safety | Caffeine and You

Caffeine Addiction Symptoms

January 31, 2013 By Kate Heyhoe

AddictionShip When does caffeine cause someone to lose control? For many of us, caffeine is no more habit-forming than relying on a morning shower to wake up.

But compulsive caffeine consumption – to the point where sleep is disrupted on a regular basis, or hands tremble – suggests a physical and a psychological dependence, perhaps even a mental health disorder.

The word “addiction” is an emotionally charged grenade, packed with social stigma and misconceptions. Many health professionals now use the term disorder, as in “Caffeine Use Disorder”– a condition where sufferers continue to use caffeine, even though it adversely affects them in some way. (It’s also been called caffeinism.)

But Caffeine Use Disorder isn’t fully recognized – yet. When the bible of addiction, The Diagnostic and Statistical Manual of Mental Disorder by the American Psychiatric Association, updated the 2013 edition (DSM-5), it placed Caffeine Use Disorder in the “conditions for further study” category. More scientific studies are needed, said the task force. Because caffeine is so commonly used, and to prevent over-diagnosis, Caffeine Use Disorder needs to have a higher threshold of diagnostic criteria than those used for other abuse substances.

Nevertheless, the proposed definition for Caffeine Use Disorder is illuminating. It identifies 9 symptoms, and says the first three or more are needed to present a diagnosis of Caffeine Use Disorder. Some of us may recognize particular symptoms in ourselves, such as: a strong craving for caffeine; unsuccessful efforts to cut back or stop caffeine use; and tolerance marked by the need for more caffeine to reach the same effect. See if any of these conditions apply to you or someone you know.

Caffeine Use Disorder: 3+ Symptoms

You need at least the first three symptoms (within a 12-month period). Plus, there must be a problematic pattern of caffeine use leading to clinically significant impairment or distress, according to the proposed definition for Caffeine Use Disorder.

1. A persistent desire or unsuccessful efforts to cut down or control caffeine use.

2. 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.

3. Withdrawal, as manifested by either of the following:

a. The characteristic withdrawal syndrome for caffeine.

b. Caffeine (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.

4. Caffeine is often taken in larger amounts or over a longer period than was intended.

5. Recurrent caffeine use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated tardiness or absences from work or school related to caffeine use or withdrawal).

6. Continued caffeine use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of caffeine (e.g., arguments with spouse about consequences of use, medical problems, cost).

7. Tolerance as defined by either of the following:

a. A need for markedly increased amounts of caffeine to achieve desired effect.

b. Markedly diminished effect with continued use of the same amount of caffeine.

8. A great deal of time is spent in activities necessary to obtain caffeine, use caffeine, or recover from its effects.

9. Craving or a strong desire or urge to use caffeine.

Having these symptoms is no guarantee you’ve got a caffeine disorder, and this is not intended to be medical advice. But if you think your caffeine habit is disrupting your life, you may want to consult your doctor.

Coming up: Quitting caffeine? Get prepared for some painful withdrawal symptoms…

Caffeine Basics: Table of Contents

Caffeine Intoxication: 5 Symptoms

January 8, 2013 By Kate Heyhoe

Can you get drunk on caffeine?

If you’ve ever slammed down a few too many coffees or Red Bulls and felt jitters or rapid heartbeat, you’ve experienced caffeine intoxication. You don’t even have to be a regular user: just a big blast of caffeine, or several blasts in a short period of time, can do it.

Caffeine intoxication is not the same thing as caffeine addiction. Addiction symptoms arise out of regular usage over a long period of time. Caffeine intoxication happens more immediately, when the caffeine has just been ingested or is still floating around in your system. Once the caffeine wears off, so does the intoxication. Here’s how to tell if someone may be experiencing caffeine intoxication…

Caffeine Intoxication: 5 of 12 Symptoms

Experts say to be diagnosed with “caffeine intoxication,” a person must display at least five of these symptoms, to the point where they impair a person’s social, work or other life functions.*

restlessness
nervousness
excitement
insomnia
flushed face
diuresis
gastrointestinal disturbance
muscle twitching
rambling flow of thought and speech
tachycardia or cardiac arrhythmia
periods of inexhaustibility
psychomotor agitation

*Source: The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

You, your kid, your parents – anyone (habitual user or not) can experience caffeine intoxication by taking more caffeine than the body can handle. Common sources like energy drinks, 5-Hour Energy shots, and too many Cokes and coffees can do it. Because each person’s metabolism is different, there’s no set amount of caffeine to trigger caffeine intoxication. Just three cups of coffee in grandma, for instance, or a supersize Coke in a small child, might push their caffeine limit, but it all depends on the person. Consult a medical professional if you think caffeine intoxication might be a problem.

Next: Important info about caffeine safety and toxicity…

Caffeine Basics: Table of Contents

Caffeine Toxicity: Dosage Risks

January 8, 2013 By Kate Heyhoe

Caffeine is safe in low doses, but high doses are risky

A lethal dose of caffeine occurs at about 10 grams, an amount more common with powdered caffeine or caffeine pills. (10 grams is about one-third of an ounce)

You’d have to drink nearly 100 cups of coffee to reach that lethal level, and your body would start rebelling long before ingesting that amount. But it’s easy to get powdered caffeine in today’s online world, and young people especially have overdosed on it. Caffeine pills, like No-Doz, are a less potent but still concentrated form of caffeine and can be risky if not taken as directed.

Athletes sometimes rely on anhydrous caffeine powder and pills as performance supplements, but in small doses. These concentrated substances enter the bloodstream much faster than coffee or caffeinated beverages.

Even with typical dosages, caffeine can interact with some prescription drugs to create unintended overdose, usually by impacting the cardiovascular system.

Caffeine and anxiety disorders also don’t mix. People prone to anxiety and panic attacks are advised to steer clear of caffeine. Among the general population, high doses of caffeine may increase anxiety, nervousness, and restlessness, but this rarely happens at low to moderate doses (one to three cups of coffee, for instance).

Shake, Rattle, ‘n’ Roll

Michael Lee Bedford, the young man who overdosed on caffeine powder in Chapter 4, wasn’t looking to feed an addiction, not in the same way a heroine addict overdoses while getting high. All indications suggest Bedford was simply unaware of the potency of the powder, and had no idea caffeine could put him at such risk. His wasn’t a case of addiction, but rather an accident caused by ignorance.

As mentioned, you’d need to consume about 100 cups of coffee to reach a lethal level of caffeine. On the other hand, caffeine powders and pills are concentrated and far riskier; as little as 2 grams of anhydrous powder can lead to caffeine intoxication, overdose, and even death (depending on a person’s size and health). Alcohol mixed with energy drinks can also be dangerous. For most people, as much as 500 mg a day (about seven Starbucks espressos) is considered safe, though not necessarily advisable; pregnant women and people with heart conditions should consume less.

Yet gauging how much caffeine you’re consuming can be tough. Manufacturers must list caffeine only when it’s been added to the product, and they’re not required to specify the amount. When caffeine occurs naturally (as in coffee, chocolate, and tea), they’re not required to list it at all.

Crazy for caffeine? The final section in this chapter peaks into caffeine and mental health…

Caffeine Basics: Table of Contents

Caffeine and Mental Health

January 8, 2013 By Kate Heyhoe

Under what conditions can caffeine become a dangerous substance?

Mental health conditions, such as bipolar disorder or anxiety, combined with an overuse of caffeine can flip a person’s mental state upside down. To understand when caffeine crosses the line, let’s look at substance addiction and dysfunctional brain conditions.

Faulty Wiring and Caffeine Addiction

Here’s a different way to look at caffeine addiction: Addiction is a disease caused by a dysfunctional brain.

In other words: Some people are simply more prone to addiction – of any substance or activity – than others. Faulty wiring in the brain’s reward circuits triggers addiction – anything that sparks an over-the-top, insatiable craving in the feel-good parts of the brain can be addictive. Which means religion, doughnuts, poker, sex, heroin, and caffeine can all be addictive – or not, depending on each individual’s brain-blueprint.

This view of addiction comes courtesy of the American Society of Addiction Medicine (ASAM), which said in 2010:

“… Addiction is about what happens in a person’s brain when they are exposed to rewarding substances or rewarding behaviors, and it is more about reward circuitry in the brain and related brain structures than it is about the external chemicals or behavior that “turn on” that reward circuitry…

We all have the brain reward circuitry that makes food and sex rewarding. In fact, this is a survival mechanism. In a healthy brain, these rewards have feedback mechanisms for satiety or ‘enough.’ In someone with addiction, the circuitry becomes dysfunctional such that the message to the individual becomes ‘more’, which leads to the pathological pursuit of rewards and/or relief through the use of substances and behaviors. So, anyone who has addiction is vulnerable to food and sex addiction.”

This is why some people can drink an occasional cocktail and choose to stop after one or two drinks, while others keep drinking and descend into a cycle of self-destruction.

Bottom line: Most people can walk away from caffeine if they want to. It stimulates their rewards circuits, but not overly so. They may have cravings, and symptoms of withdrawal, but in a matter of days or weeks, they can wean themselves off their addiction – it’s one of the benefits of our adaptable brain.

The Starbucks Defense: One driver, three shattered lives… Excessive caffeine, a mental disorder, and no sleep lead to tragic consequences. Read this post to see how the court ruled on The Starbucks Defense.

Are You Insane, or Just Over-Caffeinated?

Were witches burned at the stake simply because they were over-caffeinated? It’s possible that strange behavior and diagnosed mental disorders have actually been incidents of caffeine intoxication. Nervousness, muscle twitches, rambling speech or thoughts are some symptoms of caffeine intoxication. Mental health professionals see people with these same symptoms all the time, but until recently, they rarely asked patients about their caffeine habits.

Doctors and mental care physicians are now being urged to consider whether curing a person’s mental instability may be as simple as taking them off caffeine.

I wonder how many inmates were sent to the cuckoo’s nest with misdiagnosed mental illness, when they were really suffering the combined effects of too much caffeine and mild mental disorders.

Caffeine’s Good Mood Effects

Mental health is as complex as caffeine, and caffeine can be a boost to some mental health conditions. Scientists have associated caffeine with lifting depression and preventing suicide, topics covered in the upcoming Chapter 9.

Final Thoughts

Consider this: 90 percent of the world consumes some form of caffeine. This chapter has focused on the risks of caffeine as a general use substance. Low to moderate doses present few risks and even some benefits, but experts say high doses should be avoided. Also, every person reacts slightly differently to caffeine, so you need to determine the right dose for you.

As we’ve seen in previous sections, large chunks of humanity are consuming more caffeine (and more potent forms of caffeine) than ever in human history. Not surprisingly, this global trend reflects the same pattern of caffeine use in individuals – whether you call it addiction, dependency or simply just habit.

Global caffeine addiction may or may not be alarming. If caffeine produces positive physiological effects, regular caffeine consumption in safe quantities may be just what the doctor ordered. It could even be an evolutionary boost, a tool in the human toolkit.

COMING SOON: Chapter 9 – Caffeine’s Cognitive Effects: brain boosts, age-related benefits, and mood…

Caffeine Basics: Table of Contents