November 21, 2006
Emerging Health Concern: The Abuse of Caffeine
By Julie Deardorff
To get a good kick from caffeine, most people need only drink a 6-ounce cup of coffee, about 100 milligrams. But on a popular pro-drug Web site, a visitor reported taking seven No Doz tablets, or 1,400 milligrams of caffeine, and compared the effects to a bad trip on LSD.
Then, like many who get carried away with the world's most popular drug, the person wondered: "Can caffeine really do this?"
It can. And abuse of the legal stimulant is an emerging problem among young people, according to Northwestern University researchers, who recently analyzed three years' worth of cases reported to the Illinois Poison Center.
Symptoms include everything from nausea, vomiting and a racing heart to hallucinations, panic attacks, chest pains and trips to the emergency room.
In the study that was presented at the annual meeting of the American College of Emergency Physicians, the researchers found more than 250 cases of medical complications from ingesting caffeine supplements. Twelve percent of those cases required hospitalization, including in the intensive-care unit. The average age of the caffeine abusers was 21.
"Part of the problem is that people do not think of caffeine as a drug but rather as a food product," said study author Danielle McCarthy.
Columbia College Chicago freshman Kate Kelly, 18, began taking caffeine pills for energy after an all-nighter at her friend's 16th birthday party. As a junior at Evanston Township High School, she took four a day; two in the morning and two more throughout the day. "My friends and I also drank Red Bull when we were tired; often it was our breakfast," she said.
At first Kelly used caffeine pills as meal supplements, even though, after ingesting them, she felt shaky and the thought of food was nauseating. But at times, she could feel her heart racing and she began to have trouble sleeping.
"It really scared me," she said. "When I decided to stop 'doing them' junior year, I would fall asleep in class through my first three periods because I couldn't keep my eyes open or maintain a normal energy level without them. Getting my natural energy back to normal took about a month."
In the study, which did not define caffeine abuse (people self-reported to the poison center), the researchers excluded cases where only coffee or tea was used, and they emphasized that there is no data from the study to suggest that coffee or tea drinking causes health problems. In fact, studies have shown that caffeine can have positive effects.
The problem, said Michael Wahl, managing medical director for the Illinois Poison Center, is not necessarily in the caffeine but in the dose.
"Everything is a poison, including water, if you have too much," he said. "Caffeine is a stimulant that releases your internal catecholamines [compounds that can serve as hormones] that make you anxious, jittery and create the fight-or-flight response. When the heart beats too fast, bad things happen. It's an emerging trend to keep an eye on and see if it's getting worse."
The researchers found the situation is exacerbated because caffeine is heavily promoted as an effectively legal stimulant in energy drinks or dietary supplements on certain drug Web sites that recount users' experiences.
About 500 new energy drinks were launched this year, including a controversial one named Cocaine Energy Drink, and 31 percent of U.S. teenagers, or 7.6 million, say they drink them, according to Simmons Research.
The number of teens downing energy drinks has jumped almost 3 million in three years.
"There is a trend in the pro-drug culture toward promoting legal alternatives to illegal drugs, and it can be very harmful," McCarthy said.