Tuesday, December 2, 2014

Risks and Addictive Potential

When dealing with a psychoactive substance such as caffeine careful observations regarding the risks of consuming said substance. How much is enough to produce an effect? Are there health risks? Is there a possibility of developing tolerance, or becoming dependent?


Caffeine intake acts primarily as a Central Nervous System stimulant, but it also presents certain peripheral effects. Caffeine has been shown increase blood pressure and cause panic attacks (ref). This is especially true of energy drinks. However, caffeine is not considered a severe drug, as it has a very high lethal dose, making an overdose very difficult.


The effects of caffeine on pregnancy have also been studied. The U.S Food and Drug Administration advises pregnant women to limit their caffeine intake to 400 mg per day. To put this into perspective, 6 oz of brewed coffee contains 100 mg. This is more a precautionary measure, as a concrete relationship has not been established. Several studies have been performed, linking caffeine to spontaneous abortion and developmental malformations. However, studies have also been performed that show no relationship between caffeine and pregnancy success. (Al-Saleh et al., 2010)  


Another concern of caffeine intake is its place in the daily diet, especially of children. Caffeine by itself has not been linked to an effect on weight (ref), but it is important to consider the manner in which it is consumed. In adults, caffeine consumption is mainly via coffee, but children consume products such as chocolate, soda and other sweetened beverages. Caffeine use, in particular in the form of sugar-sweetened carbonated beverages, is associated with higher incidence of overweight in children, and studies show that children who consume more servings of soda per week also consume fewer servings of milk, fruits, and vegetables. (Temple, 2009)


Is caffeine addictive? Addiction is a difficult concept to define, with substance dependence being the more utilized term. Substance dependence is characterized by the presence of tolerance and withdrawal. In a survey conducted in 2013 to different organizations that specialize in addiction, the majority of addiction professionals believe that caffeine withdrawals and dependence are clinically important. (Budney et al., 2013) However, although caffeine can cause dopamine liberation, it does not cause dopamine liberation in the nucleus accumbens, which is the key structure in the brain for reward and addiction.


The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is the primary diagnostic tool of the American Psychiatric Association, lists caffeine intoxication and caffeine withdrawal as substance abuse disorders, and lists caffeine dependence as needing more research. Thus we can see that caffeine is recognized in the medical community as a substance that can be abused, however it lacks reward mechanism characteristic of other drugs.

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