10 Stimulating Looks at Caffeine
“The most commonly used drug in the world” may lead to physical and psychological ill effects. These 10 slides provide a concise review of the risks and what to do about them.
1. Caffeine Is a Drug of Dependence:
Consumption of low to moderate doses of caffeine is generally safe, but some caffeine users become dependent. The World Health Organization recognizes caffeine dependence as a clinical disorder. Caffeine produces behavioral and physiological effects similar to those caused by other drugs of dependence.
2. Caffeine by the Numbers:
In North America, â 80% to 90% of adults and children habitually consume caffeine; â 15% of the population report having stopped caffeine use completely because of health concerns. The average per capita daily intake among adult caffeine consumers is 280 mg. Coffee is the leading dietary source of caffeine among adults, soft drinks among children. Some OTC medicinal products also contain significant amounts of caffeine.
3. Starting at a Young Age:
Nearly 75% of American children younger than 18 years consume caffeine on any given day. Soft drinks have been the largest source of caffeine among youth (70% contain caffeine), but coffee/tea use has more than doubled since 1999 and energy drinks are becoming more popular. Concerns: dependence, anxiety/nervousness, hyperactive behavior, disrupted sleep, and obesity.
4. The Differential Diagnosis:
The DSM-5 diagnosis of caffeine use disorder includes symptoms that may contribute to a diagnosis of caffeine intoxication and caffeine withdrawal. Both conditions should be included in the differential diagnosis as should other substance use disorders, especially those related to stimulants. The presence of other psychiatric conditions, such as depressive and anxiety disorders, should be assessed.
5. Is Caffeine Use Disorder Valid?
Caffeine use disorder is included in the “conditions for further study” section of the DSM-5. Caffeine’s profile of neurobiologic, behavioral, and clinical effects is similar to that of other commonly used recreational substances. A clinically meaningful addictive disorder develops in some regular caffeine users. The literature is incomplete.
6. Caffeine Linked With Disease:
Caffeine use may be also linked with caffeine-induced sleep disorder, and caffeine-induced anxiety disorder. It has not proved to produce cancer, heart disease, or human reproductive abnormalities, but persons with generalized anxiety disorder, panic disorder, primary insomnia, gastroesophageal reflux, pregnancy, or urinary incontinence often are advised to reduce or eliminate regular caffeine use.
7. Addiction Professionals Surveyed:
Most addiction professionals think caffeine withdrawal and dependence disorders exist and are clinically important, but they are divided on whether either should be included in the DSM. Trepidation about inclusion of caffeine diagnoses is related to concerns about psychiatry being criticized for including common disorders that have a relatively low clinical severity.
8. ICD-10 Diagnostic Criteria for Research:
The WHO includes caffeine on its list of psychostimulants that produce withdrawal or dependence disorders in the ICD-10. Diagnostic criteria for research include at least 1 of several dysfunctional behavior or perceptual abnormalities, including euphoria and sensation of increased energy; hypervigilance; and grandiose beliefs or actions. At least 2 signs must be present, such as tachycardia, cardiac arrhythmias, and hypertension.
9. Decision-making Style, Use, and Dependence Examined:
In an online survey of patterns of nicotine and caffeine use, stimulant dependence was associated with psychological distress, caffeine dependence with hypervigilance. Decisional self-esteem varied with stimulant dependence and distress score. Confidence, not defensive avoidance, reduces information-seeking behaviors on the Internet.
10. Caffeine Consumption and Foraging Behaviors:
In a study of legal and readily available stimulants (caffeine, nicotine), caffeine-dependent persons consumed caffeine at, on average, 2 locations. Some exhibited a greater range and intensity of use. Stimulant foraging behavior could be described by power laws and is exacerbated by dependency. The finding has implications for attempts to control substance use.
Caffeine has been called “the most commonly used drug in the world.” Although the FDA classifies this stimulant as “generally recognized as safe,” its use can contribute to a number of physical and psychological adverse effects.This slideshow provides a concise review of the risks of caffeine consumption and what to do about them.
References:
1. Caffeine Is a Drug of Dependence
5. Caffeine Linked With Disease
6. Is Caffeine Use Disorder Valid?
7. Addiction Professionals Surveyed
8. ICD-10 Diagnostic Criteria for Research
9. Decision-making Style, Use, and Dependence Examined
10. Caffeine Consumption and Foraging Behaviors