Stimulating Facts About Caffeine

Coffee highs and lows.

[Excerpted from “Caffeine: Pharmacology and Effects of the World’s Most Popular Drug,” by Kyle M. Clayton and Paula Lundberg-Love, in The Praeger International Collection on Addictions Volume 2]:

-- Caffeine dependence is not presently recognized as a clinical disorder in the American Psychological Association’s DSM-IV-TR. Caffeine intoxication, however, is listed as a distinct clinical syndrome. Most of the symptoms of caffeine intoxication resemble symptoms of cocaine or amphetamine overdose: anxiety, insomnia, restlessness, tremor, irritability, rambling speech patterns, and irregular heartbeat. “In adult cases of highly elevated doses,” the authors write, “symptoms such as fever, hallucinations, delusions and loss of consciousness have occurred.”

--In high enough doses, caffeine is extremely toxic and can lead to death. The good news: This almost never happens, since the potentially lethal dose is on the order of 50 to 100 cups of coffee, quickly consumed. There is, however, the theoretical risk that an overdose of caffeine tablets could be fatal.

--Caffeine tolerance develops in a hurry. Tolerance to the sleep-disrupting effects of coffee in high doses can occur after only seven days of consuming 400 mg of caffeine three times a day—using 120 mg per cup as a rough average, that amounts to about ten cups of strong coffee per day. The researchers report that “complete tolerance to subjective effects such as nervousness, tension, jitters and elevated energy were observed to develop after consuming 300 mg three times per day for 18 days, and it is possible that such tolerance can occur within a shorter period of time.”

--Caffeine can interfere with the effectiveness of benzodiazepines and other medications that act on the neurotransmitter GABA. “Caffeine can inhibit the binding of benzodiazepines to their specific receptors on the GABA-A receptor sites, therefore neutralizing the effects of such medications and inhibiting their sedative hypnotic effects. Such interactions should be considered when evaluating the effectiveness of medications used to treat insomnia.”

--Conversely, caffeine can enhance the effectiveness of pain relievers. In particular, caffeine allows for faster absorption of headache medications, producing faster relieve at lower doses. Nicotine increases the rate at which the body metabolizes caffeine. Abstinent cigarette smokers often discover that their usual intake of coffee causes jitters and a bad stomach once they quit smoking. Some researchers have speculated that a high level of caffeine intake during smoking cessation might cause an increase in nicotine withdrawal symptoms.

Photo Credit: www.healingwithnutrion.com

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Coffee and Cigarettes

Recovering alcoholics and their drugs.

It's no secret that alcohol and cigarettes go together. And it is common knowledge--and an AA truism--that recovering alcoholics take to strong black coffee like ducks to water.

Now comes a study of Alcoholics Anonymous participants in Nashville, to be published in the October issue of Alcoholism: Clinical and Experimental Research, which verifies the obvious, with a twist. Of 289 AA members interviewed by Dr. Peter R. Martin and coworkers at the Vanderbilt Addiction Center, 56.9% of respondents were cigarette smokers (approximately 20% of all adult Americans smoke cigarettes).

When it came to coffee, however, 88.5% of AA attendees were coffee drinkers, and a third of them drank more than 4 cups a day. "The most important finding," said Dr. Martin in a Vanderbilt University press release, "was that not all recovering alcoholics smoke cigarettes while almost all drink coffee."

Does all that coffee guzzling and cigarette smoking help or hinder recovering alcoholics in their quest for sobriety? The answer is: nobody quite knows. Dr. Martin, professor of psychiatry and pharmacology at Vanderbilt and lead investigator of the study, entitled "Coffee and Cigarette Consumption and Perceived Effects in Recovering Alcoholics Participating in Alcoholics Anonymous in Nashville, TN," put it this way in Science Daily: "Is this behavior simply a way to bond or connect in AA meetings, analogous to the peace pipe among North American Indians, or do constituents of these natural compounds result in pharmacological actions that affect the brain?"

"It's possible that coffee is even a gateway drug, with coffee drinking beginning at about the time persons begin using alcohol," said Robert Swift of the Brown University Medical School. "In addition, a potential negative interaction is coffee's known negative effects on sleep."

Selena Bartlett of the Ernest Gallo Clinic and Research Center of the University of California, San Francisco, offers the same concerns about cigarettes. A reliance on smoking by recovering alcoholics has a biological basis, she believes, and may increase the odds of relapse. In a HealthDay article by Steven Reinberg, Bartlett said: "My prediction would be that the relapse rates among smokers is higher." Since nicotine and alcohol addiction are so often found together, Bartlett thinks they should also be treated together, and is studying the anti-smoking drug Chantix for this purpose. "The drug inhibits the effect of nicotine, and by doing that, you may also reduce the euphoric effects of alcohol at the same time," she said. "We already have some evidence that it may work."

Varenicline, currently marketed by Pfizer for smoking cessation under the trade name Chantix, caught the attention of alcohol researchers when it dramatically curbed drinking in alcohol-preferring rats. The synthetic drug was modeled after a cytosine compound from the European Labumum tree, combined with an alkaloid from the poppy plant. An estimated 85 per cent of alcoholics are also cigarette smokers. (Chantix has lately been implicated, along with a dozen other anti-seizure medications, in suicidal ideation in some patients).

"I think it is important for alcohol researchers and clinicians to know that alcoholics, even those who do not use other illicit drugs, are not just addicted to alcohol, but use other psychotropic drugs like caffeine and nicotine," said Professor Swift of Brown University. "A second important aspect is the finding that rates of smoking are much higher in alcoholics in recovery than in the general population.... Yet, AA tolerates or otherwise does not address smoking in its members."

Dr. Martin said that more detailed analyses of the results will help determine "whether these changes in coffee and cigarette use are predictive of recovery from alcoholism per se."

Photo credit: AA-Carolina.org


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