Researchers draw that conclusion from laboratory experiments on mice, in which caffeine made drunken rodents more alert but didn’t reverse learning problems caused by alcohol.

But caffeine’s effect as a stimulant may create the illusion in intoxicated people that they are alert and competent enough.

Alcohol increased movement and reduced anxiety and learning in the mice in proportion to doses given.The drunken mice learned significantly less well than the sober ones in trying to avoid the frightening bright light or loud noise.

The doses of caffeine given to the mice were the equivalent of one to six or eight cups of coffee for humans.

A co-author of the study said she and her colleagues weren’t surprised at the disparity they found, but they were surprised by how large it turned out to be.

Given that younger patients might be healthier and thus more likely to survive injuries, Rosen and her team looked separately at 18 to 30 year olds, and found the excess risk was even greater; these patients were 89 percent more likely to die if they had no insurance. (Rosen said specific numbers of deaths in each grouping were not available.)

Fibromyalgia is a syndrome with features that include chronic, widespread musculoskeletal pain and stiffness and associated with fatigue, poor sleep and the presence of discrete tender points.

Fibromyalgia affects ~3.7 million people in the U.S.; 75% of patients are women between the ages of approximately 35 to 55 .1 One small survey estimated that approximately 20% of fibromyalgia patients treated at a university-based clinic in the United States tried acupuncture within 2 years of diagnosis.2.
Description of Acupuncture
In its original form acupuncture was based on the principles of traditional Chinese medicine .3-5 The general theory of acupuncture is based on the premise that there are patterns of energy flow through the body that are essential for health. Traditional acupuncturists understand health in terms of a vital force of energy called Qi which circulates between the organs along channels called meridians. The traditional Chinese medicine acupuncture practitioner seeks to identify the nature of any imbalance in Qi, and then selects the appropriate acupuncture points from among approximately 360 points distributed along the meridians.
Acupuncture involves the stimulation of the specific acupuncture points (acupoints) on the skin, usually by the insertion of needles ranging in length from 1 cm to 10 cm. Between 5 and 15 needles are used in a typical treatment, with the point combinations varying during a course of sessions. The acupoints can be chosen based on a standardized “formulary” involving a fixed menu of consistent points for each disease or condition or selected for each patient individually based on a patient’s specific symptoms and Qi balance. Depth of puncture can be up to 5 cm.
Other forms of acupuncture include electroacupuncture, heat (including moxibustion), pressure, and laser-generated light.5, 6, 8 A glossary of these procedures is found in Appendix A. Generally, studies have addressed either manual needling or electroacupuncture because the stimulation parameters of these procedures are easiest to control.
FDA’s Role
The U.S. Food and Drug Administration (FDA) regulates devices used for acupuncture, such as the needles. Since 1973, the FDA considered acupuncture devices, including needles, as investigational medical devices. 9 In December of 1994, petitions were filed with the FDA to approve the needles as treatment for five medical conditions: pain, nausea and vomiting, substance abuse, asthma and other respiratory problems, and stroke and paralysis.10 As a result of these events, FDA undertook an extensive review of the available evidence regarding the effectiveness of acupuncture.

FDA announced on March 29, 1996 that acupuncture needles had been reclassified from Class III (experimental) medical devices to Class II (non-experimental but regulated) medical devices for “general acupuncture use” by licensed, registered or certified practitioners.11 As part of this reclassification, FDA determined that the “investigational use” labeling requirements no longer applied. However, the FDA determined that acupuncture needles must comply with the following special controls:
(1) Labeling for single use only and conformance to the requirements for prescription devices set out in 21 CFR.
(2) Device material biocompatibility, and,
(3) Device sterility.
Class II devices involve less stringent controls by FDA that include good manufacturing procedures and proper labeling. However, clinical data demonstrating clinical effectiveness is not required. To receive marketing clearance as a class II device, acupuncture devices must go through the FDA’s 510 (k) process.
The FDA requires manufacturers of acupuncture needles to label them for single use only. Acupuncture needles must also bear a prescription labeling statement which restricts their use to qualified practitioners as determined by the states. Manufacturers also have to provide information about device material bio-compatibility and sterility.
Adverse events associated with acupuncture
Serious adverse events associated with acupuncture include transmission of infectious disease, pneumothorax, other problems associated with organ punctures, spinal lesions, cardiac tamponade, and broken needles with remnants migrating to other locations.7, 8 Minor adverse events include forgotten needles, exacerbation of symptoms, minor bleeding, hematoma, fatigue, sweating, severe nausea, fainting, and headache. Adverse events may be associated with practitioner competence and training.
There have been several studies quantifying the rates of adverse events. A few studies compiled case reports. One Japanese systematic review of case reports found 25 cases of pneumothorax, 18 cases of spinal cord injury, 11 cases of acute hepatitis B and two fatalities from infections.16 This study and other similar studies establish that serious adverse events are possible, but they were not able to measure the frequency of these complications.17
Two large prospective studies in the U.K. provided estimates of the rates of adverse events. White and colleagues conducted a prospective survey of 32000 treatments and found that the rate of “significant” events were 14 per 10,000 acupuncture visits. 18 None of these were deemed to be serious. A total of 671 minor events (such as bleeding or needling pain) per 10,000 acupuncture visits were reported in this study. MacPherson and colleagues conducted a prospective survey of 34000 treatments and found that there were no reports of serious adverse events that required hospital admission or led to permanent disability or death. 19 Minor adverse events such as severe nausea and vomiting occurred in 1.3 out of 1000 visits. Mild transient reactions such as pain or bleeding occurred in 15% of the visits.

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