On a typical Saturday night in Montreal, four or five teens end up in hospital with alcohol poisoning, and a Montreal emergency room physician worries a new generation of potent, premixed drinks are part of the problem.
Dr. Robert Foxford said he believes beverage companies distributing drinks with high doses of alcohol, sugar — and in the case of the recently introduced FCKD UP, caffeine — and marketing them to young people who've barely reached legal drinking age are crossing ethical boundaries.
"They come in with alcohol doses that are through the roof," Foxford, an emergency medicine specialist at the McGill University Health Centre, told CBC Montreal's Daybreak Tuesday.
"They're comatose; they have no idea what they've done."
One can of FCKD UP, which contains 11.9 per cent alcohol, is the equivalent of drinking several beers, Foxford said.
Another alcoholic "energy drink," the American-made Four Loko, contains 11.9 per cent alcohol in its Quebec version, although the company's website says versions in some markets run as high as 14 per cent.
'They come in with alcohol doses that are through the roof.... They're comatose; they have no idea what they've done.' - MUHC ER physician Dr. Robert Foxford
"When you put 14 per cent alcohol in a drink, the goal here is to get someone really badly intoxicated," Foxford said.
Sometimes, Foxford said, the patients are so intoxicated, it's necessary to protect their airways and monitor them overnight.
Recently, a young woman came in to the emergency room suffering from a panic attack and thought she was going to die because of the heart palpitations caused by the amount of caffeine she wasn't used to drinking.
In Canada, it's illegal to mix alcohol and caffeine in a premixed beverage. But there's no prohibition on substances that contain caffeine, such as guarana — a natural stimulant that contains caffeine.
Guarana is a key ingredient in FCKD UP.
Four Loko doesn't contain caffeine now, but it used to. The original beverage was voluntary pulled from the U.S. market by its maker and reformulated in 2010, after nine teens in a single night ended up in hospital.
Four Loko's reformulation came after the FDA issued a warning to four makers of alcoholic energy drinks that the combination of caffeine, sugar and alcohol was a public health concern, with the risk of leading to "a state of wide-awake drunk," FDA Commissioner Margaret Hamburg said at the time.
- Makers of alcoholic energy drinks get FDA warning
- Alcohol ad crackdown could curb underage drinking, researcher says
Four Loko was reintroduced in the U.S. a month after it was taken off the shelves, but without the caffeine and with promises not to use models under the age of 25 in its advertising — and not to advertise at all on U.S. college campuses.
Four Loko ads pop up on Quebec campuses
The advertising guidelines adopted by Four Loko in the U.S. appear not to have influenced its marketing strategy here in Canada.
A Four Loko ad recently went up in Concordia University's Hall Building in downtown Montreal but was removed by the school following complaints.
"You'll never guess what happened last night," it read, in French.
Concordia University spokesperson Mary-Jo Barr told student newspaper The Link the ad was put up by mistake.
Concordia is not the only university in Montreal to have allowed the flavoured malt beverage's promotion on campus. A two-for-one promotional coupon also landed in a free agenda distributed to students at L'Université du Québec à Montréal at the beginning of the school year.
In response to a request for comment, the U.S. maker of Four Loko and a string of other high-alcohol products, Phusion Projects, told CBC it "takes marketing Four Loko only to adults of legal drinking age very seriously" and that it goes above and beyond government labelling requirements to keep the drink out of the hands of minors.
Geloso Group, the beverage company behind FCKD UP, also provided a statement, saying it "governs itself by the highest standards and is compliant with all Canadian regulations with regards to labelling and legal drinking age."
Need for new rules, expert says
Émilie Dansereau-Trahan of the Quebec Association for Public Health says the fact the companies are operating within Health Canada's regulations shows the rules need to change.
She said the drinks with high doses of alcohol masked by sugar are targeted to young people with little drinking experience.
She said binge-drinking is encouraged because of the beverage's deceptively small packaging, as well as by store promotions that price two or three drinks together at a reduced price.
"I don't understand why you can put the equivalent of four drinks in one, and it can be legal, and add sugar. Everything in that drink is targeting young people," Dansereau-Trahan said.
An earlier version of this story said Four Loko was pulled from U.S. shelves by the FDA in 2010. In fact, Phusion Projects voluntarily removed the drink from the U.S. market and reformulated it after the FDA issued a warning to four alcoholic beverage manufacturers that caffeine was "an unsafe food additive."Oct 11, 2017 5:01 PM ET