The term “psychoactive drug” understandably intimidates many people. Psychoactive drugs are substances that impact brain functions, and they include things like cocaine, LSD, and MDMA (or ecstasy).

When considering psychoactive drugs along those lines, it’s not difficult to understand the inherent concern people may react with when discussing them.

However, things like Benadryl and Ritalin also count as psychoactive drugs, and while both of those drugs can be and are used in ways not intended by their manufacturers, they are still considered acceptable in general society.

An even more accepted psychoactive drug, however, is the central nervous system stimulant known as caffeine.

According to the Food and Drug Administration, 80 percent of adults in the United States consume caffeine in some form. These forms include coffee, tea, supplements, and even things like chocolate and painkillers.

Because of the psychoactive nature of caffeine and the frequency with which people consume it, concerns over caffeine dependency and possible addiction have haunted the world of medicine and public health for decades.

A 2013 survey report published in the Journal of Caffeine Research said, “The majority of addiction professionals believe that caffeine withdrawal and dependence disorders exist and are clinically important.”

“However,” the report went on the say, “these professionals are divided in whether caffeine withdrawal and dependence should be included in [the] DSM.”

Both the World Health Organization and the American Psychiatric Association recognize caffeine withdrawal – the symptoms following a quick and drastic decrease in regular caffeine consumption – as significant health concerns.
Caffeine withdrawal symptoms include, but are not limited to, the following:
•Headaches
•Nausea
•Fatigue
•Impaired motor functions
•Depression

A study performed by Virginia Commonwealth University found that “one-fifth (20.6 percent) of current caffeine users reported [one or more] symptoms of withdrawal, with headaches most prevalent.”

However, withdrawal isn’t the only caffeine-related ailment that comes with side effects.

Caffeine dependency causes its own issues.

According to Johns Hopkins Medicine, caffeine dependent individuals “report an inability to quit or to cut down their caffeine use,” even when they face adverse effects to their mental and physical health.

The Diagnostic Statistics Manual of Mental Disorders, 4th edition (DSM-IV), has specific criteria for what constitutes substance dependency. The list is as follows:
•Substance tolerance
•Withdrawal symptoms
•Substance taken in large amounts or over long periods of time
•Persistent desire to control use
•A great deal of time dedicated to obtaining, using, or recovering from substance
•Important activities given up because of substance
•Continued use despite noticeable substance-related problems

To be considered dependent on a substance, one must fit at least three of the aforementioned criteria.

“In a random digit-dial telephone survey in which all seven DSM-IV criteria for substance dependence were assessed, 30 percent of caffeine users fulfilled diagnostic criteria,” Johns Hopkins reported.

Mary Beth Williams, a UIS graduate student and a full-time employee with the Memorial Behavioral Health affiliate, considers herself dependent on caffeine.

“I started drinking coffee at my first real job out of school,” she said. On her first day on the job, Williams drank six cups of black coffee.

One 6-ounce cup of black coffee typically contains 100 mg of caffeine. The recommended maximum for an adult’s daily caffeine intake is 400 mg.

“I was all jittery,” she said. “But there was something about it I kind of loved.”

However, Williams eventually reduced her daily caffeine consumption after a few bouts of insomnia. Williams now drinks three or four cups of coffee a day and hopes to cut back further.

“That’s probably going to be one of my goals for 2017,” she said.

Another UIS student, Allen Dixon, shares Williams’s taste for coffee, but not her concerns.

Dixon estimates that when he drinks coffee, he drinks roughly a pot a day. The average pot holds up to 12 cups, or 96 ounces, of coffee, though some range smaller.

Regardless, Dixon’s caffeine consumption still exceeds the recommended maximum of four cups per day.

This being said, Dixon has yet to notice any side effects.

“There are certain days when I don’t drink any caffeine at all,” he said. “I can go days without needing the caffeine.”

Dixon also noted that on days when he does drink a pot or two of coffee, he has no issues sleeping.

“I guess it doesn’t affect my brain chemistry as much as it may affect others’,” he said.

The differences in Williams’s and Dixon’s situations are not unheard of, or even uncommon. Various studies, including the Virginia Commonwealth study, found that women suffer from caffeine dependency and withdrawal symptoms more often than men.

“Among coffee drinkers, women continued to report caffeine withdrawal at higher rates than men,” the study reported. “Similarly, among [energy drink] consumers, women were twice as likely as men to report caffeine withdrawal.”

And these symptoms can be severe.

While an addiction to caffeine may not be as detrimental as an addiction to other psychoactive drugs, it’s still impactful to various aspects of one’s health.

An addiction to caffeine can trigger spells of anxiety and depression, as well as exacerbate other pre-existing mental health conditions. It can also impact physical health by inducing insomnia, as happened to Williams.

“Caffeine administered immediately prior to bedtime or throughout the day has been shown to delay sleep onset, reduce total sleep time, alter the normal stages of sleep, and decrease the reported quality of sleep,” Johns Hopkins reported.

Still, caffeine consumption is a daily reality for 80 percent of adults in the United States, and 90 percent of adults across the world. It’s playfully, and accurately, referred to as “the most commonly used psychoactive substance in the world.”

The sheer volume of people who regularly consume caffeine, regardless of its side effects, brings up the question of “why?”

In the end, Williams and Dixon, two people with similar stories yet noticeably different results, summarized it best.

When asked if the benefits of caffeine – helping them wake up in the morning, power through busy days, and stay alert for classes – outweighed the potential negative impacts, both Williams and Dixon independently answered, “Definitely.”