Energy drinks are responsible for growing numbers of underage people being admitted to hospital in Finland. In the southeast city of Kouvola, youngsters have been admitted complaining of pains in their chest, rapid heart rates and general agitation.
"They play computer games while drinking energy drinks or cola. Then they drink too much without even noticing it. The only explanation for the symptoms is the abundance of caffeinated beverages," says local paediatrician Timo Sillanpää.
He says his patients have tended to use energy drinks long-term or in binges.
"The treatment is to just cut back on the use of the caffeinated drinks. I don't think children should be using energy drinks at all," he says.
While there are no statistics on nationwide hospital care for such young people, Finland's Poison Information Centre reports of dozens of calls each year from parents who are concerned about their children's energy drink habit.
Deaths in Sweden, Canada and the US
The high caffeine content of energy drinks makes excess use dangerous to anyone. Too much caffeine can cause arrhythmia or even lead to heart attacks.
"People have different sensitivities to heart palpitations. For some, it can be a cause of death," says Heli Kuusipalo, a nutrition expert with Finland's National Institute for Health and Welfare (THL).
It is not known that anyone in Finland has died from overconsumption of energy drinks, but there have been deaths reported in the US, Canada and Sweden. For example, in Sweden two young people died from heart problems after drinking alcohol mixed with energy drinks, and another died after drinking too many energy drinks after playing in a sports event.
Southeast Finland is epicentre of excess use
A 2017 health survey of Finland's schools found that students in the southeast region of Kymenlaakso reported drinking the most energy drinks. There, young people admit to using energy drinks as a substitute for alcohol. Youth centres in the area have responded by banning the sale of energy drinks.
"So now it's quite common that they just chug them outside the building before they come in. Sometimes they'll vomit because they feel so ill," says Niina Soisalo, a youth counsellor that works for the city of Kouvola.
Youth centre employees in the region say they've met young people who boast of drinking 12 energy drinks a day. Soisalo says use among young people that play multi-player games online is particularly widespread.
"A lot of kids say they drink energy drinks to stay awake so they can play all evening or through the night. Their consumption is off the charts," she says.
As young as fourth grade
Seventh-grader Vilho Nikula says he drinks an average of two energy drinks every day.
"I started using energy drinks in secondary school so I could cope better during the school day and in my free time," he says.
Kids younger than Nikula have also taken to the drinks. Soisalo says they drink it as if they would any other soft drink.
"It's just another fizzy drink to many. Our survey shows that many even prefer energy drinks to a cola because it makes them feel alert and funny," the youth worker says.
Young Vilho Nikula has noticed the same trend.
"In a way its like a primary school fad. I spend a lot of time downtown and I see fourth graders buying energy drinks.
Soisalo is worried that the energy drinks will be a gateway towards irresponsible alcohol use.
"Children learn a drinking culture already in primary school: for example, that they should always have a drink in their hand when they spend time with other kids. It would be all too easy to swipe the energy drink for a can of beer," she says.
A new phenomenon in Finland is 'pärinäbileet', translated as shaking parties. Kids get together to drink energy drinks and the name of the party comes from the agitated, trembling state that comes from the high caffeine content.
"They party like grown-ups, drinking ten cans of energy drinks a piece. They think its cool; 'as if we were drinking beer'," Soisalo says.
Youth are easily addicted
Young people grow addicted to energy drinks easily. Finland's Food Safety Agency Evira recommends that the daily caffeine intake of children under 18 should be limited to 50 milligrams. Just one half-litre can of energy drink contains 160 milligrams.
THL has set a 15-year age limit on the sale of energy drinks, but not all retailers follow the recommendation.
Finland's Ombudsman for Children Tuomas Kurttila condemns the marketing of energy drinks to children and adolescents. Advertising often focuses on the energy boost the drink gives, along with improved performance, strength, and sustainability. However, the only thing that sets energy drinks apart from other soft drinks is their higher caffeine levels.
Forgetting to eat and drink water
Oftentimes young people are sustained by the caffeine in the drinks so well that they forget to eat.
"One secondary school pupil told me that he drank an energy drink for breakfast because he had been up all night playing online. At school, he wasn't hungry and so he drank another one. Then he comes home and starts playing again, drinking up to five cans in the evening and through the night," says Soisalo.
Energy drinks contains lots of sugar, one half-litre can holds the equivalent of 20 sugar cubes. THL's Kuusipalo is concerned about the health effects of regular consumption at so young an age.
"They don't provide any of the nutrients a body needs. The acids and sugar they contain eat away at tooth enamel and are a hazard to dental health," she says.
THL's nutritional expert doesn't recommend that anyone consume energy drinks.
"Energy drinks weren't even permitted in Finland until we joined the EU. They are full of additives and nothing else. They are completely unnecessary, on par with tobacco products."