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Substance Use Disorder - Caffeine Intoxication

Definition:  

Caffeine intoxication is an over-stimulation of the central nervous system caused by a high dose of caffeine. Caffeine is highly addictive and can cause physical, mental, and psychomotor impairments. Coffee is the most common source of a high intake of caffeine. Other sources of caffeine are tea, energy drinks, soda, chocolate, analgesics, and cold remedies. Caffeine is taken to improve mood, concentration, alertness, and cognitive function. Although caffeine intoxication typically does not last for more than a day, very high doses can require immediate medical attention and be lethal. The most common complaint of caffeine intoxication is interference with sleep. Caffeine intoxication is a growing problem in younger age groups due to the popularity of energy drinks among adolescents and students. For an overdose, a person must ingest more than 250 mg. An 8-6 ounce energy drink has 70-180 mg, an energy shot has 171 mg, and the 24-ounce size can have as high as 500 mg of caffeine.  A cup of coffee contains 100-200 mg.

Symptoms: 

For a diagnosis of caffeine intoxication, an individual must have consumed a high dose of caffeine in excess of 250 mg (2-3 cups of coffee) and display five or more of the following symptoms:

These symptoms must cause distress or impairment in social, occupational and other forms of functioning.  Children or the elderly may experience caffeine intoxication at lower doses.

Causes:  

Regular coffee users build up a tolerance to caffeine. Less frequent coffee users are more susceptible to caffeine intoxication. An increase in caffeine intake can also lead to intoxication. Caffeine dependence can develop with an intake of one or two cups daily.  Energy drinks and caffeine-based weight loss products can also provide risks of caffeine intoxication.

Treatment:

Diuretics may be used to help flush the caffeine out of the body.  In most cases, caffeine’s effects are eliminated within the day. Caffeine intoxication is more often treated as part of caffeine addiction and withdrawal. Psychotherapy, talk therapy and group therapy are used.  The treatment of caffeine withdrawal symptoms is part of any successful treatment program. Symptoms include depression, irritability, anxiety, headache, fatigue and difficulty concentrating. Relieving withdrawal symptoms is a primary reason for relapsing. Relapse rates decline in line with the length of abstinence. Headaches within 12-24 hours of withdrawal are the major withdrawal symptom.  Medication is prescribed for caffeine withdrawal headaches such as aspirin and analgesics.