Reefer madness 2010

I thought that perhaps the closest thing to reefer madness this year would be Greg Connolly and his ilk lying to the people about the hazards of dissolvable smokeless tobacco products.  But I am not aware of them actually claiming that these products caused madness and destructive behavior, so we had to wait until fraternity party season and the American Public Health Association (APHA) meetings.

Part 1 - Loko about caffeine

If you follow American news (not sure if this was reported anywhere else) you probably saw the stories of canned party drinks that are roughly a combination of Red Bull and alcohol, particularly Four Loko brand.  The scare stories were not limited to the age-60 demographic television news; they were widely reported in the new media with the same tone.  I think every news clipping email I got the day the story broke had something about it, including the ones that are just devoted to politics or tobacco.  And it was not as if it was a slow news week, coming just before the American elections.  

It seems that health beat reporters cannot resist an opportunity to blame something new and commercial for all of our ills.  I will admit I too am inclined to condemn these products:  in an era of so much brilliant craft brewing in America, I think it is a crime against culture to forgo beer in favor of what is basically ethanol (and other drug) infused Kool Aid.  Sadly, the tirades are not that the kids should be drinking good beer, but that selling a drink that contains both caffeine and alcohol presents a unique problem, a reefer-madness-worthy horror story of people drinking themselves to oblivion without realizing it.  There are several things so desperately wrong with this analysis that you think that at least one health reporter would have figured it out (I did not find any):

First, there is nothing particularly unique about parties where young people drink to dangerous levels.  Sadly, it happens all the time, but when it is chugging at a kegger or doing shots it does not trigger the same desire to blame the product rather than the consumption culture.  Rather than blame the product, perhaps we should either deal with the question of why young people in our society prefer to spend their time pursuing low-cost oblivion or concede that it is not surprising that they do. 

Second, the amount of caffeine in these drinks, though not always reported, seems to be consistently modest.  Someone alternating between Coke and beer will probably have a higher caffeine:alcohol ratio than consumers of these new vile concoctions, as will consumers of the considerably less vile old concoctions, bourbon or rum and Coke (so long as the liquor is diluted down to college party levels).  Moreover, as anyone experienced with these two drugs should know, modest amounts of caffeine does not mask the effects of being drunk other than drowsiness, and certainly will not keep someone who is close to overdose from realizing this.  In other words, something is not good about this behavior, but banning the inclusion of caffeine in alcoholic prepared beverages as has been proposed does nothing to address it.

Third, if there is a reason to worry about these drinks, it is not the widely consumed, tested, and understood caffeine, but the other stimulants that are in them.  The above link refers to alcoholic "energy drinks" being banned, but it is really just the caffeine.  But these "energy" drinks have a couple of other ingredients that have stimulant effects and which may indeed be bad for you.  I know from personal experience that Red Bull is a great study/work/concentration aid, but after combining it with strenuous exercise once, and getting heart palpitations as a result, I gave it up and now stick with a regular diet of caffeine with the occasional nicotine.  Do these other ingredients effectively mask the warning signs of alcohol overdose or otherwise create an unusually dangerous combination?  I do not know, and apparently no one else does either, but it is plausible.  What will happen when the proposed bans are carried out?  The manufacturers will reformulate to include the other stimulants but not caffeine, possibly making any actual problems worse and avoiding figuring out whether there really is a problem.

Finally, there is a bit of a class issue here, since the club set has been drinking $15 Red Bull cocktails for a decade, and you can make your own at home – it just costs twice as much as an equivalent amount of the new drinks.  In other words, it is another ban that only affects the people who do not have extra money in their pocket.

Part 2 - Stamp out social interaction now!

In a study that was presented at APHA this week and aggressively press released (do not get too excited about that – it is not as if the peer review process actually makes junk public health science any better), Scott Frank et al. of Case Western Reserve Medical School found an association between extremely high rates of text messaging (and social network site use) by teens and various risky behaviors.  They could have concluded that teens who devote more of their time and attention than average to peer socializing are more likely to text, drink, use other drugs, have sex, fight, and smoke.  Perhaps they might have even said that parents could monitor the rate of texting as a clue about propensity toward social activities, though I am not sure anyone would need a study to conclude that.

But this was APHA and declaring conclusions that are not supported by the data is practically mandatory so, of course, the authors claimed that the texting was causing sex, drugs, etc.  It is not that sending 120 texts per day is an indicator that you are probably not spending 14 hours per day studying or engaged in organized college-admissions-friendly activities.  Or that it means you are not playing World of Warcraft or working part time jobs to support your family.  It probably means that you are a comfortable popular/jock/cheerleader type.  And these researchers are telling us that those kids are more likely to have sex and try drugs?  Shocking!

(They also seem to claim, as a footnote that the texting is associated with obesity, suicide, and some other decidedly non-popular-kid behaviors, but it is kind of hard to make sense of what they are actually claiming when they publish via press release.  This may be a different subpopulation or could be most anything.)

The reason that this crap makes the news while 99.9% of the other crap at APHA does not is because of the reefer madness aspect:  Beware the scary new technology!  It is causing teens to interact and do what comes (perhaps a bit too) naturally.  I am talking about email and online chat programs, of course (no, wait, it is not 2000).  I mean the private phone line telephone (no, wait, it is not 1950, 1960, 1970,…).  I mean the Rock and/or Roll music (no, wait, it is not 1965, 1975,…).  I mean the erotic cave paintings (no, wait, it is not 100,000 BCE).  You get the idea.

Moreover, I think they may be getting this one just as wrong as the anti-caffeine people are, though for a rather different reason.  I suspect that among those who were teens in the 1980s or 1990s, controlling for native intelligence, the same kids who today would be the text masters are now more likely to be doing better based on their socializing and networking skills than their downwardly-mobile technically competent peers who have to compete with a few millions Indians and Chinese in their cohort who also studied 14 hours per day.  Not that I am advocating we encourage text, drugs, and rock-and-roll, but let's try to remember the fogies who worried about excessive use of socializing aids in past decades -- weren't they embarrassingly clueless.  Perhaps we can just try to encourage a taste for sipping good beer and listening to real music, rather that that crap that kids are pounding down and listening to today.