Caffeine addiction

DEFINITION: Caffeine addiction, a dependence on caffeine, is marked by the development of withdrawal symptoms if caffeine is not ingested. Experts are not sure if this dependence should be categorized as an actual addiction because clinical studies demonstrate mixed results concerning symptom occurrence and frequency. Also, the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association does not classify caffeine as addictive because data are insufficient to prove that the symptoms of caffeine addiction cause any clinically significant mental or physical impairment. However, the fifth edition of the DSM listed caffeine use disorder, a condition marked by the inability to reduce caffeine intake despite negative side effects, as something to be further evaluated.

Causes

Caffeine acts as a central and peripheral nervous system stimulant and is considered a mood-altering substance. Caffeine also leads to the release of dopamine in the prefrontal cortex of the brain, an area that reinforces the positive excitatory properties of caffeine. Addiction occurs when a person consumes excessive amounts of drinks or foods that contain caffeine to maximize the positive effects from caffeine and to avoid withdrawal symptoms. Several studies also have demonstrated a genetic predisposition for caffeine tolerance and dependence.

Coffee and cocoa beans, tea leaves, and fruit all contain caffeine and are harvested to manufacture food and drink products. Regular coffee contains more caffeine per serving than either tea or caffeinated cola soft drinks. Energy drinks and over-the-counter caffeine supplements (in tablet form) have become popular among people wanting to consume large amounts of the substance. Medications such as over-the-counter pain relievers and cold and cough medicines also often contain caffeine. Chocolate, cocoa products, and decaffeinated coffee have lower levels of the substance.

Risk Factors

Persons who consume a high level of caffeinated products (750 milligrams to 1 gram per day) have the greatest possibility of developing a caffeine addiction; this consumed amount equates to a minimum of five to seven cups of coffee per day. However, the wide variety in caffeine content among products (for example, a single cup of home-brewed coffee versus a large serving from a coffee shop chain) often prevents consumers from knowing exactly how much caffeine they consume, adding to the risk of overconsumption. Males, who consume more caffeine on average than females, are at a higher risk for caffeine addiction. Also, smokers and substance abusers are more likely to develop a caffeine addiction. Although scientific literature once showed that young adults ages eighteen to thirty-five years made up the largest group of consumers of caffeine, newer research suggests that young children and adolescents are a rising at-risk population because of media advertisements and the development and marketing of new products that target this demographic. According to some reports, as much as 90 percent of people in the United States consume caffeine regularly.

Caffeine consumption and dependence typically decrease after age sixty-five years because of the adverse effects of caffeine on common age-related health problems.

Symptoms

The effects of caffeine can be observed within thirty to sixty minutes of consuming caffeinated foods or drinks. When ingested in recommended doses, caffeine produces the desired effects of increased alertness and decreased lethargy. Many people do not experience symptoms of excess caffeine intake because they develop a tolerance to the substance. However, overconsumption still may lead to insomnia, nausea, restlessness, mental confusion, and tremors. At high doses caffeine increases the heart rate and causes ringing of the ears and visualized flashes of light. It also may induce cardiac arrhythmias, seizures, respiratory failure, gastrointestinal irregularities, and even, but rarely, death.

Whether or not caffeine withdrawal occurs remains debatable, as some studies have found no evidence of withdrawal and others have reported a 100 percent incidence. Withdrawal symptoms typically begin twelve to twenty-four hours after an abrupt discontinuation of caffeine use, although some persons report withdrawal effects for days or weeks. A variety of withdrawal symptoms has been reported in the literature, such as irritability, headaches, sleepiness, insomnia, tremors, slowness in performing physical tasks (such as working), anxiety, runny nose, nausea, and vomiting.

Screening and Diagnosis

A caffeine addiction diagnosis is controversial, as most reports of this addiction are subjective and cannot be reliably confirmed by randomized clinical trials. The majority of the relevant literature contains case reports from individual examples of caffeine addiction. Many experts describe most reported instances as dependency rather than true addiction, citing the lack of disruption in patients' lives at the same level as better-studied addictions. Evidence also suggests that most consumers of caffeine are able to successfully reduce their intake without the need to fully quit. While the DSM does not recognize caffeine addiction, it does include related issues such as intoxication and withdrawal.

No reliable blood or laboratory tests exist to help establish the diagnosis. Therefore, persons who feel they are having a problem with dependence or withdrawal should seek the care of a physician to confirm the diagnosis and to rule out other medical problems.

Treatment and Therapy

As with any substance of addiction, a gradual tapering off of the caffeinated substance may help to minimize withdrawal symptoms. To decrease caffeine intake, one should switch from drinking regular to drinking decaffeinated coffee, tea, or soda. Some people may benefit from outpatient therapy to treat any underlying behavioral addiction. Also, people who have additional substance abuse problems should be treated for the co-occurring addiction issues.

Prevention

The primary means of preventing a caffeine addiction is to abstain from consuming products that contain the substance. To prevent addiction among children and adolescents, parents and caretakers should be educated about caffeine’s effects and should be aware of products that contain large amounts of caffeine. Government regulations on energy drinks and other caffeinated products may be considered in attempts to deter overconsumption of caffeine, particularly among children and teenagers.

Bibliography

Allday, Erin. "Caffeine Dependence Tied to Physical, Emotional Problems." SFGate. Hearst Communications, 5 Mar. 2014. Web. 26 Oct. 2014.

Carpenter, Murray. "Generation Jitters: Are We Addicted to Caffeine?" Guardian. Guardian News and Media, 8 Mar. 2014. Web. 26 Oct. 2015.

Chou, Tony. “Wake up and Smell the Coffee: Caffeine, Coffee, and the Medical Consequences.” Western Journal of Medicine 157 (1992): 544–53. Print.

Dews, P., C. O’Brien, and J. Bergman. “Caffeine: Behavioral Effects of Withdrawal and Related Issues.” Food and Chemical Toxicology 40 (2002): 1257–61. Print.

Hartney, Elizabeth. "Caffeine Addiction Symptoms and Withdrawal." VeryWell Mind, 19 Mar. 2021, www.verywellmind.com/caffeine-addiction-4157287. Accessed 22 Nov. 2022.

Minkove, Judy F. "New Insight into Caffeine Use Disorder." Johns Hopkins Medicine, 16 Dec. 2020, www.hopkinsmedicine.org/news/articles/2020/12/new-insight-into-caffeine-use-disorder. Accessed 17 July 2024.

Satel, Sally. “Is Caffeine Addictive? A Review of the Literature.” American Journal of Drug and Alcohol Abuse 32 (2006): 493–502. Print.

Temple, Jennifer. “Caffeine Use in Children: What We Know, What We Have Left to Learn, and Why We Should Worry.” Neuroscience Behavioral Research 33.6 (2009): 793–806. Print.