It turns out that we really do need that morning coffee or afternoon soda.
A scientific review that appears in this month's edition of the journal Psychopharmacology reports that half of all adults experience drug-withdrawal symptoms when their coffee or soft drink supply is cut off. The researchers came to this conclusion after poring over more than 60 studies on caffeine withdrawal conducted over the past 170 years.
And 13% of those who part company with caffeine become such a physical mess that they can't work or socialize, the researchers report.
''You get these anecdotes all the time of people who have been switched unknowingly to decaffeinated products and they are just a wreck,'' says Roland Griffiths, a researcher at Johns Hopkins University who led the review.
In fact, the findings may lead to worldwide changes in how doctors view caffeine withdrawal. The first-of-its-kind research review is intended to support a change in two books used by doctors to diagnose and treat patients: the USA's Diagnostic and Statistical Manual of Mental Disorders and the World Health Organizations' International Statistical Classification of Diseases and Related Health Problems.
''This is the beginning of having a formal diagnosis and guidelines,'' Griffiths says. ''It provides an education forum for physicians and health professionals to recognize caffeine withdrawal, which can get confused with differential diagnosis of other illness.''
But Charles O'Brien, an addiction researcher at the Veterans Affairs Medical Center in Philadelphia, says it's too extreme to call coffee lovers caffeine addicts.
The need for coffee ''doesn't produce compulsive, drug-seeking behavior,'' says O'Brien, who served on a panel that rejected an earlier proposal to change the medical manuals. ''People can go without their coffee in the morning.''
While the scientific debate over classifying caffeine withdrawal as a world health problem may lead some people to snort and giggle, Griffiths says the science is serious.
''We know more about caffeine withdrawal than any other drug,'' he says. Researchers in the caffeine studies increased, decreased and cut off caffeine doses while monitoring bodily changes.
Among the withdrawal symptoms found were sometimes-debilitating headaches, fatigue or drowsiness, depression or irritability, difficulty concentrating and flu-like aches and nausea.
People who want to give up caffeine without suffering withdrawal symptoms can avoid the internal trauma by cutting back slowly each day, tapering their consumption to zero, experts say.
But Griffiths asks: Why?
''If you don't have a medical contra-indication and you can afford the drug and you can protect the continuity of your supply, it's not a problem at all,'' he says. ''It's relatively available and cheap.''
With 90% of American adults using caffeine, it's simply important for them to understand the effects of the drug they're using, says Griffiths, who gets no funding from the coffee or soft drink industries.
''Make decisions about your caffeine use, using it as a drug to optimize your functioning instead of willy-nilly taking it here and there,'' Griffiths says.
Giving it up has its own challenges. After being off caffeine for a while, the body needs less to feel its effects. As a result, one innocent cup can do the addict in. Says Griffiths: ''They say, 'Oh wow! I love this stuff,' and they are hooked.''
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