Caffeine is the most commonly consumed intoxicant in the world and caffeine dependence the most common substance addiction. People can become physically dependent on coffee, tea, colas and energy drinks, even chocolate.
A study found that only three days of 300 mg of caffeine a day caused withdrawal symptoms upon discontinuation. A slightly longer use of 100 mg caffeine a day – corresponding to just about one cup of coffee or 2-3 cups of tea – can produce withdrawal symptoms. In children even 50 mg a day appears to be enough.
Caffeine Withdrawal Symptoms
The most common caffeine withdrawal symptom is headache. It likely explains why many people get headaches during the weekends, when consumption of caffeinated beverages tends to be lower. It even seems to be the reason why many people get a headache after surgical operations.
Other possible withdrawal symptoms include tiredness, irritability, nausea, sweating, tremor and flu-like symptoms. Mood and even motivation, concentration, self-esteem and sociability can suffer.
Caffeine withdrawal symptoms last from one day to up to more than a week. They tend to be at their worst after one to two days. Even a very small dose of caffeine can relieve the symptoms.
Individual Differences in Addiction Potential of Caffeine
Normally the effects of caffeine last for three to six hours, but the speed of caffeine metabolism varies widely between individuals, with differences up to 10 times in magnitude. Alcohol slows down caffeine metabolism, while smoking shortens its half-life.
Pregnancy and contraceptive pill use slow down caffeine metabolism. Some other drugs like some antibiotics, antifungals and the antidepressant fluvoxamine (Luvox) also have the same effect.
The duration of caffeine effects may explain why some people become more addicted to caffeine.
Is Caffeine Addiction Harmful?
Whether addiction/dependency is inherently bad is more of an ethical issue than a medical one. Caffeine has many health benefits, as do other constituents of coffee, tea and cocoa (energy drinks and colas, on the other hand, should be avoided!), but there are some people who should avoid it.
People who suffer from anxiety or psychosis should avoid caffeine, preferably altogether. Pregnant women should limit their intake to very small amounts, no more than 200 mg a day, as larger amounts appear to increase the risk of miscarriage and other pregnancy complications. Caffeine may also cause problems for some people with epilepsy or heart arrhythmias.
The biggest problem with caffeine dependence is the often stark drop in performance and icky symptoms, if for some reason consumption of caffeine is not possible.
Many coffee drinkers also have unrealistic ideas about the benefits of caffeine. Most are not "making themselves more alert" but feeding their withdrawal symptoms. By avoiding dependency they could actually derive stimulant effects from occasional use of the drink.
How to Avoid Caffeine Addiction
As shown above, caffeine addiction develops quickly, insidiously and by using low dosages. Those who want to consume caffeine but avoid dependency should not have it every day. Besides tea and caffeine, this also includes chocolate, at least dark chocolate, as well as coffee flavoured desserts like ice creams or puddings.
Hot chocolate and decaffeinated coffee and tea do contain small quantities of caffeine, but in reasonable quantities should not pose a problem. White tea is often advertised as being low on caffeine, but in fact it often has a higher caffeine content than either black or green tea.
Most herbal teas are naturally caffeine free (including rooibos and honeybush), save for yerba mate. Carob does not contain caffeine, either. There are also some herbal "coffee substitutes".
There are some other naturally stimulating foods and herbs one can use in place of caffeine.
References
Evans SM, Griffiths RR. Caffeine Withdrawal: A Parametric Analysis of Caffeine Dosing Conditions. J Pharmacol Exp Ther. 1999;289:285-294.
Fennelly M, Galletly DC, Purdie GI. Is caffeine withdrawal the mechanism of postoperative headache? Anesth Analg. 1991 Apr;72(4):449-53.
Chambers, Kenneth P. Caffeine and Health Research. Nova Biomedical Books 2008.
Join the Conversation