WellCommons

By Christine Metz

Nasty side effects from drinking too many energy drinks are causing a sharp increase in the number of visits to emergency rooms across the country.

A federal report released last month from the Substance Abuse and Mental Health Services Administration showed that the number of emergency visits involving energy drinks increased more than tenfold between 2005 and 2009.

Public health officials in Kansas are taking note of the dangers of highly caffeinated drinks. The Poison Control Center at Kansas University receives calls from throughout the state about energy drinks.

“Mostly it’s from concerned parents. The kids are drinking these like sodas. It’s becoming part of their daily routine. And it’s stressing the heart out every time they are doing it,” said Tama Sawyer, director of the poison control center.

Too much caffeine causes the heart to beat faster and stronger, raises blood pressure and causes insomnia. Other side effects are headaches and a jittery feeling that turns to more severe anxiety.

“Many people who use energy drinks are in their teens and 20s, and they don’t think they are in danger until something happens, and then they go to the emergency room,” Sawyer said.

The research, which was reported in the Drug Abuse Warning Network, noted that a can or bottle of an energy drink can have between 80 to 500 milligrams of caffeine. That’s compared with a 5-ounce cup of coffee, which has about 100 mg, or a 12-ounce can of soda, which has 50 mg. The report also noted that certain additives (and the most popular brands have quite a few) may compound the stimulant effects of caffeine.

“The listing of caffeine doesn’t seem so bad, but it’s not giving you the full story,” Sawyer said. “It can be more like three cups of coffee per can.”

Too much caffeine

For young adults drinking several energy drinks a day, the caffeine can add up.

The report noted that most researchers and clinicians consider 100 to 200 mg of caffeine per day to be a moderate intake for adults. And they recommend that children and adolescents abstain from all stimulant-containing energy drinks.

Chad Steele knows that too much caffeine can come with some pretty serious side effects. In 2008, when he was a senior at Kansas University, he was drinking two to three energy drinks a day plus a couple of pots of coffee. All that caffeine helped him keep up with a busy schedule; he worked at night, attended school during the day and taught judo.

He knew he had too much caffeine when his eyes started twitching or when his heart began to beat irregularly or too fast while exercising. “I’d stop drinking caffeine and sleep more,” he said and noted he has since stopped drinking energy drinks.

Janice Early, spokeswoman with Lawrence Memorial Hospital, said LMH doesn’t have any data on people coming to the ER with energy-drink-related symptoms, and she doesn’t think it’s a huge problem here.

Alcohol, drugs and energy drinks

Jenny Donham, a health educator at Kansas University, said students are often taken aback when they hear about the negative side effects of too many energy drinks.

“I think people are extraordinarily surprised because they figure if they can order a Red Bull and vodka together that of course it would be safe for them,” Donham said. “If it’s available to them, why can’t they have it?”

The federal study showed that for 44 percent of the emergency department visits, the energy drink was mixed with a pharmaceutical drug, alcohol or an illicit drug, such as marijuana or cocaine.

It also noted that younger drinkers believed that energy drinks could help “undo” the effects of alcohol, making it safe to drive.

The problem with combining energy drinks and alcohol is that the two are on opposite ends of the spectrum. One is a stimulant while the other is a depressant, Donham said.

The energy drink masks signs the body gives off when someone is drinking too much, such as getting sleepy or sick.

“People are using energy drinks as a way to stay awake longer, so they are more likely to drink more, and they are at a greater risk for acute alcohol poisoning,” Donham said.

Even without alcohol, students have to be wary of energy drinks this time of year as they stay up late cramming for finals, Donham said. While energy drinks might make it easier to stay awake, Donham said that without sleep the information isn’t likely to stick.

“You don’t learn the information until you memorize it. And when that memorization occurs is during the sleep cycle,” she said.

The federal study ended the report by noting the need for a public awareness campaign about the health effects of energy drinks, especially when they are combined with alcohol or drugs.

— Reporter Christine Metz can be reached at 832-6352.

A federal report released last month from the Substance Abuse and Mental Health Services Administration showed that the number of emergency visits involving energy drinks increased more than tenfold between 2005 and 2009. Sources: Information was pulled from product labels, product websites or the Mayo Clinic website. by Nick Krug

Kody Dieker, 7, and his mother Ronda Dieker, wait to get a flu shot Wednesday, Nov. 24, 2010, at Take Care Clinic, 3421 W. Sixth. New research shows that retail clinics, such as this one, can save patients between $279 and $460 a visit compared with emergency department costs. by Mike Yoder

New research shows one in four U.S. emergency room visits could take place at retail clinics or urgent care centers with a potential savings of $4.4 billion annually.

That’s between 13 percent and 27 percent of ER visits, according to the research published in the September issue of Health Affairs.

Lawrence Memorial Hospital data shows that 3 percent of its patients use the ER for non-urgent care — for treatment of such maladies as a rash, earache, or short-term upper respiratory infection — and could be seen elsewhere.

Another 33 percent fall into a gray area, where maybe they could be seen elsewhere and maybe not.

Karen Shumate, chief operating officer and a registered nurse, said sometimes you can’t tell until an X-ray or lab test has been done.

“I think it’s every person’s decision. There are no clear guidelines,” she said. “If my little one had a temperature of 104 and 105 and it was Friday afternoon and I couldn’t get them into a doctor, ‘Yeah, they need to be seen if it’s not coming down.’”

Karen Shumate

Shumate said it would be difficult to provide the cost of an ER service because every patient is different and each health professional charges differently.

“It’s always going to be more than a doctor’s office because of the resources that are available to take care of the patients. We have overhead that they don’t have,” she said.

More affordable options

According to a 2008 study in Health Affairs, the average cost of medical care per episode is:

• $356 — ER.

• $127 — doctor’s office.

• $124 — urgent care clinic.

• $65 — retail clinic.

A Take Care Clinic, inside Walgreens at Sixth Street and Kasold Drive, provides medical care — for treatment of a variety of problems, from a respiratory illness to sprains to earaches — on a walk-in basis for anyone older than 18 months.

“We provide high-quality care that’s easier to access, more affordable and more convenient, said Deborah Prior, market manager of clinic operations.

But, it isn’t open 24/7 like an ER. The Lawrence’s clinic is open 12 hours during the week and eight hours on weekends. Prior declined to say how many patients visit the clinic, but said volume is growing.

As the primary care shortage increases, she said, the clinic is alleviating some of the pressure by treating more patients in nonemergency situations.

Emergency room use has increased about 10 percent, or 96,000 visits, in Kansas from 2004 to 2009, according to the Kansas Hospital Association. During fiscal year 2008-2009, there were 1.068 million visits.

“We’ve always believed that Take Care clinics were an important part of the solution to the health care crisis,” Prior said.

More importantly, they accept Medicaid, which fewer and fewer doctors are taking.

Shumate said the hospital’s ER already sees Medicaid patients who just can’t get into a primary care doctor. Under the federal Affordable Care Act, more people will become eligible for Medicaid. The fear is that there won’t be enough doctors to take care of everyone.

“Are we going to be able to absorb patients who may not have high acuity but still can’t get the care that they need?” she asked.

Lawrence Memorial Hospital, 325 Maine.

ER sees everyone

Hospitals are required by federal law to take care of every patient within 250 yards of its emergency room. They have to be seen by a physician and screened — no questions about insurance can be asked.

“Once they are on our property, we can’t tell them to go somewhere else legally,” Shumate said.

An ER staff member can only offer an alternative option after the patient has been screened, seen by a doctor, and it has been ruled they do not have an emergency medical condition. By then, Shumate said, the patient already has had testing done.

There is a triage system so that the sickest patients receive care first. Shumate said longest ER wait time is about 90 minutes.

“We monitor our patient times very carefully. We monitor how long they wait and how long they are in the emergency department,” she said.

Its busiest days are weekends and Mondays, between 3 p.m. and 11 p.m. — when other options often aren’t available.

“If they really are sick, they should come in. We don’t want people to not come,” Shumate said. “We just want them to be understanding about any possible wait.”

LAWRENCE MEMORIAL HOSPITAL'S EMERGENCY ROOM USAGE

Lawrence Memorial Hospital’s emergency room treats about 103 patients per day. There are five levels of triage and the sickest patients, level one, are treated first. Here’s a breakdown of ER use, according to Joan Harvey, director:

• Levels 1 and 2 — 11 percent. They are critically ill and need treatment now.

• Level 3 — 53 percent. They are sick and require several things to be done. They are going to need IVs, monitoring and testing.

• Level 4 — 33 percent. Patient has a single system problem. It’s a gray area where the patient may or may not need to be seen in an ER.

• Level 5 — 3 percent. It’s nonurgent care that could be taken care of in a doctor’s office.