Well done Evo - that would be the second citation in the report's end-notes.
METHODS: We searched PubMed and Google using “energy drink,” “sports drink,” “guarana,” “caffeine,” “taurine,” “ADHD,” “diabetes,” “children,” “adolescents,” “insulin,” “eating disorders,” and “poison control center” to identify articles related to energy drinks.
... i.e. it is a meta-study where the selection criteria may be biased towards those papers unfavorable to energy drinks.
[edit: i.e. consider - what sort of research would combine "poison control center" with "children" and "caffeine"? Try doing a search on "stuffed toys", "children" and "poison center" for example.]
Half of the energy drink market consists of children (<12 years old), adolescents (12–18 years old), and young adults (19–25 years old).7,–,10
... what proportion of the US population is under 25? What proportion of ED visits?
It's actually quite difficult for me to track this down - perhaps a native would have more luck. The stats for 2007 (the year used) are divided into unhelpful blocks at the 17/18 year divide. Same with the ED visit stats: eg. http://www.cdc.gov/nchs/data/databriefs/db38.pdf
[edit - the study means to justify why they focus on under 25s.]
Still ... this study, by itself, and with the citations within, would be a good reason to look further.
[edited for emphasis]
[edit: People who are unused to scientific literature are often at a loss when it comes to assessing various claims, especially when they contain alarming sounding elements... some questions to consider when reading these documents are:]
There is reason for concern - but how much concern?
How much of a concern is this compared to other health priorities?
How scared should people be compared with all the other things they have to be scared of?
How much do we want the government to coddle the population?
Is the level of hysteria in the SAMHSA report
[see link post #1] supported by the evidence available?
There are six studies in the endnotes.
1. an FDA study from 2007 on the effects of caffeine on the body from 2007
... since caffeine is a regulated additive, then regulating it in energy drinks as well is probably on the cards.
2. a study on the effects of energy drinks on adolescents
... cited, in the report, as evidence that adolescents drink energy drinks. gosh!
3. (2011) researchers discover that energy drink companies do market research (using social media)
... cited as evidence that energy drinks companies do market research.
I think the idea in the above two is to show that the companies are targeting people deemed vulnerable to adverse effects from their product. This is not sinister - the companies are researching their marketplace. We can also expect marketing to be attractive to the people in the market... the report implies that the marketing reinforces risk-taking behavior.
4. 2009 press release by MINTEL: a marketing firm(?)
- energy drink ingredients unhealthy
- so is candy.
Could manufacturers promoting energy drinks as healthy be prosecuted for false advertising?
5. energy drinks are associated with problem behaviors
Frequency of energy drink consumption was positively associated with marijuana use, sexual risk-taking, fighting, seatbelt omission, and taking risks on a dare for the sample as a whole, and associated with smoking, drinking, alcohol problems, and illicit prescription drug use for white students but not for black students.
... wild! However - does this mean that energy drinks promote risk-taking or that whites pre-disposed to risk-taking will also consume energy drinks? Corellation is not causation.
6. people who consumed energy drinks mixed with alcohol in bars were more likely to leave intoxicated and more likely to drive.
Possibly they feel alert? I wonder if, prior to energy drinks, people who had a strong coffee at the end of the night would be more likely to drive? What proportion of people stopped on suspicion of DUI chew gum?
The researchers correctly call energy-drink consumption an indicator of risky behavior rather than a cause. Similar to gum-chewing and tattoos.
I didn't see what proportion of bar-patrons this indicator would apply to but it seems part of the "stimulants make you less drunk" myth.
Personally I expect better from my government.
Probably the best research was reference #2 (the meta-study - trying to find other papers citing this one)... and those researchers have some advise:
... compare with the SAMHSA report in content and tone.
They (see endnote #2) basically advocate a calm and targeted education and awareness approach - particularly with health professionals and people who work with adolescents. The regulation comment is wide open - compare regulation for tobacco, alcohol, and prescription meds? It is not clear which end of the spectrum the researchers favor, but the preceding call for more research suggests they are saying they just don't know.
And that is what I got from the SAMHSA report - but with more alarm and less qualification - there is not enough information to know how much we should be concerned or how best to react.