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New Study Describes "Caffeine Dependence Syndrome"


September-October 1994

A study in the October 5 issue of the Journal of the American Medical Association gives a name to the headaches, slowness, and occasional depression associated with caffeine withdrawal, calling those symptoms "caffeine dependence syndrome" (Eric C. Strain, Geoffrey K. Mumford, Kenneth Silverman, and Roland R. Griffiths, "Caffeine Dependence Syndrome: Evidence From Case Histories and Experimental Evaluation," JAMA, vol. 272, no. 13 (Oct. 5, 1994): p. 1043-1048; John Schwartz, "Caffeine Craving Gets Official Name," Washington Post, Oct. 5, 1994, p. A3).

The study by researchers at the Johns Hopkins University School of Medicine classifies caffeine withdrawal symptoms under the categories in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which defines the criteria for substance abuse diagnosis. "Subjects can be intoxicated with the excessive use of caffeine and  ... caffeine can produce a withdrawal syndrome when subjects stop habitual use ... subjects also can become clinically dependent on caffeine" (p. 1048).

94 percent of the 27 people in the study exhibited symptoms of dependence -- experiencing withdrawal when no longer using caffeine and persisting in their use of the drug despite physical or psychological problems they blamed on caffeine use. The study's authors were quick to point out that they do not think caffeine users should necessarily stop using the drug unless it causes physical or psychological problems.

The study raises questions about the regulation of caffeine products. The Food and Drug Administration is currently looking into the regulation of tobacco products, arguing that nicotine is an addictive substance. Groups opposing tobacco regulation have argued that substances like caffeine could be next on the FDA's agenda. According to Patricia Schwartz of the FDA, foods containing natural caffeine (chocolate, for instance) are not regulated. The agency does monitor the labeling of products with added caffeine (soda, over-the-counter stimulants) and sets maximum levels a product can contain.