Caffeine-Related Disorders

Definition

Caffeine is the most commonly used drug in the world, found in coffee, tea, caffeinated soda, energy drinks, over-the-counter cold medications, weight-loss aids, and chocolate. Although consumption of small to moderate doses of caffeine is thought to be safe, some users become dependent on caffeine and are unable to cut back despite problems caused by their caffeine intake. While not technically a diagnosable condition, caffeine-related disorder, or caffeine-use disorder is listed in the DSM-5 as a condition that warrants further study, because the stimulating effects and side effects of caffeine can mimic those of recreational drugs. In fact, some people, particularly adolescents, are known to use and abuse caffeinated products such as energy drinks to achieve a "high" and to combine caffeine and alcohol for more effect. Caffeine-related disorders include caffeine intoxication and caffeine withdrawal.

Symptoms

Light to moderate caffeine consumption does not generally lead to worrisome symptoms and, in fact, may provide some health benefits, including reduced risk of heart disease and stroke, treatment of migraine headaches, increased alertness and mental acuity, fewer symptoms of depression, and even reduced risk of dementia. For some people, these benefits may outweigh any risks or negative side effects associated with caffeine use. Overuse, however, can lead to what is known as "caffeine intoxication." Caffeine intoxication refers to recent consumption of an amount of caffeine that results in restlessness, nervousness, excitement, flushed facial skin, insomnia, increased urine production, gastrointestinal upset, irregular heartbeat, muscle twitching, jumpiness or shakiness, or any combination of these symptoms. Since caffeine affects different people in different ways, the definition of "overuse" can vary.

Although some research suggests that regular use of caffeine is more of a habit than an addiction, the fact that overuse causes physical and psychological symptoms, and withdrawal symptoms develop when people stop drinking caffeinated beverages indicates the substance has addictive qualities. Symptoms of caffeine withdrawal can include headache, significant fatigue or drowsiness, depressed mood, difficulty concentrating, and even flu-like symptoms such as nausea and muscle pain. Withdrawal symptoms typically begin 12 to 24 hours after the last caffeine dose, peak after one to two days of abstinence, and may last up to nine days.

Causes

Caffeine is defined as a drug because it is a central nervous system stimulant. Regular use may cause a mild physical dependence but generally does not affect your physical health or social or financial well-being like other addictive substances. One study that looked at the association between caffeine and alcohol use in adolescents found, however, that young people who used caffeinated energy drinks were more likely to use alcohol in later years. This appeared to be due, in part, to lack of parental supervision and lack of early intervention. Caffeine withdrawal occurs when an individual consumes caffeine on a daily basis for an extended period of time and then abruptly stops caffeine intake. 

Treatments

Since caffeine-related disorder is not recognized as a diagnosable condition, there is no standardized treatment. It is on the list of substance-related disorders that require more investigation, however, because progressive caffeine overuse that results in a dependency could lead to negative physical, psychological, and social consequences. As a result, caffeine is regarded as an addictive substance that may require diagnosis and treatment due to potentially harmful health and safety consequences for some people.

References

Uddin S, Sufian MA, Hossain F, Rafe R. Neuropsychological effects of caffeine: is caffeine addictive? Journal of Psychology & Psychotherapy. 2017;7(2).

Shobhit J, Srivastava AS, Verma RP, Maggu G.  Caffeine addiction: Need for awareness and research and regulatory measures. Asian Journal of Psychiatry. 2017; doi:10.1016/j.aip.2017.01.008.

Budney AJ, Lee DC, Juliano LM. Evaluating the validity of caffeine use disorder. Current Psychiatry Reprots. September 2015;17:74.

Miyake ER and Marmorstein NR. Energy drink consumption and later alcohol use among early adolescents. Addictive Behaviors. April 2015;43:60-65.

American Psychiatric Association. Understanding Mental Disorders: Your Guide to DSM-5. 2015. American Psychiatric Publishing.

Last reviewed 09/22/2017