Watch Your Mouth: Four Loko and the Search for a Safe Caffeinated Booze Four Loko and the Search for a Safe Caffeinated Booze

Last fall, emergency personnel found a New York teenager lying on the subway tracks. Other kids had been discovered passed out at school, asleep in a building lobby, and splayed out in a dark public park. Each of them turned up in Bellevue Hospital Center’s pediatric emergency room with one thing in common: They had reportedly downed Four Loko, a 23.5-ounce concoction that originally contained as much caffeine as a cup of coffee and about as much alcohol as four regular beers.

Caffeine and alcohol are two of the world's most popular legal drugs, and in theory, their effects pair nicely. Following last year's youth health scare, Food and Drug Administration commissioner Margaret Hamburg declared caffeine an illegal additive in alcoholic drinks, stating that the active ingredients in Four Loko produced "a state of wide-awake drunk."

Precisely. That effect was so popular that fans rushed to stock up on the stuff before it was cleared from the shelves. So how do we get a wide-awake drunk feeling without winding up zombie-eyed on a subway platform?

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"I don’t think we’ll ever be able to develop a drug that produces pleasure and doesn’t produce harm," Dennis Thombs, an expert on addictive behavior, told me. "That’s the problem with alcohol, isn’t it? It’s a source of great social enjoyment. Most people enjoy it and don’t have that many problems with it. Then again, 10 to 30 percent of drinkers do have a problem."

And those trying to compensate for one of alcohol's unwanted side effects—drowsiness—can find themselves battling bigger issues. Before Four Loko was relegated to hoard status, drinkers could amp up with a vodka-spiked Red Bull or a classic rum and Coke. Researchers have linked these caffeinated cocktails with an increased risk of alcohol-related injuries, drunk driving, and sexual assault; caffeinated drinkers are also more likely to register higher blood alcohol levels and underestimate their impairment.

When researcher Cecile Marczinski had 56 volunteers drink caffeinated and non-caffeinated alcoholic drinks—for science!—she found that those mixing caffeine and alcohol felt less inhibited and more awake than those just drinking. "Even when they don’t even know what drink they’re receiving," she told me, "they still show greater impairment with the Red Bull and vodka and they also don’t feel as intoxicated.” She writes: "a worrisome scenario develops when individuals perceive themselves as feeling less intoxicated, even while impulse control remains significantly impaired. In the real world, a drinker who can accurately assess his or her level of impairment is probably safer than a drinker who cannot."

So caffeine-infused cocktails could be encouraging drinkers to make more poor, risky decisions: having another VRB, for example.

If modern science fails to a provide a safer way to drink up and stay up, perhaps history can be our guide. The Lokovore phenomenon may appear uniquely suited to the 21st-century cultural climate of hyped-up frat boys and oonts-oonts nightclubs, but pharmacists have been concocting non-drowsy drinks for centuries.

In the late 1800s, French chemist-entrepreneur Angelo Mariani created Vin Mariani, a Bordeaux infused with cocaine. The science behind today’s stimulating alcoholic beverage hasn't evolved much beyond Mariani's "cocawine" (one modern-day caffeine-infused alcopop was, in fact, marketed as “Cocaine"). But Mariani's formulation had one thing today's alcohol-infused energy drink don't—a veneer of intellectualism. As Howard Markel writes in his new book, An Anatomy of Addiction, Mariani solicited celebrity endorsements from Jules Verne, Thomas Edison, and Sir Arthur Conan Doyle. Even the shah of Persia and U.S. President Ulysses S. Grant drank the stuff.

Of course, no one really understood what coca was back then, and Markel's book links the substance to both William Halsted's descent into addiction as well as some of the more cracked-out theories of Sigmund Freud. But Vin Mariani's branding as an elite intellectual drug may have protected against some of the worst effects of cocaine and booze.

Today's drug culture exerts a similar influence on the drugs themselves. Daniel P. Evatt, a research fellow at Johns Hopkins University Medical School who has been studying the effects of caffeinated alcoholic beverages, one volunteer at a time, believes that cultural expectations play a significant role in the consequences of caffeinating while drunk.

"It's probably true that caffeine has some effects and they might be dangerous," he told me. "But if you say, 'I'm going to go out and drink 10 Red Bull-vodkas,' well, that might be as dangerous as drinking ten vodkas."

In other words, if you're "going out with the idea to go crazy and party,” you may end up going crazy and partying. If the names alone are any indication, many of these drinks—Four Loko! Joose! Wide Eye! Hard Wired!—are in fact marketed as go-to drinks for going crazy and partying.

While wide-awake drinkers of the past sipped their highly-charged Bordeaux, today's revved-up drunks chug tall boys flavored like candy and dyed the color of glow sticks. Certain kinds of drinkers—those in search of novelty, adventure, and a drink that matches their neon camouflage cargo pants—may be more likely to reach for booze with a buzz. Perhaps changing this group's behavior may be more effective than replicating Prohibition's failed experiment, this time with caffeinated alcohol. After all, who can calmly sip a Four Loko?

Photo collage by Dylan C. Lathrop. Poster "Vin Mariani - Popular French Tonic Wine, 1894" by Jules Chéret, courtesy of William H. Helfand Collection/Philadelphia Museum of Art.