The combined effects of alcohol, caffeine, and expectancies on subjective experience, impulsivity, and risk-taking.
Open accessAbstract
Caffeinated alcoholic beverage (CAB) consumption is a rapidly growing phenomenon among young adults and is associated with a variety of health-risk behaviors. The current study examined whether either caffeinated alcohol or the expectation of receiving caffeinated alcohol altered affective, cognitive, and behavioral outcomes hypothesized to contribute to risk behavior. Young adult social drinkers (N = 146) participated in a single session where they received alcohol (peak Breath Alcohol Content = .088 g/dL, SD = .019; equivalent to about four standard drinks) and were randomly assigned to one of four further conditions: 1) no caffeine, no caffeine expectancy, 2) caffeine and caffeine expectancy, 3) no caffeine but caffeine expectancy, 4) caffeine but no caffeine expectancy. Participants' habitual CAB consumption was positively correlated with measures of impulsivity and risky behavior, independently of study drugs. Administration of caffeine (mean dose = 220 mg, SD = 38; equivalent to about 2.75 Red Bulls) in the study reduced subjective ratings of intoxication and reversed the decrease in desire to continue drinking, regardless of expectancy. Caffeine also reduced the effect of alcohol on inhibitory reaction time (RT) (faster incorrect responses). Participants not expecting caffeine were less attentive after alcohol, whereas participants expecting caffeine were not, regardless of caffeine administration. Alcohol decreased response accuracy in all participants except those who both expected and received caffeine. Findings suggest that CABs may elevate risk for continued drinking by reducing perceived intoxication, and by maintaining the desire to continue drinking. Simply expecting to consume caffeine may reduce the effects of alcohol on inattention, and either expecting or consuming caffeine may protect against other alcohol-related performance decrements. Caffeine, when combined with alcohol, has both beneficial and detrimental effects on mechanisms known to contribute to risky behavior.
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Some studies have indicated detrimental effects of l-theanine on reaction times and numerical working memory and of caffeine on inhibitory control.
“Yet, some studies have indicated detrimental effects of l-theanine on reaction times and numerical working memory27,35 and of caffeine on inhibitory control32.”
From Effects of l-theanine–caffeine combination on sustained attention and inhibitory control among children with ADHD: a proof-of-concept neuroimaging RCT (2020) · cites this paper as [32]
The Results (Other Experimental Measures; page unavailable) found that caffeine with alcohol was associated with less hesitation on trials where participants failed to inhibit a response. But caffeine did not affect stop-signal reaction time, the study’s measure of inhibitory ability. The Discussion describes a possible detrimental effect on inhibition, while acknowledging that caffeine may simply have sped responses; the citation therefore overstates the finding. (LLM, conf=0.86)
Experimental — accuracy not yet measuredCaffeine administration is associated with an acute reduction of impulsivity in Spontaneous Hypertensive Rats and alcohol-associated impulsivity in healthy adults.
“Furthermore, administration of caffeine was associated with an acute reduction of impulsivity in Spontaneous Hypertensive Rats, an animal model of ADHD31 and also the alcohol-associated impulsivity in healthy adults32.”
From Effects of l-theanine–caffeine combination on sustained attention and inhibitory control among children with ADHD: a proof-of-concept neuroimaging RCT (2020) · cites this paper as [32]
The Discussion (page not provided) says that expecting or consuming caffeine may reduce inattention, an index of impulsivity, in the alcohol experiment. But it also reports no improvement in inhibition from caffeine consumption and concludes that caffeine has no direct, uniform effect on impulsive behavior under alcohol. The rat finding is attached to a different citation, so this verdict concerns only the claim about adults. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe data on alcohol-mixed energy drinks are equivocal, with studies showing that caffeine combined with alcohol does not always increase the amount of alcohol consumed or does not have an impact on risk taking behavior.
“These data are equivocal, however, with studies showing that caffeine combined with alcohol does not always increase the amount of alcohol consumed (240) or does not have an impact on risk taking behavior (235, 241).”
From The Safety of Ingested Caffeine: A Comprehensive Review (2017) · cites this paper as [241]
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- Authors
- Heinz, A. J., de Wit, H., Lilje, T. C., & Kassel, J. D.
- Affiliations
- VA Palo Alto Health Care System (US)
- Uniformed Services University of the Health Sciences (US)
- University of Illinois Chicago (US)
- Venue
- Experimental and Clinical Psychopharmacology
- Published
- 2013
- Volume
- 21
- Issue
- 3
- Pages
- 222-234
- ISSN
- 1064-1297 (ISSN-L)
- 1936-2293
- PMC
- PMC4354945
- OpenAlex
- W2057829605
- Cited by
- 78
- References
- 86
- Citations by year
- 2025: 5 · 2024: 2 · 2023: 8 · 2022: 5 · 2021: 5 · 2020: 5 · 2019: 6 · 2018: 7 · 2017: 7 · 2016: 8 · 2015: 7 · 2014: 11 · 2013: 2
- FWCI
- 6.87
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Experimental and Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Illinois at Chicago
- National Institute on Alcoholism and Alcohol Abuse (F31 (AA018918))
- VA Office of Academic Affairs
- Health Services Research and Development
- Topics
- Health Sciences › Medicine › Pharmacology › Coffee research and impacts
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- subjective intoxication, impulsivity, risk-taking, inattention
- MeSH terms
- Adult, Ethanol, Caffeine, Double-Blind Method, Drug Synergism, Female, Humans, Impulsive Behavior, Male, Risk-Taking, Young Adult
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