Caffeine: Addiction; Toxicity; Overdoses

[JamesWhitehead]

http://www.guardian.co.uk/Columnists/Column/0,5673,792944,00.html



Ticked off with caffeine

For years, Pro Plus has helped students hit essay deadlines. But is it really just a harmless pick-me-up?

John Sutherland
Monday September 16, 2002
The Guardian

School's back from summer. Stock up on condoms, hangover remedies and - of course - Pro Plus. These are the little student helpers prominently on display in every college shop.
What is Pro Plus? The truly instant coffee. Every pill contains 50mg of caffeine - about as much as your wake-up doppio (no foam, no frills, all kick).
Pro Plus is as essential a part of the modern student's toolkit as the mobile phone. As the company's website boasts: "Whether you are studying for exams, burning the candle at both ends, or simply exhausted from overwork, the caffeine in Pro Plus will help relieve your tiredness to keep you on track. Pro Plus has reached cult status in universities and the workplace, relieving the temporary tiredness of studying students and weary workers alike - not to mention those compulsive clubbers and passionate partygoers."
The Pro Plus pack is emblazoned with a huge tick. "Swallow me and win your prof's approval," is the message. The cost is around 10p a pill. It beats Starbucks.
Gloom-mongers will see Pro Plus's "cult status in universities" as proof that today's student is being performance-enhanced to destruction.
This analysis is supported by that sad story, two weeks ago, about a first-year chemistry undergraduate at Cardiff University who consumed four 96-pill cartons of Pro Plus and died. He had, apparently, researched caffeine toxicity with scholarly thoroughness. Alongside the body notes were found. One read: "It is not having too much effect." Another said: "I want to die." He did. The court was told that he had "been doing well in his course and was scoring highly in the forensic chemistry module." Verdict: suicide. A death for our times.
The dosage instructions on the Pro Plus packet are crystal clear: "One to two tablets with water. Do not exceed two tablets in any one hour or 12 tablets in 24 hours."
If you inadvisedly wash it down with Pepsi (30mg), Red Bull (80mg), or munch a chocolate bar (150mg), your caffeine intake will be boosted. Caffeine LD (lethal dose) kicks in at 75mg per kilogram of body weight (around 200 Pro Plus pills for the average adult). Heart damage can start at lower levels; sleep disturbance with relatively small amounts.
Students don't drink or eat sensibly, or rigidly practice safe sex. Will they be sensible about caffeine intake? Nanny states, such as Canada, have made the pills prescription-only. The International Olympic Committee is also strict: three Pro Plus and you're in the sin bin with Alain Baxter.
Even if used as advised, or moderately abused (which is probably the general pattern), it is the installation of stimulants ("tiredness relievers") as a routine educational aid that niggles. If a pill for week-night studying why not a pill for weekend clubbing? If Pro Plus, why not ecstasy?
Pro Plus was launched in 1956. It was the year I came up for my A-levels. For some time, strong amphetamines had been available over the counter as slimming aids. The stimulant of choice in my sixth form was Preludin. An obscure rock group, founded in Liverpool in that same year, were also frying their heads with "Prellies".
Alas, Preludin (phenmetrazine) was put on Schedule 4 of the Poison Rules in 1957. No longer would your friendly chemist supply it, no questions asked, for your (mythical) overweight sister. For me and my mates, Pro Plus filled in - less kick, but legal. The Beatles bravely explored other substances.
Let's not ban Pro Plus: leave that to the wimpy Canadians. But let's, with all the other advice we give students, warn them that undiluted caffeine is not a harmless pick-me-up, but a powerful drug. Big ticks to that.

 

[Anonymous]

Hmm. There are surely easier ways to stay up? Or you could go to bed at a reasonable hour and get up early so you can study all day? Just a thought.

 

[Yithian]

Friday, 30 August, 2002, 12:54 GMT 13:54 UK
Student caffeine tablet suicide
A south Wales chemistry student who killed himself by overdosing on caffeine may have been lying dead in his flat for six days before being discovered.
An inquest in Cardiff heard that James Christopher Bird, 20, was last seen alive by his friend David Semp at Cardiff University's Talybont halls of residence on 24 January.

Sergeant Warren Poole said a receipt revealed that hours later the first-year student bought four boxes of the over-the-counter stimulant Pro Plus at a local supermarket.

Phone ringing

His friends thought he had gone home to visit his family in Hereford for the weekend.

They became concerned when they had not seen him for several days, but heard his mobile phone ringing unanswered in his room.

David Semp contacted security staff on 31 January at the halls and Mr Bird's body was found on the bed in a decomposed state.

Sgt Poole told the inquest that several handwritten notes were found in the room.

Website research

One of the notes showed calculations working out how much caffeine would be needed to kill someone.

A search of Mr Bird's computer also found that he had been looking at websites about caffeine on the internet.

One note stated: "It is not having too much effect." Another said: "I want to die."

Despite a comprehensive investigation, no reasons were found for Mr Bird to take his own life.

Cause of death

He had been doing well in his course and was scoring especially highly in the forensic chemistry module.

Pathologist Dr Alan Gibbs told the inquest that the cause of death was overdose of caffeine.

A total of 150mgs of caffeine was found in 100mls of blood - enough in Dr Gibbs's view, to cause death.

Recording a verdict of suicide, Cardiff and Vale coroner Dr Lawrence Addicott said that while James had wished to die, there did not seem to be a clear reason why.

 

[Min Bannister]

I have seen the effect of someone trying to do an endurance run on two cans of red bull, I thought he was going to DIE. He recovered OK, but I guess, just like anything else you can't really blame the caffeine pills, like it says, the instructions are pretty clear and if someone is going to kill themselves, they will do it anyway. Must be a pretty horrible way to die though.

 

[Anonymous]

I have seen the effect of someone trying to do an endurance run on two cans of red bull, I thought he was going to DIE.

Sometimes they do...

 

[OneWingedBird]

An ex flatmate of mine used to take Proplus, she said it made her so hyper that one of her lecturers asked her if she was on drugs, she took loads while cramming for exams, then complained that she couldn't sleep for about 3 weeks afterwards.

*sings*

One pill makes you larger
One pill makes you small
But 388 caffeine tablets
Will kill you in the hall

 

[Timble2]

Back in the mid 70s...

We used to speculate in Pharmacology how much caffeine it would take to kill you. We figured that you could do more damage by putting the pills you'd need into a sock and clubbing someone to death. We reckoned you could drown in the coffee you'd need.

BTW never drink six Red Bulls, unless you really want a horrific headache as the effects wear off.

 

[Anonymous]

i may of talked about the daft amount of pro plus i took during my a-levels and first two years of uni on another thread. but has anyone ever noticed that it can give you a really dodgy stomach i you take aload.

i still preferre black coffee and ciggerettes to keep you awake - too much of that and you feel so made you wn't sleep for hours!

 

[Anonymous]

Caffeine pills should be prescription only. It may take 500 pills to kill someone but it only takes a few a day to turn them into a walking zombie. Everybody reacts differently to artificial stimuli, just because Pro Plus is harmless to you as an individual does not mean that it is harmless to the general population. The number of caffeine addicts here in America is disguisting. I hope the manufacturers of Red Bull drown in their own foul caffeinated syrup.

.....in other words: I recommend taking caffeine-free products.

 

[mejane]

An ex flatmate of mine used to take Proplus, she said it made her so hyper that one of her lecturers asked her if she was on drugs, she took loads while cramming for exams, then complained that she couldn't sleep for about 3 weeks afterwards.

Er, she was on drugs

I managed to get through Uni with nothing more than a packet of ciggies and two pots of coffee a day - never needed drugs On the other hand, I did fall asleep during an exam once...

Jane.

 

[Beakmoo]

Caffeine is a nasty insidious drug. Both me and Hubcap get anxiety attacks from it, so we came off it years ago. Which was all fine until one day at work when I was having particular trouble staying awake (I can fall asleep sitting at my desk), and added a bit of caffeine coffee on the end of a teaspoon to my regular decaff. It felt good. Now I have it every work day, and on the days I don't work (every second day) I've started getting headaches. I'm only having less than half a teaspoon a day!
I refuse to have any in the house though, that really would be the slippery slope to another breakdown. :eek!!!!:

 

[inkedmagiclady]

Caffeine depletes the adrenal system, and makes for more stress on the body in the long run. I drink way too much coffee, and I need to cut down.

I did at one time experience anxiety attacks which are NOT fun especially if you have never had one and you don't know what is happening! Coffee did not help the matter.

The area where I live has a Starbucks on almost every corner. Seems I am not the only one with a caffeine addiction!

 

[The_Discordian]

On the subject of caffeine overdoses:

I once drank six cans of Red Bull in about an hour; I'd had a heavy night the night before, had to help run a stall at a fete in the blistering heat during the afternoon, AND was working collecting glasses in the pub in the evening...and I was a trembling wreck by late afternoon. I had to call in sick in the evening.

And a friend of mine claims to once have eaten 24 Pro-Plus in a cake. And felt rather the worse for wear afterwards:cross eye .

 

[Breakfastologist]

One of my friends knocked back a bunch of pro plus and about a litre of green tea one night before going clubbing. Shortly afterwards he turned green and started shaking. His housemates persuaded him to make his way to A & E who thought the whole thing hilarious in a "It won't do you any harm- normally we'd just suggest a patient sleep this off, but ... you can't" kind of way.

 

[JamesWhitehead]

Ironically, this thread slept for a whole year until Caroline revived
it!

The lethal dose of caffeine is so high that it seems impossible to kill
yourself with it inadvertantly. However, I agree with the posters who
have found it a disturbing experience at far lower doses.

Anxiety, bad temper and a bad stomach are symptoms I recognize from
over-indulgence. I do enjoy really good fresh coffee but most days
I avoid it in favour of some instant swill, which carries a very low dosage.

The worst effects have always been from espresso, where the steam
brings a maximum blast of flavour and poison into the cup. Filter
coffee is much less evil, unless made ultra-strong. Somewhere between
is the now rather retro Cona method. I can't remember when I last fired
up one of my fifties originals; the coffee never meets boiling water but it
remains in contact slightly longer than it does in a filter.

 

[OneWingedBird]

I used to keep a one cup capacity Caffetiere o my desk at work, usually when I got in I was so asleep still that I'd make the first cup ludicrously strong without realising.

I always figured that if I could rebrew it for the 3rd time and it was still drinkable it meant the first cup must have been ridiculous.

 

[inkedmagiclady]

I always figured that if I could rebrew it for the 3rd time

Ack!!! :blah:

 

[JamesWhitehead]

I seem to recall some research from ten or more years ago which
suggested there were dangers in boiling or reheating coffee. It
came, IIRC, from a Scandinavian country where the preferred method
involved boiling coffee on the stove top.

The scare story suggested that it was bad for the heart.

 

[ramonmercado]

First they push alcohol-free "beer". Now they say we're nuts if we like coffee!!!

grrr

Caffeine Addiction Is a Mental Disorder, Doctors Say

George Studeville
for National Geographic Magazine

January 19, 2005
Question: What do heroin addicts who receive a daily dose of methadone have in common with people who feel they cannot function without that morning cup of caffeine?

Answer: They are tending to their addiction—keeping the physical devils of drug withdrawal at bay.


As writer T.R. Reid pointed out in his January 2005 National Geographic article, "Caffeine," researchers agree that regular caffeine use triggers a physical dependence, a mild form of addiction.

The article describes how some heavy caffeine users grow irritable, get headaches, or feel lethargic when they can't get that coffee, soft drink, energy drink, or cup of tea. (See a photo gallery of the many forms of caffeine.)

But should those effects of caffeine withdrawal be classified as a definite psychological disorder?

Yes, contends Roland Griffiths, a professor of behavioral biology and neuroscience at the Johns Hopkins School of Medicine in Baltimore, Maryland.

Griffiths, who helped review the caffeine article in National Geographic, is a principal author of a comprehensive caffeine-withdrawal study. He hopes the report presents a strong case to include caffeine withdrawal in the next edition of the Diagnostic and Statistical Manual of Mental Disorders.

Known as the DSM, the manual is published by the American Psychiatric Association. Mental-health practitioners use it to help identify conditions and treatment strategies. The next edition will be published in 2010.

In addition, Griffiths believes that the diagnosis criteria for caffeine withdrawal should be updated in the International Statistical Classification of Diseases and Related Health Problems, a medical manual used by the World Health Organization.

His conclusions are based on a review of more than 170 years' worth of scientific research and published medical observations on the physiological affects of caffeine and its withdrawal symptoms.

The researchers cited 57 experimental studies and 9 survey studies to support their recommendations for including caffeine withdrawal in the DSM. Their study was reported in the October 2004 issue of the journal Psychopharmacology.

"Doctors and other health professionals have had no scientifically based framework for diagnosing the syndrome," said Griffiths, explaining why he undertook the research project.

In an interview, Griffiths said that the studies had demonstrated that people who take in as little as a hundred milligrams of caffeine per day—about the amount in half a cup of coffee—can acquire a physical dependence that would trigger withdrawal symptoms.

"Although most regular caffeine users know that caffeine is a mild stimulant, many are not aware that abrupt cessation can sometimes produce unpleasant withdrawal symptoms," Griffiths said.

The studies suggested five clusters of common withdrawal symptoms:
• Headache
• Fatigue or drowsiness
• Depression or irritability
• Difficulty in concentrating
• Flulike symptoms including nausea, muscle pain, and stiffness

Griffiths said that the studies consistently indicated that at least half of regular caffeine consumers would experience withdrawal symptoms if they abstained. And, he added, that the research showed that symptoms could flare up regardless of what type of caffeine product was used.

"With regard to severity, 13 percent of people had clinically significant distress or functional impairment," Griffiths added. "At its worst, caffeine withdrawal involved missing work, canceling social functions, and going to bed with the belief that they had the flu."

The onset of symptoms, research indicated, occurred within 12 to 24 hours after stopping caffeine intake. Peak unpleasantness occurred within the first two days, but other symptoms could continue for as long as nine days.

An interesting finding of the research, Griffiths said, is that regular caffeine consumers may use it more to stave off withdrawal symptoms than to simply enjoy the product.

[Emp edit: Addin in the Source

 

[Timble2]

I drink far too much coffee, seven or eight cups a day, but on the odd days when I've not had any coffee or other caffeine containing drinks or food and on my periods of herbal tea drinking, I've never had those withdrawal symptoms.


Sounds like another attempt to medicalise something that isn't really much of a problem...the missing social engagements and work bit is I suspect down to rather more issues than caffeine withdrawal alone.

 

[Beakmoo]

When Hubcap went to group therapy for anxiety, they of course mentioned caffeine as a possible contributary factor. One woman was astounded at this, and reckoned her crippling anxiety problems could all be down to her coffee consumption. So they asked her how much she drank................40 to 50 cups a day :shock: :shock: "14 or 15?" they said. Noooo, 40 to 50 it was.
I wouldn't like to experience her withdrawal symptoms, poor ignorant cow.

 

[Anome]

Timble: Not so. Just because you don't suffer withdrawal doesn't mean others don't suffer real withdrawal symptoms.

The same happens with Heroin, Tobacco, etc. Some people can quit in an instant, others never do quit despite trying.

I don't know about calling it a mental illness. If you do that, then so is any form of addiction, including alcoholism.

 

[Timble2]

Actually, I should probably add that while I don't get withdrawal symptoms if I drink too much (around 15 cups filter coffee) I either get into into an "I'm going to rip off the head of the next person who annoys me and pee down their neck" mood , or get to a near panic attack state....

I just don't get withdrawal symptoms...

Sorry, my first post came out a bit sharper than it was meant to...just a bit fed up of every bit of human behaviour being medicalised...and I'm on my seventh coffee BTW.

 

[Stormkhan]

I am not addicted to coffee.
I am dedicated to it.
Ever since chewing whole roast coffee beans like sweeties while studying at school, my taste for coffee is one of those things in life that no amount of over-funded scientists with an axe to grind are going to stop!

To paraphrase Charlton Heston:

"They'll have to prise my Espresso machine out of my cold, dead fingers!"

 

[Electric_Monk]

I hate coffee I don't mind tea though, but don't drink it very often as it's a pest (got to boil kettle, wait for teabag to release some flavour, mix in lots of sugar, wait for it to cool down). The only source of caffeine I really consume is chocolate, and I try not to eat too much of it anyway (and it's not meant to be nearly as strong as coffee).

 

[Rubyait]

I always hated coffee until i started working in a restaurant.We had a 8K coffee machine and after a few samples (which i was practically forced to try as my work colleagues insisted) i am now an avid drinker of the stuff.Mind you i dont drink instant as i think it tastes like nat piss but proper coffee is sooooooooooo good!!

 

[lopaka]

What's funny is that the article in the January issue [EDIT: of National Geographic] is mostly an ode to The World's Most Popular Psychoactive Drug. The piece on Griffiths' anticaffeine research does not appear. Some bits from the hard-copy version w/commentary:

So while, yes, it is drug

Repeated studies have shown that caffeine is analeptic (it stimulates the central nervous system) and ergogenic (it improves physical performance).

It's a nice buzz

As a mental stimulant it increases alertness, cognition, and reaction speed;

with little apparent downside

And despite its nearly universal use, caffeine has rarely been abused.

and not only is it not bad for you

The consensus view seems to be that [caffeine]...is not dangerous at moderate levels of consumption.

but in fact

much of the research suggests that caffeine may have benefits for human health.Studies have shown it can help relieve pain, thwart migraine headaches, reduce asthma symtoms, and elevate mood.

Given all this I somehow don't imagine Dr. Griffiths crusading will get very far...and showing that regular use of caffeine leads to mild withdrawal symptoms if one stops isn't exactly a fresh angle on the research.

I love coffee, if you can't tell.

 

[Beakmoo]

I don't know about it being that harmless Lopaka. There are a lot of people out there with mild to severe anxiety and heart palpitations caused by caffeine. Some are more sensitive to it than others I suppose, and it's not as widely known as it should be that it's possible to ruin your life with the stuff if you are sensitive.

 

[ramonmercado]

beakaboo wrote:

it's possible to ruin your life with the stuff if you are sensitive.

yeah but you can kill yourself with a trace of peanut if you are allergic to it. lets get a grip. there are far more dangerous substances out there.

 

[Beakmoo]

beakaboo wrote:

it's possible to ruin your life with the stuff if you are sensitive.

yeah but you can kill yourself with a trace of peanut if you are allergic to it. lets get a grip. there are far more dangerous substances out there.

I suppose so, and I'm against medicalising (if that's the word) a simple addiction to coffee, but saying it's harmless just isn't true.
it's beakboo by the way