Caffeine Use Disorder: A Review of the Evidence and Future Implications

Abstract

The latest edition of the Diagnostic and Statistical Manual (DSM-5) has introduced new provisions for caffeine-related disorders. Caffeine Withdrawal is now an officially recognized diagnosis, and criteria for caffeine use disorder have been proposed for additional study. caffeine use disorder is intended to be characterized by cognitive, behavioral, and physiological symptoms indicative of caffeine use despite significant caffeine-related problems, similar to other Substance Use Disorders. However, since nonproblematic caffeine use is so common and widespread, it may be difficult for some health professionals to accept that caffeine use can result in the same types of pathological behaviors caused by alcohol, cocaine, opiates, or other drugs of abuse. Yet there is evidence that some individuals are psychologically and physiologically dependent on caffeine, although the prevalence and severity of these problems is unknown. This article reviews the recent changes to the DSM, the concerns regarding these changes, and some potential impacts these changes could have on caffeine consumers.

Mechanisms of the psychostimulant effects of caffeine: implications for substance use disorders

“…According to the DSM-5, this higher threshold is intended to prevent over-diagnosis of caffeine use disorder given the prevalence of non-problematic caffeine use in the general population (American Psychiatric Association 2013). Even though there is a substantial amount of studies and reports indicating that a subset of caffeine users develops clinically significant symptoms severe enough to seek treatment (Juliano et al, 2012; Budney et al 2015), there is no agreement about the real health danger upon caffeine regular consumption (Addicott 2014). The difficulties in accepting caffeine use disorder parallels the preclinical evidence for the relatively mild reinforcing effects of caffeine as compared to those of prototypical psychostimulants.…”

Concurrent Validity of Caffeine Problems and Diagnostic Criteria for Substance Use Disorders

“…''Harm,'' ''Time,'' and ''Crave'' criteria were all endorsed significantly more frequently in relation to caffeine compared to either alcohol or marijuana. ''Withdrawal'' was endorsed more frequently in relation to caffeine than 17.6% have an alcohol disorder, which is more than expected by chance). **p < 0.01 for chi-square analyses showing relationship between column and corresponding row (e.g., of those who endorsed caffeine use within the past 30 days, 43.8% report past-year alcohol use, which is more than expected by chance).…”

“…For example, combining alcoholic drinks with caffeine may offset the subjective intoxicating effects of alcohol, 17,18 contributing to increased intake. It is also possible that adolescents with alcohol or marijuana problems cannot distinguish which substance is causing a problem (such as withdrawal symptoms) and they may incorrectly attribute.…”

Therapeutic Opportunities for Caffeine and A_2A Receptor Antagonists in Retinal Diseases

“…It is well recognized that repeated exposure to caffeine results in rapid tolerance and will lead to withdrawal symptoms, which happens when an abrupt cessation or reduction occurs after a prolonged daily use of caffeine [75]. Despite these effects, caffeine has a weaker reinforcing efficacy when compared with classical psychostimulants, which means that caffeine does not have the ability to maintain self-administration or choice behavior [71].…”