Caffeine Addiction and Abuse
Caffeine is a stimulant that increases alertness and enhances concentration in consumers. However, regular ingestion of the drug alters the brain’s chemical makeup, and can cause fatigue, headaches, and nausea when attempting to quit.
What Is Caffeine Addiction?
Caffeine is a central nervous system stimulant that has the ability to enhance concentration, increase metabolism, and boost mood. Whether it comes from coffee, tea, energy drinks, or soda, many people feel like they “need” caffeine in the morning to increase alertness and the motivation to work. More than 90% of adults regularly drink caffeine in the United States, consuming an average of 200 mg of caffeine per day – the equivalent of two 6-ounce coffees or five 12-ounce cans of soft drinks. In most cases, drinking caffeinated beverages is a relatively safe, non-harmful habit; however, when the need for caffeine crosses the line from a pleasant pick-me-up to a daily necessity, it can be indicative of an addiction.
People can develop a dependence on coffee and other caffeinated beverages quite quickly. This is due to the chemical changes that sustained consumption produces in the brain. If someone drinks caffeine on a daily basis, he or she will develop a tolerance, just as one would to other drugs or alcohol. After a while, the user requires more and more caffeine to produce the same effects of alertness. Regular caffeine drinkers become acclimated to the wake-up aspect that the substance produces, and gradually require higher amounts to achieve the same “caffeine fix.” Similar to other drugs, people who abruptly stop drinking caffeine after prolonged use will start to suffer from withdrawal symptoms and experience cravings. This causes many individuals to relapse when attempting to quit and resume drinking caffeine, regardless of the health problems associated with chronic caffeine use.
The Controversy Surrounding Caffeine Addiction
Despite the similarities between caffeine dependence and other drug addictions, some health care officials debate as to whether it can qualify as an actual addiction. The main reason for this is that other addictive substances, such as amphetamines and cocaine, stimulate the area of the brain linked to reward and motivation to a higher extent than caffeine does. Caffeine causes surges of dopamine within the brain, but it is not a large enough surge to unbalance the reward system in the brain like other drugs. Because of this, the American Psychiatric Association (APA) does not currently identify caffeine addiction as a substance use disorder; however, it does recognize caffeine withdrawal as a clinical condition. The World Health Organization (WHO) became the first medical corporation to formally recognize caffeine addiction as a clinical disorder in 2012.
How Caffeine Affects the Brain
Caffeine is addictive because of the way that the drug affects the human brain and produces the alert feeling that people crave. Soon after caffeine is consumed, it’s absorbed through the small intestine and dissolved into the bloodstream. Because the chemical is both water- and fat-soluble, it’s able to penetrate the blood-brain barrier and enter the brain.
Structurally, caffeine closely resembles a molecule that’s naturally present in the brain, called adenosine. Caffeine resembles the molecule so much so that it can fit neatly into the brain cells’ receptors for adenosine, and effectively block them off. Normally, the adenosine produced over time locks into these receptors and produces a feeling of tiredness. When caffeine molecules are blocking those receptors, they prevent this from occurring, and generate a sense of alertness and energy until the caffeine is metabolized. Additionally, some of the brain’s own natural stimulants are released, such as dopamine, and work more effectively when the adenosine receptors are blocked. The surplus of adenosine cues the adrenal glands to secrete adrenaline, another stimulant, and this further increases alertness and reduces feelings of tiredness.
In people who drink caffeine regularly, the brain’s chemistry and physical characteristics actually change over time. The brain cells will begin to grow more adenosine receptors in an attempt to maintain equilibrium. This is how tolerance to caffeine develops; because the brain has more adenosine receptors, it takes more caffeine to block a significant proportion of them and achieve the same desired effect.
Signs of a Caffeine Addiction
Rather than the actual amount of caffeine consumed per day, caffeine addiction is characterized by the way that the substance affects an individual’s day-to-day functioning. The severity of the addiction is calculated based on how distressed someone feels when they want caffeine and can’t get it, and how much of a disruption this causes in their daily life.
The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders does not recognize caffeine addiction as a substance abuse disorder, but it does recognize it as a condition for future study. According to the DSM-V, problematic caffeine consumption is characterized by at least three of the following criteria:
- A persistent desire or unsuccessful efforts to cut down or control caffeine use
- Continued caffeine use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by caffeine
- Withdrawal, as manifested by either of the following:
- The characteristic withdrawal syndrome for caffeine
- Caffeine (or a closely related substance) is taken to relieve or avoid withdrawal symptoms
- Caffeine is often taken in larger amounts or over a longer period than was intended
- Recurrent caffeine use resulting in a failure to fulfill major role obligations at work, school, or home
- Continued caffeine use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of caffeine
- Tolerance, as defined by either of the following:
- A need for markedly increased amounts of caffeine to achieve desired effect
- Markedly diminished effect with continued use of the same amount of caffeine
- A great deal of time is spent in activities necessary to obtain caffeine, use caffeine, or recover from its effects
- Craving or a strong desire or urge to use caffeine
Most experts recommend that adults should consume no more than 400 milligrams of caffeine per day – the equivalent of approximately four cups of coffee. If someone is regularly drinking more than that, he or she may be at risk of negative side effects, including: sleep disruption, migraines and other headaches, irritability, quickened heartbeat, muscle tremors, nervousness, and nausea. For some people, those side effects can kick in with even fewer cups, as caffeine tolerance is highly individual. If someone is experiencing these side effects, has trouble controlling consumption, or feels totally out of sorts when unable to get their “fix,” that individual is most likely dependent on caffeine and should cut back.
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Caffeine withdrawal is a medically-recognized condition that occurs when people experience significant symptoms after abruptly quitting caffeine consumption. These symptoms typically appear within a day of quitting and can last a week or more.
Symptoms of caffeine withdrawal include:
- Difficulty concentrating
- Depressed mood
- Low energy
Gradually reducing caffeine intake over several weeks instead of quitting “cold turkey” can help reduce the severity of withdrawal symptoms. Compared to other addictions, the withdrawal and recovery period from caffeine is relatively short. Most caffeine addiction symptoms can be resolved in 7-12 days of consumption reduction. During that period, the brain will naturally decrease the number of adenosine receptors on each cell, responding to the sudden lack of caffeine. If an individual can decrease intake until it becomes nothing within a few weeks, the levels of adenosine receptors in the brain will reset to their baseline levels, and the addiction will be broken.
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Finding Treatment for Caffeine Addiction
Caffeine has addictive properties that may lead to physical dependence. People that regularly consume caffeine need to make responsible and good choices when it comes to consumption, such as limiting intake to only one or two cups of coffee a day. Caffeine addiction is more likely to occur in someone that’s also suffering from a co-occurring mental health disorder, such as insomnia or an eating disorder, and this can make it harder for him or her to stop. If someone that you love has a caffeine addiction or another complicating disorder, contact a dedicated treatment provider today and learn about potential treatment options.
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