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Stoned Plus Buzzed: Mixing Caffeine and Pot Brings New Risks

Eighty percent of Americans get a daily jolt from caffeine, and now, as marijuana legalization has spread across the nation, some users and businesses have begun touting a combination of the two drugs.

“After years of smoking, I’ve found that caffeine and weed are a perfect mix. If I get nicely stoned then drink a strong cup of coffee, the effects mix so perfectly,” wrote one Reddit user.

A company called Cannabiniers recently tapped into the trend with the launch of Brewbudz, which are cannabis-infused coffee, tea and cocoa pods that pop into any Keurig coffee brewer. [25 Odd Facts About Marijuana]

But what happens when you combine the drugs, and are there possible dangers?

It’s important to keep in mind that the caffeine in a regular cup of coffee or tea is a pretty powerful psychoactive drug, meaning it’s capable of affecting the mind, emotions and behavior, Dr. Sergi Ferre, a senior investigator at the National Institute on Drug Abuse (NIDA), told Live Science.

Caffeine exerts its effects by blocking receptors in the brain for a neurotransmitter called adenosine, Ferre told Live Science. Adenosine is an inhibitory neurotransmitter, meaning that it blocks other neurotransmitters that excite the neurons; its activity thus leads to feelings of fatigue. So, by blocking adenosine, caffeine changes peoples’ moods and leaves them feeling more alert and awake.

Caffeine is also known to boost another neurotransmitter: dopamine, Ferre said. This neurotransmitter is often called the “feel-good” chemical, because it’s responsible for feelings of pleasure and reward. It just so happens that tetrahydrocannabinol (THC), the active ingredient in marijuana, is also known to stimulate dopamine neurons throughout the brain, he said.

Indeed, one reason why people may like the combination of marijuana and caffeine so much is that caffeine can magnify the effects of dopamine released by marijuana.

“Caffeine increases tremendously the effects of a psychostimulant, including THC and cocaine,” Ferre said. “So, any substance that releases dopamine, including THC, its effects are increased by caffeine.”

Magnified marijuana

That enhancement may be why more people are combining the drugs, but Ferre cautioned that doing so is a bad idea. Using caffeine with any psychostimulant drug, and enhancing the drug’s high, can make the drug much more addictive than it would be if it was used alone, he said. [7 Ways Marijuana May Affect the Brain]

Ferre and colleagues published a 2014 study in The Journal of Neuroscience that tested the effects of combining THC with a compound called MSX-3 that mimics some of the effects of caffeine. In experiments on squirrel monkeys that were addicted to THC, the researchers measured whether a range of doses of the caffeine-like compound influenced the monkey’s likelihood to give themselves more hits of THC.

The researchers concluded that the caffeine-like compound enhanced the effects of THC at any dose.

Caffeine “is not good, at any dose, to associate with THC,” Ferre said.

Another cause for concern is that adding caffeine may worsen the memory impairment commonly associated with using marijuana, he said.

A 2012 study in rats, also by Ferre and colleagues, showed that combining caffeine with marijuana worsened the memory problems induced. The effect is likely to be particularly acute in teens, because their brains are still developing, Ferre said.

“The worst is with kids,” Ferre said. “Caffeine can be a really powerful drug that can have strong effects on a developing brain.”

Questions remain

Although Ferre’s research presents significant warning flags about combining caffeine with marijuana, not all experts agree. [Marijuana Could Treat These 5 Conditions]

In general, there is not much research on marijuana and its effects, said Gary Wenk, a professor of psychology, neurology and molecular virology at the Ohio State University. Marijuana is classified as a Schedule 1 drug under the Controlled Substances Act, meaning the drug is considered to have a high potential for abuse and no medical use.

“There has been very little research, because there is a lack of funding,” Wenk told Live Science. “The National Institute on Drug Abuse does some research, but it’s all related to treatment or determining ways it’s harmful. But otherwise, it’s hard to get funded, because it’s a Schedule 1 drug.”

Despite the lack of research on marijuana’s effects, an increasing number of Americans are using the drug. Currently, around one-fifth of Americans now live in states where marijuana is legal for adults to use recreationally, according to the Brookings Institution, and some 200 million live in places where it’s legal to use the drug for medical reasons.

Aside from being cautious, in recognition of what research there is on the effects of combining caffeine and marijuana, Wenk said that users are, to some extent, on their own.

“When people ask, ‘How will it affect me?’ you have to ask, ‘What are your genes? What are your vulnerabilities?'” Wenk said. “Combining the drugs will have a different effect on different people, so it can be hard to predict.”

As marijuana use becomes more common, so may using the drug together with caffeine. But what do we know about the health effects of mixing weed and a cup of joe?

Energy Drinks

Energy drinks are widely promoted as products that increase energy and enhance mental alertness and physical performance. Next to multivitamins, energy drinks are the most popular dietary supplement consumed by American teens and young adults. Men between the ages of 18 and 34 years consume the most energy drinks, and almost one-third of teens between 12 and 17 years drink them regularly.

There are two kinds of energy drink products. One is sold in containers similar in size to those of ordinary soft drinks, such as a 16-oz. bottle. The other kind, called “energy shots,” is sold in small containers holding 2 to 2½ oz. of concentrated liquid. Caffeine is a major ingredient in both types of energy drink products—at levels of 70 to 240 mg in a 16-oz. drink and 113 to 200 mg in an energy shot. (For comparison, a 12-oz. can of cola contains about 35 mg of caffeine, and an 8-oz. cup of coffee contains about 100 mg.) Energy drinks also may contain other ingredients such as guarana (another source of caffeine sometimes called Brazilian cocoa), sugars, taurine, ginseng, B vitamins, glucuronolactone, yohimbe, carnitine, and bitter orange.

Consuming energy drinks raises important safety concerns.

  • Between 2007 and 2011, the number of energy drink-related visits to emergency departments doubled. In 2011, 1 in 10 of these visits resulted in hospitalization.
  • About 25 percent of college students consume alcohol with energy drinks, and they binge-drink significantly more often than students who don’t mix them.
  • The CDC reports that drinkers aged 15 to 23 who mix alcohol with energy drinks are four times more likely to binge drink at high intensity (i.e., consume six or more drinks per binge episode) than drinkers who do not mix alcohol with energy drinks.
  • Drinkers who mix alcohol with energy drinks are more likely than drinkers who do not mix alcohol with energy drinks to report unwanted or unprotected sex, driving drunk or riding with a driver who was intoxicated, or sustaining alcohol-related injuries.
  • In 2011, 42 percent of all energy drink-related emergency department visits involved combining these beverages with alcohol or drugs (such as marijuana or over-the-counter or prescription medicines).

Bottom Line

  • A growing body of scientific evidence shows that energy drinks can have serious health effects, particularly in children, teenagers, and young adults.
  • In several studies, energy drinks have been found to improve physical endurance, but there’s less evidence of any effect on muscle strength or power. Energy drinks may enhance alertness and improve reaction time, but they may also reduce steadiness of the hands.
  • The amounts of caffeine in energy drinks vary widely, and the actual caffeine content may not be identified easily. Some energy drinks are marketed as beverages and others as dietary supplements. There’s no requirement to declare the amount of caffeine on the label of either type of product.

Safety

  • Large amounts of caffeine may cause serious heart and blood vessel problems such as heart rhythm disturbances and increases in heart rate and blood pressure. Caffeine also may harm children’s still-developing cardiovascular and nervous systems.
  • Caffeine use may also be associated with anxiety, sleep problems, digestive problems, and dehydration.
  • Guarana, commonly included in energy drinks, contains caffeine. Therefore, the addition of guarana increases the drink’s total caffeine content.
  • People who combine caffeinated drinks with alcohol may not be able to tell how intoxicated they are; they may feel less intoxicated than they would if they had not consumed caffeine, but their motor coordination and reaction time may be just as impaired.
  • Excessive energy drink consumption may disrupt teens’ sleep patterns and may be associated with increased risk-taking behavior.
  • A single 16-oz. container of an energy drink may contain 54 to 62 grams of added sugar; this exceeds the maximum amount of added sugars recommended for an entire day.

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NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.

A growing body of scientific evidence shows that energy drinks can have serious health effects, particularly in children, teenagers, and young adults.