Caffeine abuse

VV. K. (1992). Should caffeine abuse, dependence or withdrawal be added to DSM-IV or ICD-10 American Journal of Psychiatry,... 

The subjects of alcohol, tobacco, and caffeine abuse deserve much more attention than space permits in this chapter. Therefore the information here should serve as a brief overview of these topics, and the reader desiring more details is urged to consult one or more of the many textbooks and articles devoted to these subjects. 

Glassification of Substance-Related Disorders. The DSM-IV classification system (1) divides substance-related disorders into two categories (/) substance use disorders, ie, abuse and dependence and (2) substance-induced disorders, intoxication, withdrawal, delirium, persisting dementia, persisting amnestic disorder, psychotic disorder, mood disorder, anxiety disorder, sexual dysfunction, and sleep disorder. The different classes of substances addressed herein are alcohol, amphetamines, caffeine, caimabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics or anxiolytics, polysubstance, and others. On the basis of their significant socioeconomic impact, alcohol, nicotine, cocaine, and opioids have been selected for discussion herein. 

Jaffe JH Drug dependence opioids, nonnarcotics, nicotine (tobacco), and caffeine, in Comprehensive Textbook of Psychiatry, 5th Edition, Vol 1. Edited by Kaplan HI, Sadock BJ. Baltimore, Williams c Wilkins, 1989, pp 642-686 Jaffe J, Knapp CM, Ciraulo DA Opiates clinical aspects, in Substance Abuse A Comprehensive Textbook. Edited by Lowinson JH, Ruiz P, Millman RB, et al. New York, Lippincott Williams and Wilkins, 2004, pp 158—165 Jarvis MA, Schnoll SH Methadone use dming pregnancy. NIDA Res Monogr 149 58— 77, 1995... 

The idea of regulating caffeine use in connection with athletic competition is not new but it has gained an impetus from the recent widespread abuse by athletes at all levels of competition. Currently, the IOC bans the use of high doses of caffeine, equivalent to approximately eight cups of coffee,5 an amount that would not be reached by a casual coffee drinker. 

The DSMIV notes the potential for caffeine to be abused and includes Caffeine Intoxication under the category of Substance Abuse Disorders.262 Despite this official classification, there continues to be controversy as to whether or not caffeine is actually a drug of abuse. Some researchers maintain that caffeine has very low, if any, potential for abuse,235 while others believe that it can be addictive and has characteristics similar to those of other addictive drugs.263... 

A formal diagnosis of substance dependence requires a maladaptive pattern of abuse that leads to clinically significant impairment or distress. More detailed criteria revolve around the development of tolerance, the experience of withdrawal when abstinence is required, the inability to stop using the drug, and continued use over a protracted period of time. The question is whether or not these criteria, clearly applicable to cocaine, heroin, and other drugs, are met by caffeine. 

Gilbert, R. M., Caffeine as a drug of abuse, in Research advances in alcohol and drug problems. Edited by Gibbins, R. J., Israel, Y., and Kalant, H., Eds., John Wiley and Sons, New York, 1976. 

Gilliland, K., Bullock, W., Caffeine A potential drug of abuse. Advances in Alcohol and Substance Abuse 3(1-2), 53-73, 1984. 

Rush, C., Sullivan, J. and Griffiths, R., Intravenous caffeine in stimulant drug abusers Subjective reports and physiological effects. Journal of Pharmacology and Experimental Therapeutics 273(1), 351-358, 1995. 

Falk, J. L., Zhang, J., Chen, R., and Lau, C. E., A schedule induction probe technique for evaluating abuse potential Comparison of ethanol, nicotine and caffeine, and caffeine-midazolam interaction. Special Issue Behavioural pharmacology of alcohol. Behavioural Pharmacology 5(4-5), 513-520, 1994. 

Kozlowski, L. T., Henningfield, J. E., Keenan, R. M., Lei, H., et al., Patterns of alcohol, cigarette, and caffeine and other drug use in two drug abusing populations. Special Issue Towards a broader view of recovery Integrating nicotine addiction and chemical dependency treatments. Journal of Substance Abuse Treatment, 1993 Mar-Apr Vol 10(2), 171-179, 1993. 

Foltin, R. W., The importance of drug self-administration studies in the analysis of abuse liability An analysis of caffeine, nicotine, anabolic steroids, and designer drugs. Annual Meeting of the American Academy of Psychiatrists in Alcoholism and Addictions (1990, Santa Monica, California). American Journal on Addictions Spr Vol 1(2), 139-149, 1992. 

Patients must be educated to avoid caffeine, drugs of abuse, and stimulants. 

Rogers PJ, Dernoncourt C. (1998). Regular caffeine consumption a balance of adverse and beneficial effects for mood and psychomotor performance. Pharmacol Biochem Behav. 59(4) 1039-45. Rounsaville BJ, Anton SF, Carroll K, Budde D, Prusoff BA, Gawin F. (1991). Psychiatric diagnoses of treatment-seeking cocaine abusers. Arch Gen Psychiatry. 48(1) 43-51. 

Substance-Induced Anxiety Disorder. Numerous medicines and drugs of abuse can produce panic attacks. Panic attacks can be triggered by central nervous system stimulants such as cocaine, methamphetamine, caffeine, over-the-counter herbal stimulants such as ephedra, or any of the medications commonly used to treat narcolepsy and ADHD, including psychostimulants and modafinil. Thyroid supplementation with thyroxine (Synthroid) or triiodothyronine (Cytomel) can rarely produce panic attacks. Abrupt withdrawal from central nervous system depressants such as alcohol, barbiturates, and benzodiazepines can cause panic attacks as well. This can be especially problematic with short-acting benzodiazepines such as alprazolam (Xanax), which is an effective treatment for panic disorder but which has been associated with between dose withdrawal symptoms. 

Impulsivity is manifested by a hot temper or quick decision making that is later regretted. Finally, adults with ADHD often have significant problems with alcohol or illicit substance abuse. They may also heavily use caffeine or cigarettes. This pattern of substance use is likely, in part, an attempt to medicate the illness. 

Stimulants. From coca leaves chewed by native laborers in South America to brewed teas and coffees used across the globe, stimulants have been used since antiquity. In these essentially naturally occurring forms, coca and caffeine were long known to provide a boost of energy, focus attention, and decrease appetite. However, compared to today s refined stimulants, the effects were relatively mild. There is no clear evidence that these substances were used to treat the ancient antecedents of psychiatric illness in past cultures. The isolation of cocaine in the mid-1700s and the synthesis of amphetamine in the late 1800s dramatically increased stimulant use (and abuse) in society. 

Once chronic insomnia has developed, it hardly ever spontaneously resolves without treatment or intervention. The toll of chronic insomnia can be very high and the frustration it produces may precipitate a clinical depression or an anxiety disorder. Insomnia is also associated with decreased productivity in the workplace and more frequent use of medical services. Einally, substance abuse problems may result from the inappropriate use of alcohol or sedatives to induce sleep or caffeine and other stimulants to maintain alertness during the day. 

In order to limit this ambiguity, the terms psychoactive substances (referring to licit and illicit substances, e.g., caffeine and nicotine but also cannabis and heroin) and dmgs of abuse (referring only to recreational dmgs, e.g., cocaine, cannabis, etc.) will be used throughout the present work. 

Most of the research and results have been focused on the effects of drug therapy on the disorders induced by alcohol, and by opiates abuse. For all drugs, the first objective is to wean the patients from the drug, treating or preventing the effects of withdrawal for those drugs which cause physical dependence (alcohol, nicotine, opiates, caffeine, certain psychotropic agents such as benzodiazepines, possibly antidepressants). The second phase is the prevention of recurrence or relapse, which relies on a com-... 

Marcel Proust was also a big coffee fan, and he required the brew to be thick and as strong as possible. His stimulant abuse, which included caffeine and adrenaline, required him to take opium at bedtime to calm down. ... 

Anxiety is characterized by fear and apprehension that may or may not be associated with a cieariy identifiabie stimuius. Anxiety is a common reaction to significant life stress, is seen in conjunction with almost every psychiatric disorder, and is a common component of numerous organic disorders as well (e.g., hyperthyroidism, hypoglycemia, pheochromocytoma, complex partial seizures, pulmonary disorders, acute myocardial infarction, caffeine intoxication, various substances of abuse). Anxiety is almost invariably accompanied by physical symptoms such as the following ... 

Stimulant drugs commonly abused in the USA include methamphetamine ("crank," "crystal"), methylenedioxymethamphetamine (MDMA, "ecstasy"), and cocaine ("crack") as well as pharmaceuticals such as pseudoephedrine (Sudafed) and ephedrine (as such and in the herbal agent Ma-huang) (see Chapter 32). Caffeine is often added to dietary supplements sold as "metabolic enhancers" or "fat-burners" and is also sometimes combined with pseudoephedrine in underground pills sold as amphetamine substitutes. 

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