Four Loko Removes Caffeine...Surprise, Surprise

Well, we didn't really think Four Loko was going to go away just because of a ban did we? Of course not! As I posted last November the focus on Four Loko appeared to be all on the caffeine content which was a dramatic missing of the point. Well, Four Loko has removed the caffeine, guarana and taurine, and is good to go again.

Almost.

Apparently someone has actually noticed that the alcohol content is kind of a problem. Probably because all those kids were suffering from alcohol poisoning rather than caffeine overdoses.

The focus is now on changing the label so that people know that when they consume one Four Loko, they are actually consuming 4 or 5 drinks rather than one. I'm sure this labeling will stop the problem, after all it's not like anyone ever abuses alcohol or that college kids knew full well that they were getting a good deal for $2.50... I'm sure it will all be better now.

The Trouble with DUID: Part I

Five years ago, give or take, when Vermont was first getting a DRE ("Drug Recognition Evaluator" formerly "Drug Recognition Expert") program I did a presentation for my colleagues entitled "The Trouble with DUID." With the recent talk of banning Four Loko and dealing with the "Spice" issue, which I will save to discuss in detail later, it's gotten me thinking again about that presentation and the issue of legislation.

Legislation, as with any move from government agencies it seems, is very reactionary in it's nature. "Oh my God, here's one instance of something that happened, quick ban it!" Maybe a bit of a dramatization, but it certainly seems that way. Don't believe me? Look up www.stupidlaws.com. You'll note that in Vermont at one time it was illegal to tie a giraffe to a telephone pole. Think that was reactionary? Or another example. How about the TSA screening procedures?

What has the focus been on the Four Loko ban? Look at any of the articles or the bills being introduced and you will see the focus is on the caffeine and the brightly colored packaging. Were those college kids hospitalized for caffeine intoxication? No, it was alcohol poisoning. My prediction is that the bills will ban caffeine containing alcoholic beverages. My second prediction is that Four Loko will simply drop the caffeine, add a little more guarana and be back on the shelves in no time. Leaving the problem of a 12% alcohol 24 ounce pop top beverage that will still be intriguing due to it's low price and high alcohol content.

The same thing is occurring with Spice. There are 400 variations of the synthetic THC used, but the lawmakers are all busily making lists of chemicals to ban. Chemicals that they are seeing now. They'll ban those few that are common place now, leaving the rest legal. The manufacturers will simply switch variations and it will be legal again. A presenter at NEAFS presented an interesting idea. Simply ban anything that binds to the cannabinoid receptor. Then every variation is, by mechanism of action, illegal.

So what does that have to do with DUID? Driving Under the Influence of Drugs for those not familiar with the acronym. Well, several years ago, I was presented with pending legislation to change the DUID statute in Vermont. We were asked to review and comment on the wording. The bill wasn't original. It was adapted from another state and followed a similar pattern and a poor one at that. It simply listed drugs that were no-nos. This created a problem for some. #1 Drugs that were Schedule I were less of an issue, since they are already illegal, but the legislature wanted numbers like the per se limits in the DUI laws. #2 Those drugs that had therapeutic uses were concerning. The legislature did not want to make it illegal for someone to drive "legally impaired."

That phrase absolutely screeches in my head like nails on a chalkboard. I'm sure I'd feel much better if a friend or family member were killed by someone driving "legally impaired." What they meant was that they felt that people who were prescribed medication should not be banned from driving since they were given the drug legally by their doctor. Some how the fact that those medications all come with warnings that people should not operate motor vehicles was irrelevant. The biggest problem with this is our country's love affair with pharmaceuticals, but that's a separate issue.

Anyways, I digress. Alcohol is a nice clean, linear, neat drug. The effects are universal and occur at vice nice linear progressions until at the highest level death occurs. Per se limits can be put into effect because ethanol's affect on people is very consistent. Drugs don't follow this pattern. They don't all affect people linearly nor have the same effects on every person. This makes per se limits very difficult to impose. Factoring in as well that people don't want to ban therapeutic levels of drugs, it's a complicated issue.

I think when we focus on lists and per se limits we're starting to be unable to see the forest for the trees. In Vermont, the DUI laws indicate that a person can not operate a motor vehicle when they are under the influence of alcohol to the slightest degree. The drug law however, states that the person must be unable to operate a motor vehicle safely. That is a huge discrepancy and due in part to the difficulties stated above. Unless someone crashes their car with an illegal drug in their blood at a high level, it's difficult to prove that the drug caused it.

On the next post we'll continue from there and continue to outline the Trouble with DUID.

Four Loko: A US ban?

The FDA is expected to make a decision on the safety of Four Loko by Wednesday in response to a number of states moving to ban the drink. It will be interesting to see how this proceeds and what the exact phrasing is once it's done. The focus appears to be on the caffeine portion of the drink, but removing the caffeine from the drink still leaves the basic problem: the alcohol concentration. Too often this type of legislation is a knee jerk response which is barely enforceable because the time is not taken to word it properly and understand the real issue. We will have to wait and see...

Staying up to Date Part I: What is a Standard Drink now?

Recently I've realized that my entire primary school education has been proven wrong. Christopher Columbus did not discover America. Pluto is not a planet. You don't really use cursive. Brontosaurus is Brachiosaurus or Apatosaurus as they're calling it now and apparently the Triceratops was just the juvenile form of another dinosaur. Hmmm... Things change.

It's a good thing to remember especially as scientists whose job it is to stay up on the latest info. There used to be an old saying that is finally falling by the wayside. The saying that people eliminate one drink an hour. That hasn't been true for a long time for several reasons:

One: People gain different alcohol concentrations from the same drink based on gender and body type and Two: The alcohol concentration of drinks has risen.

In the "olden days" when the Brontosaurus roamed the earth and gas was 99 cents a gallon, regular beer was 4% alcohol. In the slightly more modern days when Apatosaurus roamed the Earth and gas was $4.50 a gallon, regular beer was 5% alcohol. That extra percentage makes a difference!

Now in the current days where some random dinosaurs may or may not roam the Earth and gas is around $2.80 a gallon at recent glance we need to re-evaluate what we are using for a standard beer. Budweiser advertises at 5% beer. Is that "standard?" I live in Vermont where micro brews reign supreme. When the typical micro brew is at least 6% and often more, should I be using a 5% beer as my standard drink? A quick look at Rock Art beers show 25 different brews where half of them are at least 8% alcohol and rise up to 10% alcohol. This means that a typical Rock Art is equal to nearly two Budweisers. That's using 12 ounce servings. If we start talking pints or the 20-24 ouncers that are starting to be served we're talking a substantial difference.

That's simply talking beer. You all know my opinion on Four Loko, the insanity of all alcohol beverages. Expert witnesses need to be aware of what's out there. We must stay on top of what is being sold and what is happening to the alcohol concentration of common beverages.

A few years ago, if  I were presented with a test of 0.160 and asked if it were possible for a person to reach that point on two drinks consumed a couple of hours ago as stated in a processing form, I would have answered in the negative. No way could a person do that. Now however with the presence of Four Loko and the trend of micro brews to reach 10% alcohol, the answer would not be so simple. Yeah, it's possible. Depending on what they were drinking, it may even be likely.

The problem we will be seeing is that the general public is not aware of the change either. I've already posted about the hospitalizations of people drinking Four Loko, but on the more common front defendants will easily be over an 0.08 and not understand how it happened. I've had to point out to my own husband, "That equals two!"

Keeping all of this in mind, what is a Vermont standard drink? Should we base the "standard" drink on region or should we get rid of it all together? I think that's best left up to a case by case basis, but expert witnesses should spend more time investigating what it is that is actually being consumed. If you have the name of the beer, it's very easy to find the alcohol concentration and well worth the extra couple of minutes for the greatly increased accuracy of your calculation.

Four Loko: I'm sensing a theme...

And Four Loko again, this time at Central Washington University.

I'm very big on people taking responsibility for their actions, but in this instance this applies more to the manufacturer of Four Loko then anyone else. Packaging a drink like this in 24 ounce pop tops, implies that it is one serving. When you're talking calories, fine. Worst case scenario someone gains weight. When you're talking alcohol, that's just dangerous and irresponsible.



Put it this way: What do you think the uproar would be if they packaged oxycodone in over-sized packages and then said it's up to the people taking them to take them responsibly?

Six ounce bottles people, I'm telling you. That's the way to fix this.

Four Loko: STILL a very bad idea.

Forgive this brief interruption in our Forensics of Horror series, but "Four Loko" has hit the news again. This time a New Jersey college is calling for a ban on all alcohol containing energy drinks and singles out "Four Loko" by name after a dozen students have been hospitalized with alcohol poisoning.

There is a very easy fix to the drink beyond simply not drinking it. The manufacturer should be called upon to simply repackage the drink into six ounce bottles. By making that change a 140 pound female would gain a 0.046 BAC per bottle rather than the 0.183 BAC they gain by the current packaging. Although I guess making this change would make the "Loko" part of the name less applicable.

Say it with me people:   

                     Good Crazy = Dyeing your hair purple.

                  
                  Bad Crazy = Killing yourself with Four Loko

Four Loko: A very bad idea...

After so long of review processing forms for DUI offenses it is always surprising when a drink is mentioned that I've never heard of. Obviously, this leads to further investigation. How is there a drink I don't know about? I must learn more!

This was the case the other day with the drink Four Loko. For those like myself just learning about this drink, Four Loko is a 24 ounce energy drink containing 12% alcohol.

Yes, let me repeat that.

A 24 ounce serving of 12% alcohol.

To put that into perspective a regular beer is typically a 12 ounce can of 5% alcohol. Certainly those too can be served in 24 ounce cans, but they still only contain 5% alcohol. Using Widmark, for a woman my size, if I were to consume an entire Four Loko, my blood alcohol concentration would be 0.167. For one drink...

Now, obviously this is assuming no elimination, so in reality it wouldn't be that high. However, in order for a woman my size to drink one Four Loko and remain below the legal limit for driving, I would have to consume this drink over the span of SIX hours.

The drink comes in a variety of fruit flavors and although the website does have a very nice "drink responsibly" section, lets be honest: A 24 once carbonated beverage in a pop top implies one serving, whether that's what is on the label or not, we know that to be true. Someone buying a 24 ounce soda would not drink one serving and then leave the drink to lose it's carbonation for later consumption.

Additionally the drink contains caffeine and all the other typical ingredients in a standard energy drink.  Here's a nice description of drinking the beverage.It's essentially a Red Bull and Vodka on crack.


The drink is starting to get some press. However, in my opinion they are focusing on the wrong things. The press is the typical press that has continued since the start of Red Bull and vodka drinks, the combination of alcohol and caffeine.

The real danger of Four Loko is back to basics. It's a 24 ounce serving of 12 % alcohol!

Now just to make all of you out there do a Homer Simpson impression, here's the best news: The drink is sold for $2.50 at 7 Eleven. Pause a minute and think about that. A $2.50 bottle of wine, with stimulants served in a one serving size container. In Europe, it will even contain absinthe for you. Although we could debate the pharmacological activity of today's wormwood, this addition does seem to just give the drink a little something else.

My prediction is that we're going to be seeing this more in driving under the influence cases and more ominously, it will be incorporated into the college scene. This in itself is a scary thing. College, where funneling and keg stands are already tradition, you're going to add a beverage that will take an average size woman to more than double the legal limit in one sitting. Now change that to a 110 pound, naive drinking female and you get a blood alcohol concentration of a 0.233. When you consider that the average BAC level attributed to death by alcohol intoxication alone is a 0.250, this is reason to be concerned.

The drink is tailor-made for that crowd with the energy aspect, the low cost, high alcohol and fruit flavors. It is sure to become very popular. One can only hope that they will show better judgment than college students are known to display.