Caffeine Addiction

What Causes Caffeine Addiction?

Caffeine produces feelings of well-being by increasing the level of certain brain chemicals, called neurotransmitters, that cause those good feelings. Over time and with repeated use, caffeine may cause changes in brain cells that alter how the cells respond to certain neurotransmitters. These changes can result in a dependency on caffeine because the now-altered brain can’t feel well without it.

Although anyone who uses caffeine is at risk of developing a dependency on the drug, some factors increase addiction risk. These risk factors include:

• Family history. People who have close relatives who have suffered from drug addiction are more likely to develop an addiction themselves.
• Abuse of other substances. Caffeine use often occurs in conjunction with the use of nicotine or alcohol.

Is Caffeine Addiction Hereditary?

Addiction to drugs can have many causes, and many are situational. However, studies have indicated that some people are more likely to abuse or become addicted to certain drugs, including caffeine. The increased risk seems to be determined by genetics and is likely inherited within families.

Scientists do not fully understand inherited addiction risk. It is likely that many different genes are involved and that the inherited risk has a complex cause.

How Is Caffeine Addiction Detected?

Because many people consume caffeine without noticeable adverse effects, it can be challenging to identify when someone has a problem with the drug.

Potential warning signs of problematic caffeine use include:

• Impairment of daily functioning, either because of caffeine use or withdrawal symptoms
• Regularly experiencing negative effects of the drug
• Being unable to reduce caffeine use despite the adverse effects

How Is Caffeine Addiction Diagnosed?

The Diagnostic and Statistical Manual (DSM), the guide used by mental health practitioners to diagnose disorders, includes diagnostic criteria for several caffeine-related disorders, including:

• Caffeine Intoxication
• Caffeine Withdrawal
• Other Caffeine-Induced Disorders
• Unspecified Caffeine-Related Disorder

The latest version of the DSM also includes diagnostic criteria for caffeine use disorder (CUD). However, this disorder is categorized as needing further research before inclusion in the manual as an officially diagnosable condition. The proposed diagnostic criteria for CUD include:

• The person wants to quit using caffeine but has been unable to do so.
• The person continues using caffeine despite its harmful effects.
• The person experiences withdrawal symptoms when abstaining from caffeine.

How Is Caffeine Addiction Treated?

It can be difficult to find treatment for caffeine use disorder because the condition is often not taken seriously as an addiction. Because caffeine is legal and widely available, a dependency on the drug does not lead to the same sorts of legal and financial risks as addictions to illicit drugs. Caffeine’s effects on the nervous system are also not as pronounced as those of other addictive drugs, leading some doctors and scientists to dismiss the risks of caffeine dependency.

However, recent research has called attention to the prevalence of problematic caffeine use and suggested using education-based treatment programs for people who wish to control their caffeine consumption.

How Does Caffeine Addiction Progress?

Most people do not experience severe, long-term consequences from their caffeine dependence. However, some people might be at risk of health problems from their caffeine consumption. Possible complications include:

• Older people might experience a decline in calcium levels with caffeine use, possibly raising the risk of bone loss.
• Some people might be at increased risk of high blood pressure, heart problems, or stroke while using caffeine.
• Pregnant women who consume more than 200mg (about one large cup of coffee) a day are at increased risk of miscarriage.

How Is Caffeine Addiction Prevented?

Many people who regularly consume caffeine will develop a dependence on the drug, and there is no known way to prevent the condition. However, you can take steps to reduce the possibility that your caffeine use will have adverse health effects, including:

• Don’t consume too much. Most doctors recommend no more than 400mg of caffeine a day. That’s roughly equivalent to four eight-ounce cups of brewed coffee. However, some popular coffeehouse beverages have nearly that much in a single serving.
• Limit your caffeine intake if you are pregnant, trying to get pregnant, or breastfeeding.
• Consult your doctor about caffeine use if you have high blood pressure or heart-related health problems.
• Consult your doctor about caffeine if you are taking medications or dietary supplements. Some over-the-counter decongestants, for example, can have harmful interactions with caffeine.

Caffeine Addiction Caregiver Tips

Some people with caffeine dependency also suffer from other brain and mental health-related issues, a condition called co-morbidity. It is likely that these disorders are merely associated with caffeine dependency and not that caffeine use causes them. Here are a few of the disorders sometimes associated with caffeine use:

• Caffeine use may be associated with attention-deficit/hyperactivity disorder (ADHD) in young people.
• Caffeine dependence and nicotine addiction are often associated.
• People with other substance use disorders often also have a caffeine dependency.

Caffeine Addiction Brain Science

Researchers have long known that some people are more prone to substance abuse and addiction than others. Some of the increased risk can be attributed to an inherited trait that makes certain people respond differently to drugs. Their different responses may make these people more likely to develop a dependence on drugs once they begin using them.

One recent project has looked at a different explanation for why some people are more prone to substance abuse problems. Focusing on the notion that substance abuse and addiction are problems that stem from decision-making errors, a team of scientists at the University of Southern California has suggested that the prefrontal cortex–the part of the brain responsible for impulse control, goal-setting, and prediction of consequences of actions–may be to blame.

The scientists believe that an underdeveloped prefrontal cortex may make an individual more likely to make the choices that lead to substance abuse and addiction–or even to using drugs in the first place. Genetic factors may cause the prefrontal cortex’s underdevelopment, or it may result from a head injury or other environmental circumstances. The team hopes that further research can narrow the search for the root causes of addiction.

Caffeine Addiction Research

Title: Caffeine and Cerebrovascular Reactivity

Stage: Recruiting

Contact: Andriy Yabluchanskiy, MD, PhD     

University of Oklahoma

Oklahoma City, OK

Normal brain function is critically dependent on moment-to-moment adjustment of cerebral blood flow to match the demands of activated neurons. This process is known as neurovascular coupling (NVC), and recent in vivo studies demonstrate that impairment of NVC responses is associated with worse cognitive performance. Several methods are available to measure NVC responses in human subjects, including transcranial Doppler (TCD), functional near-infrared spectroscopy (fNIRS), and dynamic retinal vessel analysis (DVA). Although all these methodologies aim to measure hemodynamic changes in the brain vasculature in response to cognitive, motor, or visual stimulation, the responses are evaluated on the different levels of cerebral vasculature, including microvasculature (fNIRS), large cerebral vessels such as middle cerebral artery (TCD), or in the arterioles and venules of the retina (DVA). Currently, there are limited data available on the simultaneous assessment of NVC responses using these methodologies.

Caffeine is the most commonly used stimulant drug with well-documented effects on cerebral vasculature. Caffeine binds to adenosine receptors in the brain non-specifically and reduces resting blood flow while improving attention and cognitive function, suggesting it may allow a more efficient dynamic blood flow regulation through neurovascular coupling. This study will use a standardized dose of caffeine to test its effect on NVC responses in cerebral and retinal arterioles.

This study is designed to establish the direct link between reactivity in the cerebral and retinal micro- and macrovasculature. To achieve this goal, a prospective, single-blinded, placebo-controlled, cross-over study will be employed to evaluate changes in the NVC responses measured simultaneously with DVA and TCD or DVA and fNIRS before and after administration of 100mg of encapsulated caffeine or a placebo pill.

Title: Remote Guided Caffeine Reduction

Stage: Recruiting

Principal Investigator: Dustin Lee, PhD

Johns Hopkins University

Baltimore, MD

There is emerging evidence that some individuals have difficulty cutting down or eliminating caffeine consumption despite clinically significant problems exacerbated by caffeine use. This study will evaluate whether a caffeine reduction program developed at Johns Hopkins can help people reduce their caffeine use in an online format. Volunteers will participate in an intervention study conducted entirely online, including video visits for screening, instructions for caffeine reduction, and follow-up. The study also involves filling out online surveys sent via email and text message. During screening, participants will be asked questions about their personal characteristics, including demographic information, weekly caffeine consumption, and general medical history. Participants who are determined to be eligible after the screening will be randomized to either the immediate or delayed treatment group. Those in the immediate treatment group will have their next session immediately after screening, while those in the delayed treatment group will have their next session seven weeks after screening. At this session, participants receive a digital copy of a caffeine reduction manual and instructions on gradually cutting down caffeine. After this, participants will complete weekly online surveys over six weeks. Participants will complete two follow-up video visits at 7 and 14 weeks after receiving the caffeine reduction instructions. The investigators will measure caffeine consumption over time using the online surveys and interview questions during video visits. The investigators will also measure how caffeine-related problems may improve during caffeine reduction, such as sleep problems, gastrointestinal issues, and anxiety. During the end of the study sessions, participants will answer questions related to the acceptability of the online format and report on participants’ current caffeine use.

Title: The Acute Effects of Exercise and Caffeine on Working Memory During Acute Caffeine Deprivation

Stage: Not Yet Recruiting

Principal Investigator: Harry Prapavessis, PhD

Western University

London, Ontario

Participants will be asked to keep caffeine consumption before the first visit to their regular dose (ex., morning coffee) and abstain from alcohol and drugs for at least 18 hours prior to testing. Participants will be urged to arrive at the same time for each visit. Upon arrival at the Exercise and Health Psychology lab (located in room 408 of the Arthur and Sonia Labatt Health Science Building at Western University), participants will be given the letter of information and asked to sign the informed consent form. Participants will also be asked to complete a demographic survey, PAR-Q (Physical Activity Readiness Questionnaire) readiness for exercise, Godin Leisure-Time Exercise Questionnaire, CCQ-R (Caffeine Consumption Questionnaire), and the CWSQ (Caffeine Withdrawal Symptom Questionnaire). Vitals (heart rate and blood pressure) will be assessed following the completion of the questionnaires as well as post-assessment in the seated position. Prior to evaluation on the N-back task (cognitive memory task described below), a practice stage will be conducted until the participant can consistently score 75% or higher on three consecutive trials to eliminate a learning effect. After establishing familiarity, a baseline cognition score will be conducted through the n-back assessment.

Before arrival for the second visit, participants will be asked to refrain from caffeine for at least 24 hours and abstain from alcohol and drugs for at least 18 hours prior to testing. During the second visit (approximately 24 hours after the first), the participants will complete the pre-caffeine or pre-exercise questionnaire. The CWSQ and vitals will be monitored pre and post-intervention. Caffeine abstinence will be validated through self-report with the use of deception (participants being told that their saliva sample is being tested for the presence of caffeine). A cotton swab will be placed under their tongue for one minute and placed into a tube to collect saliva. Then a co-investigator will discard the tube into a biohazard deposal container immediately. Participants will then complete another n-back assessment.

The participants will be randomized into moderate-intensity exercise or caffeine ingestion groups. The interventions are as follows: Moderate Intensity Exercise will consist of a 20-minute bout of moderate-intensity aerobic activity. Exercise will consist of a 2-minute warm-up, followed by 15 minutes of walking at a rate, which will allow you to reach 2/3 of your max heart rate (moderate intensity exercise= (220-age) x 0.6), and then a 3-minute cool down on a treadmill (together equaling 20 minutes). HR will be monitored through heart rate monitors worn by the participants. The caffeine ingestion group will ingest 1.2 mg/kg of caffeine in powder form with water to drink. After ingestion of caffeine, participants will wait 20 minutes to ensure peak plasma levels. The post-intervention n-back assessment will begin within two minutes of the completion of either intervention.