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By Derek Williams
Special Contributor, EDM Digest
Say the words “substance abuse” to any first responder or emergency medical services worker. It immediately evokes a certain response.
They will tell you about the opioid epidemic in America and about prescription drug abuse. They will tell you how many times they have seen Narcan (a medicine used to treat an opioid overdose) work its magic. They’ll also let you know about the one patient they saved who turned his or her life around and came to thank them years later.
But it is more than likely they won’t think of themselves as substance abusers. But the truth is that many substances can be abused. There’s one substance in particular that is often abused by emergency services workers: energy drinks.
The Harmful Effects of Too Many Energy Drinks
I have been in emergency services for the past 25 years, working for my current department for over 22 years. I’ve had over two decades of health and fitness evaluations.
After all those years of being poked and prodded, running on treadmills with wires and tubes hanging off me and standing still for untold X-rays, I always had a clean bill of health. That lasted until my annual health assessment three years ago.
I was off duty when I got a call from our Fire Department physician. “Derek,” he said, “I would like you to come in to my office right away. We need to discuss your last health assessment.” That is not what you want to hear from the man holding a copy of your bloodwork in his hands.
I went into his office and sat down with to discuss the results. “Derek, I am concerned about your results. Your kidney function test was poor, your blood pressure and pulse are up 20 points from last year, and your white blood cell count is slightly elevated. Something is up!”
We started a week-long series of tests and discussions to determine my health issue. Eventually, the discussion came around to sleep, stress and diet.
Because I was stationed at the busiest engine company in my department (nicknamed the “Midnight Express”), sleepless nights and stress were par for the course. But I had worked there for years and never had any seriously adverse repercussions.
Then something occurred to me. Lately, I had been handling the operational tempo and sleepless nights differently than in past years. The difference was that one of my rookies introduced me to a beverage called an energy drink.
For about a year and a half, I drank a commonly available energy drink to combat fatigue. It started with just one drink in the morning to wake up a bit and to get some accelerated energy for our morning workouts and training.
Slowly, the number of energy drinks I consumed crept up to three or sometimes four drinks a day. The day before I went in for my health assessment, I’d had four energy drinks.
I discussed this development with my doctor. He told me, “You can have as much coffee or caffeinated soda as you would like. You can even try an herbal vitamin ‘shot’ [commonly sold in convenience stores right beside my favorite energy drink] if you wish. But no more energy drinks, period.”
He wanted me back in a month to get more bloodwork and to review the results. A month later, I got a clean bill of health. My kidney function and white blood cell count were back to normal and my pulse and blood pressure had dropped by almost 20 points each.
Research on the Effects of Energy Drinks
Now I realize that my story is anecdotal at best. But having gone through this health issue and having suffered withdrawal-like symptoms for a week after my last energy drink, I wanted to do some research to find out if the drinks were indeed to blame for my poor health.
In June 2014, the Center for the Science in the Public Interest examined this issue in its article, “Documents Link More Deaths to Energy Drinks.” The authors point to documents obtained from the Food and Drug Administration (FDA) that show that since 2004, a total of 34 deaths have been linked to energy drinks.
Additionally, 56 previously undisclosed “injuries” were reported to the FDA through its adverse event reporting system. These “injuries” included 54 hospitalizations with patients experiencing high blood pressure, convulsions, heart attacks and other problems after consuming energy drinks.
CBS News further investigated the hazards of energy drink substance abuse in 2016. In an article by CBS News health journalist Mary Brophy Marcus, “Energy Drinks Raise More Health Concerns,” Marcus reviewed the findings of University of the Pacific and David Grant Medical Center scientists in a study regarding the use of energy drinks.
The study included 27 healthy volunteers between the ages of 18 and 40, who drank either two cans of an energy drink or a placebo beverage once a day, every six days, for three weeks. The researchers measured participant’s heart rhythms and blood pressure before the drinks were consumed and took measurements four more times over six hours after the volunteers consumed the energy drinks.
The results showed that those who drank the energy drinks had a statistically significant increase in a marker of an abnormal heart rhythm risk known as the QTc interval. They also experienced a slight rise in blood pressure the effects of which persisted for up to two hours afterward.
What Are the Potentially Harmful Ingredients in Energy Drinks?
So what is in these drinks that can cause such ill effects? It may be a combination of several ingredients that can wreak havoc on the body:
- Caffeine is a chemical compound that stimulates the central nervous system and is relatively safe in smaller doses. However, caffeine in larger amounts may cause blood pressure spikes, headaches, nausea and sleeplessness. It is also a diuretic, which may lead to dehydration. Energy drinks typically contain very high levels of caffeine.
- Sugar in the form of sucrose, glucose, fructose, corn syrup or high fructose corn syrup is known to give an instant boost of energy. Sugar has four calories per gram. An energy drink can contain 27 grams or more of sugar, which equates to 108 non‐nutritional calories.
- Guarana is a South American plant that produces seeds with 4% to5% caffeine content (a coffee bean has the caffeine content of 1% to2%). Guarana in a 16‐ounce energy drink ranges from 1.4 milligrams to as much as 300 milligrams, but exact amounts are unknown because many companies do not list milligram amounts. The safety of guarana in higher levels remains unknown, but high levels of guarana could be easily consumed with the ingestion of multiple energy drinks.
- Ginseng is an herbal extract made from the root of the ginseng plant. Since ginseng is not regulated by the FDA, it is difficult to know the exact amounts of ginseng in energy drinks because manufacturers are not required to list amounts. Herbs such as ginseng can trigger side effects and interact with other herbs, supplements or medications. They should not be taken at the same time. Ginseng may also cause nervousness or sleeplessness, especially if taken at high doses or combined with caffeine. Other side effects are rare, but could include high blood pressure, insomnia, restlessness, anxiety, vomiting, headache and nosebleeds.
- Taurine is one of the most abundant amino acids in the brain. Most energy drinks have anywhere from 20 to 2,000 milligrams of taurine in a 16‐ounce beverage. Currently, there is little research on taurine consumption in humans.
How Is All of This Energy Drink Information Important to First Responders?
More often than not, emergency operations personnel are more than willing to sacrifice sleep, rest, recovery and personal health to stay in the fight to save others. Emergency services personnel choose a life of service for a reason.
To the majority of us, our work is more than just a job and a paycheck. There are other intrinsic motivators to choosing a life of service, such as a sense of duty, honor and service to our fellow man.
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I have personally been on scenes where personnel will stay awake for days at a time, refusing to leave for rest. And how do many of us get through these long hours of sleepless, stress-filled work? Energy drinks.
Emergency services personnel can attest that energy drinks are common props around stations. They appear in the cabs of our vehicles and in workers’ hands during our downtime.
But in an industry in which stress, elevated heart rates, high blood pressure, dehydration and poor diet are part of the job, the last thing we should do is fill our bodies with a substance that can exacerbate all of these health issues.
Since my incident, I have sworn off energy drinks and gone back to my old friend: a big ol’ cup of coffee. The science and research behind the negative effects of energy drinks may not be definitive for some, but they are for me.
About the Author
Captain Derek Williams serves as the Mesa, Arizona Fire and Medical Department (MFMD) Battalion 203 Safety Officer in Mesa, Arizona. Over his 25-year firefighter-paramedic career, Captain Williams earned certifications from the State of Arizona, FDSOA and FEMA as a Fire Department Incident Safety Officer (ISO) and Fire Department Health/Wellness and Safety Officer (HSO). Captain Williams is an author and instructor, and he is currently researching and studying in the Emergency and Disaster Management program at American Military University.