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**Adam Stacoviak:** We haven't talked about that one... We talked about sugar and other sidecars, not alcohol, like Red Bull and vodka...
**Mireille Reece, PsyD:** I don't know -- I think a lot of people, or it's been marketed often as a Red Bull and vodka. These go together.
**Danielle Rath:** Yes.
**Mireille Reece, PsyD:** So yeah, can they go together? Is alcohol okay with caffeine or energy drinks?
**Danielle Rath:** \[01:08:07.22\] No. Do not mix your uppers and downers. The problem with mixing caffeine and alcohol is 1) it takes the fun out of alcohol. I can't speak for everyone, but I drink alcohol to feel dizzy, like "Wooh! This is fun!" But if you have caffeine, you don't feel that, which - that's the whole ...
And that's the problem - you don't feel drunk. So you feel like you can get into a car, you feel like you're making good judgments, trusting this person you've just met...
**Adam Stacoviak:** Oh my gosh, yes...
**Danielle Rath:** You feel like you can have 3, 4, 5 more shots, because you don't feel drunk. But you are. So the people that have been hospitalized from energy drinks - it's the correlation/causation thing. Are they hospitalized because of energy drinks? Are people that have energy drinks more likely to be in these ...
**Adam Stacoviak:** Yeah... Because one, alcohol makes you feel like you can do anything, to some degree. Like you can make choices that you wouldn't normally make, and they're safe; that's what I mean by that. And then the caffeine gives you the energy to do so. So normally, alcohol alone gives you the ability to make...
**Mireille Reece, PsyD:** Right.
**Adam Stacoviak:** But the caffeine is like "No, no, you've got the energy. Just go jump. Just go do. Just go drive."
**Danielle Rath:** Yeah, "Go jump off the cliff. It's a great idea."
**Adam Stacoviak:** "Yeah, this is a great thing to do." So you're even more dangerous.
**Mireille Reece, PsyD:** It's just cringeworthy to me. It makes me shudder on the inside. Wasn't that one of the things you wrote or have talked about on other occasions was I think actually for a college student out of somewhere here in Washington? Is that right?
**Danielle Rath:** Yes, so in 2009 there was a student from Central Washington University that was hospitalized with a blood alcohol content of 0.35...
**Mireille Reece, PsyD:** 0.35... !
**Danielle Rath:** 0.35. 0.30 is lethal, so they were above that... And the reason they were above that is because they had this drink, which thankfully is no longer around in its original formula, Four Loko, a.k.a. "blackout in a can".
**Adam Stacoviak:** Oh, yes. I heard about it.
**Danielle Rath:** So the problem with Four Loko is it was giving you way too much alcohol, and way too much caffeine, all in one nice little package. So people that would have one can had enough alcohol to black out... But that's the problem - when you just have alcohol, your body has this safety mechanism where it sa...
So that's what happens to these college students, and specifically this one that was admitted to the hospital, that kind of shed the light on the dangers of Four Loko, that had been happening for at least a year before this incident at Central Washington University.
**Mireille Reece, PsyD:** Oh, that's just so terrifying... I think education and teaching people, and especially when consuming alcohol, when your frontal lobe doesn't work the same way, right? As a result, to be able to go "How do we learn to make wise choices, and enjoy our lives, but still have guard rails?" This is...
**Danielle Rath:** Yes.
**Adam Stacoviak:** That's right.
**Mireille Reece, PsyD:** And so one last... Going back to our quiz then - consuming caffeine leads to dehydration. True or false?
**Danielle Rath:** False.
**Mireille Reece, PsyD:** False?
**Danielle Rath:** \[01:11:52.03\] Surprisingly. Caffeine's diuretic effect is very weak, meaning caffeine will only make you have to pee if one of three things is true. One, if you have more than three cups of coffee, more than 250 milligrams of caffeine; then it will make yo have to pee. Two, if you've had enough liq...
Otherwise, if it's not a lot of liquid, if it's not a lot of caffeine, and if it's not your first time having caffeine, you won't have to pee. It won't make you dehydrated.
**Mireille Reece, PsyD:** See, I think that is one of the most common misconceptions, right? Don't you agree?
**Danielle Rath:** Yes, it's very common.
**Mireille Reece, PsyD:** Adam?
**Adam Stacoviak:** Well, they say it's a "natural diuretic", which is true, but to a certain degree, based on what you're saying.
**Danielle Rath:** Yes.
**Adam Stacoviak:** So it is a diuretic...
**Danielle Rath:** It's like saying chemicals are poison. Everything is poison at the wrong dose. Too much water can kill you, because you can drown...
**Mireille Reece, PsyD:** Yes, right.
**Danielle Rath:** So if you have a normal dose... If you have as much caffeine as you're supposed to, you're fine.
**Mireille Reece, PsyD:** So how does it work, and why is it that many people often have to not just go number one, but number two? Because I think this is really interesting, and I want our listeners to--
**Adam Stacoviak:** Come on... \[laughter\]
**Danielle Rath:** Oh, no...!
**Mireille Reece, PsyD:** We're going there!
**Danielle Rath:** We're going there... As we should. It's important. It's a regular question that I get. I can't speak to number two as well, because that has more to do with the chemicals that are in coffee. I think there's caffeic acid and some other anti-oxidants and nutrients in coffee, that kind of trigger that i...
It has to do with your glomerular filtration rate, so it doesn't change the amount of water your body is producing, but it changes how salty that water is. And so because it's more concentrated, the water that's in your kidney feels more salty and feels more concentrated, you have a greater desire to pee because of tha...
**Mireille Reece, PsyD:** So is there anything -- because something I read was more relative to the way in which it relaxes your muscles, hence why you would be more prone... It seems counter-intuitive to some degree, that caffeine is a stimulant, but it actually relaxes the muscles of your intestines, which makes you ...
**Danielle Rath:** That makes sense. I feel like that's one of those things that's a good theory, but like how do you measure it in a research setting? Because yeah, that makes sense; caffeine is a vasodilator, it widens your blood vessels, so that totally makes sense.
**Mireille Reece, PsyD:** So one of the things I want to -- because you know, I'm gonna take a hard left now...
**Danielle Rath:** Sure.
**Mireille Reece, PsyD:** ...and talk about caffeine relative to mental health.
**Danielle Rath:** Oh, yes.
**Mireille Reece, PsyD:** Because this is something really important for our listeners to understand. In my line of work I see oftentimes people struggle with -- they already are coming to me for one issue or another... But in the case of anxiety, that caffeine can be a sort of mixed bag, and potentially not helpful wh...