Ostensibly, a vodka Red Bull seems like the end-all be-all of hard partying cocktails. You’ve got the energy drink that assures you won’t be the first of your friends to call it a night combined with the inhibition-lowering effects of alcohol. What could go wrong? From a health perspective, a lot.

A study conducted at Dartmouth's Norris Cotton Cancer Center has found that American teenagers between the ages of 15 and 17 who have ever mixed energy drinks and alcohol are four times more likely to develop an alcohol use disorder compared to teens who have never experimented with this combination.

"These findings are concerning," first author of the study Dr. Jennifer A. Emond said in a statement. "They highlight that mixed use of alcohol and energy drinks may signal the development of abusive drinking behaviors among adolescents."

Emond and her colleagues used a sample of over 3,000 adolescents and young adults between the ages of 15 and 23 from across the United States. While a growing number of studies have focused on the negative outcomes of combining energy drinks and alcohol, these analyses have generally focused on undergraduate college students and rarely include high school students.

Out of 3,342 study participants, 9.7 percent of adolescents between the ages of 15 and 17 reported consuming an energy drink combined with alcohol. Adolescents who reported mixing energy drinks and alcohol not only increased their risk for binge drinking but were also four times more likely to meet the criteria for alcohol use disorder.

"Abusive alcohol use among adolescents is a dangerous behavior that can lead to injury, chronic alcohol use and abuse, and even death," Emond added. "Identifying those most at risk for alcohol use is critical. Given that this is a sensitive issue, it's possible that clinicians, parents, and educators might open dialogues about alcohol use with adolescents by starting the discussion on the topic of energy drinks."

A similar study conducted by researchers from Australia found that the combination of energy drinks and alcohol increased a person’s desire to keep drinking. People under the age of 30 who consumed 60ml of vodka with a Red Bull Silver Edition energy drink had a stronger desire to continue drinking alcohol compared to people who consumed 60ml of vodka with club soda.

Clearly, the desire to drink more alcohol was accompanied by “a cycle of greater intoxication,” namely binge drinking. Other hazardous behaviors that can result from a greater urge to drink include drunk driving, risky sexual behavior, and alcohol-related violence.

Source: Gilbert-Diamond D, Tanski S, Sargent J, Emond J, et al. Energy drink consumption and the risk of alcohol use disorder among a national sample of adolescents and young adults. Journal of Pediatrics. 2015.