The Dartmouth team, led by James D. Sargent with first author Jennifer A. Emond, published "Energy drink consumption and the risk of alcohol use disorder among a national sample of adolescents and young adults," in Journal of Pediatrics.

"These findings are concerning," said Emond. "They highlight that mixed use of alcohol and energy drinks may signal the development of abusive drinking behaviors among adolescents."

Several studies have documented a link between consuming alcohol mixed with energy drinks and the increased rates of negative outcomes while drinking, including binge drinking. However, most studies to date have been conducted among undergraduate college students.

Sargent's team looked at a sample of 3,342 adolescents and young adults aged 15-23 years old recruited across the US. They found that 9.7% of adolescents aged 15-17 years old had consumed an energy drink mixed with alcohol. Analyses showed that group to have greatly increased odds of not just binge drinking, but also clinically defined criteria for alcohol use disorder.

"Abusive alcohol use among adolescents is a dangerous behavior that can lead to injury, chronic alcohol use and abuse, and even death," said Emond. "Identifying those most at risk for alcohol use is critical. Given that this is a sensitive issue, it's possible that clinicians, parents, and educators might open dialogues about alcohol use with adolescents by starting the discussion on the topic of energy drinks."

Looking forward, the Dartmouth team will consider how the marketing of energy drinks may influence an adolescent's perception of use of energy drinks, including the acceptability of mixed use with alcohol.