Say Ah: Four Loko

By Donna Patrick, ANP
Special to the Sun Star

Q: What is Four Loko?

A: Also called “Black out in a can” and “Liquid cocaine” Four Loko is essentially an alcoholic energy drink.   A popular drink amongst teens, it combines caffeine with alcohol in concentrated amounts. It has been marketed as using fruit flavors which masks the taste of alcohol.  Suggestive of a fruit drink rather than an alcoholic beverage it comes in a brightly colored can which also seems to appeal to teens.  A single 23.5 ounce can of Four Loko has 12 percent alcohol content and is comparable to drinking 5 or 6 beers.  It also has the equivalent of 2 very strong cups of caffeinated coffee.

Q: Sounds like a cheap way to get wasted …why not drink it?

A: It is extremely dangerous to mix caffeine which is a stimulant with a sedative such as alcohol. Especially in these concentrated amounts.   People who drink this combination don’t begin to fully realize how drunk they really are.  The caffeine delays the effects of the alcohol allowing people to continue to drink long after they would have normally stopped.  In addition, the caffeine and other stimulants in the drink allow a person to ingest larger amounts of alcohol because the individual fails to “pass out”; a normal defense mechanism of the body to protect itself from alcohol poisoning.   The stimulants in the drink prevent the person from feeling the effects of tiredness, loss of coordination and vomiting; again the body’s natural defenses against ingesting lethal amounts of alcohol.  You may have read recently in the news about the nine Central Washington University students who were hospitalized after ingesting Four Loko at a party.  One student was put on a respirator and nearly died.

Q:  But people have been mixing alcohol with caffeine in drinks like “Rum and Coke” and “Baileys and coffee” for a long time.

A: True.  These too can cause the same effects as the alcoholic energy drinks that I have described. Typically, however, they do not have the concentrated ingredients that the Four Loko has.


  • Mixing caffeine and alcohol can increase the risk of alcohol poisoning. Since caffeine makes people feel “less drunk” than they really are, they tend to drink more than they should.
  • Mixing alcohol and caffeine can make your heart rate and blood pressure rise.
  • Caffeine can make you feel energetic even if you’re drunk. Why is this dangerous? Because people can be “tricked” into thinking they are alert enough to do things like drive a car, when they really aren’t.
  • Caffeine and alcohol are both diuretics, leading to dehydration (and really bad hangovers).
  • Adding caffeine to alcohol can make drinking alcohol all the more addictive.
  • Before you drink:  A standard drink typically equals a 12-ounce beer, a 5-ounce glass of wine, or 1.5 ounces of hard liquor, whether people have it as a mixed drink or a shot. Each contains about 0.06 ounces of alcohol. Some beverages, especially malt beverages and beverages marketed with caffeine can contain much more than one standard drink. To always know what and how much you’re drinking; be sure to read the label.

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