Is it safe to drink Red Bull and vodka? Dubious research tied to the company has shaped energy drink policy.

This story, co-published by STAT, is part of the Behind the Buzz project, an investigative collaboration involving The Examination, The Bristol Cable, Daraj, Investico, Paper Trail Media, Der Spiegel, Der Standard and the Toronto Star.On a winter morning in a Long Island town about two hours east of New York City’s skyscrapers, a Dutch researcher told local officials that their concerns about mixing heavily caffeinated energy drinks with alcohol were overblown.A few months earlier, the U.S. Food and Drug Administration had effectively banned Four Loko, a caffeinated malt liquor dubbed “blackout in a can” by college students. Suburban Suffolk County was now considering something more sweeping: a ban on selling energy drinks to minors.Joris Verster, an academic from Utrecht University, said there was no scientific basis for the law. Though booze and energy drinks are often consumed together, Verster argued that beverages like Red Bull aren’t to blame for bad things that happen when people get drunk. He offered an analogy that might resonate with locals; Suffolk County includes the beach towns that inspired the thriller “Jaws.” Blaming energy drinks for binge drinking and alcohol-fueled injuries, he said, would be like blaming shark attacks on summertime ice cream sales.“The shark attacks are not caused by the ice cream sales,” Verster said in the February 2011 hearing. He was one of three scientists who had crossed the Atlantic to urge officials to drop the proposal. The others were a British professor and Red Bull’s chief scientific officer. The trio shared more than a research interest: Through paychecks or research grants, all three had gotten money from Red Bull, the world’s largest energy drink company.Their argument won the day. Lawmakers dropped the age limit, marking an early victory for the Austria-based company in what would become a global campaign to use science to combat restrictions on its products.For more than a decade, Red Bull paid hundreds of thousands of dollars for university professors to conduct research that has been favorable to the energy drink industry, a joint investigation involving The Examination, The Bristol Cable, Daraj, Investico, Paper Trail Media, Der Spiegel, Der Standard, STAT and the Toronto Star found. The company has flown academics to U.S. cities and provided talking points for meetings with government officials who were considering restrictions on energy drinks. It funded a doctorate for a researcher in the United Kingdom and another in the Netherlands. In the United States and Canada, research backed by Red Bull or conducted by academics with financial ties to the company has been used to defeat measures such as age restrictions and warning labels. A pivotal report by a European food agency in 2015 cited these studies in finding that there wasn’t clear evidence that mixing energy drinks and alcohol was harmful. That report remains the last word in Europe and has been used to prevent action elsewhere.The studies backed by Red Bull have been nearly unanimous in their message: Consuming energy drinks and alcohol together is no more harmful than drinking alcohol alone. That stands in stark contrast to the vast majority of independent studies on the subject.The Examination gathered more than 100 studies about the health or behavioral risks of mixing energy drinks and alcohol. Of the studies that received funding by Red Bull or were conducted by researchers who disclosed financial conflicts of interest with the company, 95% concluded that mixing alcohol with energy drinks did not increase those risks. Roughly 80% of independent studies reached the opposite conclusion, The Examination found.Companies often fund research into controversial products, a practice that is criticized by health advocates. But leading alcohol researchers who reviewed some of the studies with financial ties to Red Bull said there are deeper problems.A number of the studies are flawed, they said, raising questions about their conclusions. In Boston, a team of scientists withdrew from a Red Bull-funded study after Verster, the Dutch researcher, refused to address problems they believed would bias the results.In a brief statement to The Examination and its partners, Karlheinz Niederreiter, Global Head of Science, Regulatory and Government Affairs at Red Bull, wrote, “Health authorities across the world have concluded that Red Bull Energy Drink is safe to consume.” That’s why, he wrote, nearly 14 billion cans were sold worldwide last year. Niederreiter and other Red Bull executives did not answer questions about the news outlets’ findings, including those about the safety of consuming energy drinks with alcohol.Voluntary guidelines published by American and European industry groups say their member companies, which include Red Bull and Monster Beverage Corp., don’t promote mixing energy drinks with alcohol and don’t claim that energy drinks counteract the effects of alcohol. The European group said academic research has found that mixing the two doesn’t pose additional risks.Peter Miller, a professor at Deakin University in Australia, said the news outlets’ findings weren’t surprising. Back in 2013, around the time that much of this research was published, he wrote an essay in a medical journal criticizing the wave of industry-funded studies about mixing energy drinks and alcohol. Those research grants are “an investment using universities’ reputation to be able to influence policy,” Miller told The Examination. “This is a campaign to protect their profits and to avoid legislative intervention.”And it’s worked, he said. Red Bull-funded researchers have “absolutely undermined the evidence base,” Miller said. “It leads to this doubt where politicians don't act.”Much of this research was conducted at a time of growing public debate about the safety of energy drinks. Especially for young people. And especially in combination with alcohol.Wide-awake drunkAs concerns intensified, the U.S. Food and Drug Administration logged reports of heart problems and other adverse events allegedly related to energy drinks. In Quebec, Canada, a coroner concluded that 21-year-old Zachary Mitchell drowned after a probable arrhythmia linked to exercise and energy drink consumption.Illustration by The Examination/Evident MediaOne weekend night in August 2016, Zachary Mitchell joined some friends for a getaway at a lakeside cottage in Quebec. The 21-year-old visited the cottage nearly every summer weekend, his mother said.Mitchell drank several cans of Red Bull and about six beers over about two hours before he and his friends decided to go for a swim, according to a coroner's report.Mitchell had been born near a lake and learned to swim from a young age. “He was a fish,” said his mother, Heather Mitchell.Zachary Mitchell, shown at his high school graduation in 2012.Photo provided by Heather MitchellBut shortly before midnight, Mitchell hit the water awkwardly when he dove from a 15-foot high deck. He briefly resurfaced, spoke a few words and went under again. That was the last his friends saw of him, according to a coroner's report.The coroner wrote that Mitchell had drowned, likely due to an arrhythmia triggered by the combination of energy drinks and physical exercise. She noted that he had a blood-alcohol content of about 0.1%, slightly over the legal limit for driving. In her report, she called for a “vast advertising awareness campaign targeting a young audience” about the risks of energy drinks, including those from combining them with alcohol.Mitchell, pictured diving into Lake Saint Pierre in Quebec on another occasion, grew up around the water and was a strong swimmer, his mother, Heather Mitchell, recalled. “He was a fish,” she said.Photos provided by Heather MitchellResearchers have a term that captures their concern about mixing alcohol and energy drinks: wide-awake drunk.Tim Stockwell, who headed the Canadian Institute for Substance Use Research from 2004 to 2020, said adding the stimulation of energy drinks to the impaired judgment caused by alcohol is a recipe for risky behavior. The caffeine in energy drinks ranges from 80 mg in a Red Bull, slightly less than a typical cup of coffee, to 300 mg in other brands. But energy drinks also contain ingredients such as taurine and guarana that can magnify its effects on the body.“It's a pretty potentially dangerous combination, giving you the energy to do crazy, daft things,” Stockwell said, “and something that takes away the fear of the consequences.”People have been hurt or killed all over the world after consuming alcohol and energy drinks, according to news reports. In England, an 18-year-old woman suffered three cardiac arrests after downing 10 Jägerbombs, a cocktail that combines an energy drink with the spirit Jägermeister. In Washington state, a 17-year-old boy died of acute alcohol intoxication after mixing hard liquor and energy drinks while playing video games with friends. In Quebec, a 14-year-old girl was found dead behind her school after consuming a caffeinated alcoholic drink called FCKD UP.A considerable body of research suggests that incidents like these aren’t just chance or circumstance. Mixing alcohol and energy drinks was linked to higher rates of binge drinking, sexual abuse and drunk driving, according to a study conducted among U.S. college students. Another study of hospital patients in Canada found the combination was tied to higher levels of injury; among women, the risk of injury tripled.Health authorities have shared these views. The U.S. Centers for Disease Control and Prevention warn that mixing alcohol and energy drinks can lead to more drinking and a greater risk of injury, drunk driving and unwanted or unprotected sex.This research was just emerging back in 2010 during a string of deaths involving young people and Four Loko. The FDA acted quickly, ordering Four Loko and other companies to stop selling caffeinated alcoholic drinks.At the