In the movie Top Gun, Tom Cruise, playing hot-shot fighter pilot “Maverick,” yells “I feel the need for speed!” He is of course talking about jets. In medicine, we are talking about stimulant use. Humans around the world commonly take the stimulant called caffeine, whether in coffee, tea, or diet coke. We drink caffeine to wake up in the morning and to pick us up in the groggy afternoon. We take it because it makes us feel good and by-and-large, it works pretty well.
Life gets pretty busy for kids when they become teenagers, and they start using caffeine too. They use it to stay up with school work or with friends, then drink it to wake up the next morning. And as we all know, many teenagers cannot get enough of a good thing, and start to overuse stimulants. Teenagers overuse stimulants in two ways: by drinking energy drinks, and by taking Attention Deficit-Hyperactivity Disorder medications that are not theirs.
Energy drinks like Red Bull, Monster Energy, and Rockstar became popular in the 1980s. They were invented to give more of what one could get from a cup of coffee- more sugar, more caffeine. They tasted terrible (still do), but marketing them as the drink for the really busy got people to try them. Since they worked, people got hooked.
Energy drinks work because they have a lot more caffeine and sugar than coffee or cola. They contain caffeine plus a substance called guarana, which is essentially a high-potency version of caffeine. Energy drinks can be so potent that besides use as a wake-up or study aid, some teenagers drink them to get a ”high.” When mixed with alcohol, the energy drink and the alcohol enhance each other’s effects, and the high is multiplied.
The potency of energy drinks makes them a problem for us in the Emergency business. We see many teenagers in the Emergency Department with complaints of chest pain, palpitations, dizziness, and anxiety. These conditions are often benign, but they are made worse, and happen more often, with the use of energy drinks. Take a teenager with anxiety and school pressure, amp him up on an energy drink, and the anxiety gets amped up too. When energy drinks are mixed with alcohol, alcohol effects are worse as well- more car accidents from drunk driving, more fights, more alcohol poisoning.
Another stimulant teenagers are using a lot are Attention Deficit Hyperactivity Disorder medications like Adderall, Concerta, and Vyvanse. Children and teens with ADHD are often helped by stimulants to keep awake the part of their brain that helps them stay focused and calm. The medicines are mostly derivatives of amphetamine, the drug known as “speed.” Many high school and college students without ADHD use these medications as a study aid. They buy them from kids with ADHD for a few dollars per pill (the price goes up at finals time!).
These stimulants can be effective study aids. The non-ADHD teen uses them to stay awake to study for a test or pull an all-nighter to write a paper. Two kinds of teens use these meds. One is the kid who failed to plan his school work and left a lot for the last minute. The other is the highly competitive kid in a highly competitive school environment, trying to stay ahead of his classmates.
Though ADHD medicines often work for these kids, they bring many problems. They are addictive. Typical teens will try a pill for a one-time study session. It works so well that they start using it for more tests, then to write papers, then to just get through their piles of homework. Eventually it is a steady cycle of blasting through work on an amphetamine high, followed by crashing and sleeping it off, often accompanied by weight loss and depression.
Also, it is illegal for kids to take these medications without a prescription. It is illegal for kids with ADHD to sell them. It is also just plain cheating to use stimulants for school work. Just like it is cheating for professional athletes to use these and other performance-enhancing drugs to get ahead in their sports, it is cheating for teens to use them to get better grades.
Finally, these drugs have the same side effects as energy drinks, only worse. Anxiety, tachycardia, hyperventilation, sleep deprivation, and post-high depression are all problems that bring teen users into the Emergency Department. Even worse, these medications bring risks like heart arrhythmias and sudden death to the user who has not had a proper medical screen by a doctor.
So help your teens to avoid wanting to use energy drinks or illegal stimulants to get school work done. Help them learn good time management, study habits, and sleep habits when they are younger. Learning those good habits is not only good for managing school work; they help when planning life. And if they feel like a pick-me-up, if they “feel the need for speed,” buy them a cup of coffee.