the possibility of those drinks getting into the hands of minors — be it accidental or intentional.

"They look the exact same as other energy drinks to a parent, young adult, anybody purchasing these," said Pat Bird, prevention manager for the Utah County Division of Substance Abuse.

Popular energy drinks such as Red Bull and Rockstar are at the forefront of one of the nation's fastest growing markets, one that appeared in the late 1990s and had grown to $3.4 billion in annual sales by 2005.

Industry forecasts call for $10 billion in annual sales by 2010.

Some of the stronger drinks contain more than three times the physician-recommended daily limit on caffeine intake in a single can. Some companies that are now including alcohol in their energy drinks make the case in advertising materials that the energy component offsets the side effects of alcohol consumption — most notably the hangover — but Bird disagrees.

"They are impaired no matter what because the alcohol is in their system," he said. "They may feel less impaired because they're more alert, they're hyped up, they're not sleepy, but the impairment is still there. It does not diminish the impairment by any means."

Bird is more concerned, however, with the possibility of minors obtaining alcoholic energy drinks, which contain the same level of alcohol as beer in Utah — 3.2 percent by weight. The health department has logged "numerous" cases of minors who successfully purchased an alcoholic energy drink.

"Two weeks ago, an underage buyer purchased Tilt (which contains alcohol) on a compliance check," Bird said. "The cashier sold it even though (the computer system) stated she needed to ID. Her premise was anything with alcohol in their store came in four packs or six packs."

A representative for the Utah Department of Alcoholic Beverage Control said that department has not had any complaints about alcoholic energy drinks so far.

"It hasn't been an issue that's come up in our department," spokeswoman Sharon Mackay said. "We haven't received any complaints."

Health department officials said they weren't surprised by that, since minors trying to buy the drinks wouldn't report stores where they find success, and stores aren't likely to report themselves.

"Just saying that there isn't a complaint doesn't mean there isn't a problem," said Utah County Health Department spokesman Lance Madigan.

The health department has formulated a presentation detailing the potential risks of energy drinks, with or without alcohol. Employees have given the presentation to various groups throughout the state, and requests for other presentations are pouring in.

But for a real change to be made, Bird said, the U.S. Food and Drug Administration will need to step in and increase the labeling requirements on manufacturers of alcoholic energy drinks.

Many such products have packaging similar to traditional energy drinks at first glance and are marked as alcohol by phrases on the label such as "malt beverage" and "alc/wt," which Bird said only about half of those surveyed by the health department recognized as an alcoholic beverage.

An attempt to reach an alcoholic energy drink manufacturer was not immediately successful.

Traditional energy drinks, which use ingredients such as ginkgo and ginseng that that are not regulated by the U.S. government, also need a closer look from the FDA, Bird said.

"An environment is being created where the consumer knows little about the product," he said. " ... A lot of these particular ingredients are from Eastern medicine. There are some claims around them that have not been validated."

Like Utah County health officials, there are others who are raising red flags about the ingredients in energy drinks. Last fall, researchers at the University of Maryland petitioned the FDA to make a close evaluation of energy drinks.

The Center for Substance Abuse Research (CESAR) at the University of Maryland is in the midst of a five-year study called the College Life Survey. It is a comprehensive, five-year lifestyle study of 1,200 college students that is funded by the National Institute on Drug Abuse.

Questions about energy drink abuse were added a year and a half ago at the suggestion of student interviewers.

"The more and more I looked at it, the more I thought, 'Wow, this is going under the radar of people in the substance-abuse field,"' said Amelia Arria, deputy director of research at CESAR. "I'm not assuming there are negative effects (from energy drinks), but because of their prevalence, I'm thinking we need more research."

The FDA is still mulling the request, Arria said.

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