In a single generation, energy drinks have conquered the beverage world. Starting as an upscale version of the humble NoDoz pill, then sugared up for guzzling, they are now the caffeine jolt of choice for the sluggish and the sleep-deprived. In an odd commercial convergence, they have also hooked up with the burgeoning wellness movement by adding favorites like ginseng, vitamins, and amino acids to the mix, making the energy drink seem like a friendly sports drink. Presto! An $85-billion-a-year (and growing) global market is upon us.
Which is fine. Caffeine in whatever form, be it in coffee or tea or Coca-Cola, has long been a staple of the American kitchen table.
But there is a large problem with allowing market forces alone to square the deal: Energy drinks are not safe, especially for teens and pre-teens. Too much caffeine (and perhaps the sporty added favorites, too) can push the naïve teen heart or mind into overdrive, leading to acute illness and even death. A decade-plus ago, the evidence was strong enough to lead the American Medical Association, the American Academy of Pediatrics, and even Congress to advise extreme restraint.
In response, many producers agreed to not advertise to those under 12 years of age — but declined to protect 13 to 18-year-olds. They anticipated that, after a few years of further “debate,” politicians would move on from the issue. Which they did.
Meanwhile, the financial clout of the industry has grown considerably, resulting in a new, more dangerous problem.
Faced with promises of big cash pay-outs, American universities have entered the fray on the wrong side of the argument. The first mega-splash came over the summer, with the $20 million-a-year agreement between Monster Energy and college sports’ Big 12 Conference (which includes the caffeine-avoidant Brigham Young University). The deal makes Monster the Big 12’s “official entitlement partner” and specifically includes placement of a Monster patch onto every game jersey.
Not to be outdone, Celsius, another prominent energy drink, has partnered with ESPN to sponsor College GameDay, the hub of the let’s-have-fun-and-watch-TV-sports-all-day movement. Why support a TV show? As an ex-teen boy, I know why: College football is the promised land of uber-impressionable boys dreaming of becoming bros. Or as John Higgins, professor of cardiology at UTHealth in Houston, an expert on the risk the drinks pose to the young, put it to me, “An energy-drink logo on a Big 12 jersey tells [a] child: this is part of sports, performance and success.”
Celsius makes the same point in market terms. “College is where the next generation of fans and consumers are shaping culture,” the write, calling their collaboration with ESPN “a natural evolution of that commitment” in a press release. There it is: fans and consumers together as one, indivisible! Forever!
To make the misalliance even more concerning, some of the universities receiving the dough are also doing research that demonstrates the benefits of the drinks. One study, for example, found that “active individuals may improve acute metabolic outcomes via consumption of a caffeine- and protein-containing energy drink.” Indeed, this sort of play-to-be-paid approach with energy drinks is now global.
Some wealthy countries, including Norway and Kuwait, have imposed strict rules to formally ban sale to teens. Others are considering the same. Most notably, the European Food Safety Authority is updating its guidance on energy drinks, having given the drinks a soft pass a decade ago.
In most countries, however, well-funded measures developed by the energy drink oligarchy have been successful at keeping regulation at a distance.
So here we are with a mega-cash cow that poses a recognized health threat to young people. Despite the hard work of many physicians and citizens who are speaking out, the U.S. is still dithering about how best to move forward.
But take heart! In recent years, there have been two great public health triumphs in protecting teens from commercially lucrative harm: Both cigarettes and alcohol have real restrictions on access and on advertising as well.
Mothers Against Drunk Driving, or MADD, was founded in 1980 by a mother whose 13-year-old daughter was killed by an intoxicated driver. The story of moms (and dads) forcing profound change is grassroots campaigning at its most inspiring. Because of their work, we now have designated drivers, a national drinking age, and a definition of when blood alcohol levels are too high. And by an older MADD estimate, drunk driving death have fallen 55%.
A similar parent-powered movement appears to be forming against energy drinks. In Texas, parents have demanded that school districts ban all energy drinks in the public schools. Similar actions have come from Tennessee, Kentucky, and beyond.
The rise and fall of Joe Cool, the Camel cigarette advertising gimmick that launched a thousand teen smokers, was accomplished with a more top-down approach. Using cold hard facts, the Federal Trade Commission brought a lawsuit against R.J. Reynolds stating that the cigarette maker caused “substantial injury to the health and safety of children and adolescents under 18.”
Surely those seeking to restrict access to energy drinks can draw on these successes. But the anti-energy drink campaign lacks a key ingredient: There is a paucity of cold hard facts about the harm being done. Even now, we cannot say with any confidence how many people die annually from energy drink ingestion.
Unlike deaths from a drug such as fentanyl, no government agency tracks the number of deaths connected to energy drinks nationally. Some data are available: Emergency room visits by teens and young adults from energy drink ingestion doubled from 2017 to 2023. America’s Poisons Centers reported a 24% increase in calls for “pediatric exposure to energy drinks” between 2022 and 2023. The state of Connecticut formally into their General Assembly entered the heartbreaking details of more than three dozen local deaths strongly linked to energy drinks. Compelling information, but not strong enough to convince a politician.
In the absence of population-based evidence, the energy drink cabal is having an easy time of it, lazily deflecting criticism about risk by citing an alternative explanation to each death: Maybe the deaths were due to the person drinking too many energy drinks (which the makers themselves advise against). Or maybe the death was from another medication they were taking, or from a preexisting heart condition or the use of an illicit substance.
Thus far the U.S. has done very little. A disappointingly wimpy government attempt to start the ball rolling includes the Susan Katz Caffeine Safety Act (named for a 21-year-old woman who died of cardiac arrest after consuming an energy drink), which would impose mandatory disclosure of caffeine amounts in beverages and food. But this bill has failed in both 2025 and 2026 to pass in Congress.
The Food and Drug Administration has issued “Guidance for Industry” on how various commercial concerns should (not “must”) display caffeine amounts in their drinks.
My guess is that parents of school-aged kids, supported by physicians, will be the ones to bring enough focus to the danger to finally address this problem. But this will take time that some unlucky teens simply don’t have.
Kent Sepkowitz is a professor emeritus of medicine at Weill-Cornell Medical College.
Source: www.statnews.com
