Caffeine Use Disorder: A Comprehensive Review and Research Agenda

Ok, I'm probably a caffeine addict. You'll have to pry it from my cold dead hands or find the cure to stroke fatigue. Great, I now have a mental disorder to join my other ones.

Caffeine Use Disorder: A Comprehensive Review and Research Agenda

Steven E. Meredith,¹ Laura M. Juliano,² John R. Hughes,^3,4 and Roland R. Griffiths^1,5

¹Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

²Department of Psychology, American University, Washington, District of Columbia.

³Department of Psychology, University of Vermont, Burlington, Vermont.

⁴Department of Psychiatry, University of Vermont, Burlington, Vermont.

⁵Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Address correspondence to:

Roland R. Griffiths, PhD

Behavioral Pharmacology Research Unit

Department of Psychiatry and Behavioral Sciences

The Johns Hopkins University School of Medicine

5510 Nathan Shock Drive

Baltimore, MD 21224

E-mail: rgriff@jhmi.edu

ABSTRACT

Caffeine is the most commonly used drug in the world. Although consumption of low to moderate doses of caffeine is generally safe, an increasing number of clinical studies are showing that some caffeine users become dependent on the drug and are unable to reduce consumption despite knowledge of recurrent health problems associated with continued use. Thus, the World Health Organization and some health care professionals recognize caffeine dependence as a clinical disorder. In this comprehensive literature review, we summarize published research on the biological evidence for caffeine dependence; we provide a systematic review of the prevalence of caffeine dependence and rates of endorsement of clinically meaningful indicators of distress and functional impairment among habitual caffeine users; we discuss the diagnostic criteria for Caffeine Use Disorder—a condition for further study included in the Diagnostic and Statistical Manual of Mental Disorders (5^th ed.); and we outline a research agenda to help guide future clinical, epidemiological, and genetic investigations of caffeine dependence. Numerous controlled laboratory investigations reviewed in this article show that caffeine produces behavioral and physiological effects similar to other drugs of dependence. Moreover, several recent clinical studies indicate that caffeine dependence is a clinically meaningful disorder that affects a nontrivial proportion of caffeine users. Nevertheless, more research is needed to determine the reliability, validity, and prevalence of this clinically important health problem.