
Caffeine use disorder - nancybrucheta
http://hub.jhu.edu/2014/02/07/caffeine-really-is-a-drug
======
mdip
I discovered that if I only consumed caffeine when I had a Migraine headache,
that it was the most effective medicine I could take provided I didn't already
have a tolerance built up so I gave up caffeine in my 20s.

Frankly, it was a lot harder than I thought it would be. I was plagued with
minor but persistent headaches for almost a month and was exhausted most of
that time since I was used to grabbing a cup of coffee to get me started in
the morning. I avoided caffeine for almost 15 years until about a year ago
when I finally found a medicine that has successfully prevented Migraine
(completely). Now and then I enjoy a cup of coffee (or a Coke -- I'm a skinny
guy) but I've not gotten to the point of it being a regular thing.

The difference is huge. I am convinced that Caffeine is a much more powerful
stimulant than we coffee drinkers think it is. When I am feeling tired, a cup
of coffee will completely wake me up and I'm _full_ of energy. I can't see how
I managed to drink two of these every morning and still barely feel the
effects. If I have two cups now, I'm _overwhelmed_ with jittery feelings, my
mind races, and I go from the heightened concentration of one cup to not being
able to concentrate at all due to my mind going in every direction at once.

~~~
tylermac1
What was the medicine that ended up helping your migraines?

I suffer from migraines semi-regularly and have at separate times taken
Maxalt, Imitrex, or generic OTC migraine meds + caffeine.

~~~
jawilson2
Excedrin worked for me before I quit coffee.

Also, since starting a low-carb keto diet two years ago, I haven't had a
single migraine (I used to get 2-3 per month, both painful ones and visual
auras). When I was a pediatric neurology prof a few years ago, a keto diet was
standard of care for the kids, and the department was starting research into
keto for chronic migraines. Give it a try!

~~~
pixelperfect
I had the same result after switching to a keto diet 10 months ago. Do you
know if there are any research papers on this? I was really surprised how
effective the change in diet was because I did it on a whim without receiving
medical advice.

~~~
reitanqild
Not exactly research paper, and not migraine but it was mentioned in a ted(x?)
talk linked from HN a week ago or so IIRC. The talk was about keto and cancer
but touched into keto against epilepsy as well. I think the Charlie Foundation
or something was mentioned as well.

Maybe some of that research can hold some pointers?

------
Pitarou
I've given up caffeine for Lent[1]. It's been hard.

Beforehand, I knew I had a bad coffee habit. In a typical day I'd drink, maybe
6 or 7 mugs of strong coffee. I'd tried to cut down many times, but never
succeeded; there just seemed to be too many reasons in my life to have another
coffee.

So when Ash Wednesday (the start of Lent) came, I thought, "Now's the time to
quit."

The first day was fine. I didn't notice anything. I guess I was still flushing
the remaining caffeine out of its system.

The second day certainly wasn't. I had a headache, and felt tired, dizzy and
confused.

The headache didn't last long, but the other symptoms persisted for about ten
days. In hindsight, I should have consulted a physician before attempting
this, because it could have aggravated other medical conditions I have.

I now have twelve days left of my caffeine fast. Do I feel healthier? Do I
sleep better? No, not really; I feel pretty much the same as I did before, but
without the urge to drink coffee all the time.

I think the real benefits will come when I let myself drink coffee again. I
intend to only use it when I really need a pick-me-up. The less often I use
caffeine, the more effective it will be.

[1] Lent is a period of 46 days' self-denial observed in many Christian
churches.

~~~
schoen
> I've given up caffeine for Lent

I've heard from many people on HN and elsewhere individually choosing
something to give up for Lent.

In my understanding, the traditional Lenten restrictions in most Christian
churches that observe Lent are pre-specified dietary restrictions that are the
same for everybody (for example, it was unexpectedly convenient for me as a
vegan to visit Eastern Europe because the Eastern Orthodox churches' Lenten
fast was similar to veganism).

Is the practice of giving up a personally-selected thing for Lent something
that many people have chosen to do individually as a sort of new
interpretation of the tradition, or is it now also recommended by some
churches?

~~~
antognini
I can only really speak from the Roman Catholic perspective, but traditionally
there are three pillars of Lent: fasting, prayer, and almsgiving. The
requirements for fasting have varied over the centuries. The strictest fast is
the Black Fast [1], which was regularly observed (I think) sometime around the
Early or High Middle Ages. It's similar to the fast observed by the Orthodox,
though it intensifies during Holy Week (only bread, salt, herbs, and water
allowed). Up until the early twentieth century or so, Catholics were required
to fast every day of Lent except Sundays [2] (i.e., take only one full meal a
day with two small meals that cannot, combined, form a full meal).

In the modern Roman Catholic Church the fasting requirements have been
substantially relaxed. The only requirements are fasting on Ash Wednesday and
Good Friday and abstaining from meat on Fridays. The other days of Lent are
still penitential days, but the bishops of the region have the authority to
determine the form of the penance. In the United States the bishops have
stated that it is acceptable to substitute fasting for some other form of
penance determined by the individual.

My impression is that the Eastern Orthodox and Eastern Catholic churches still
observe a much more rigorous fast, more like the Roman Catholic Church used to
a few centuries ago. As a side note, I've always been the most impressed with
the Coptic Christians. They observe, by far, the most rigorous fasting
schedule. They fast 210 days out of the year! [3]

[1]:
[http://www.newadvent.org/cathen/02590c.htm](http://www.newadvent.org/cathen/02590c.htm)

[2]: Hence Lent is strictly speaking only 40 days (a more biblically
significant number) because the Sundays are excluded from the fasting.

[3]:
[https://en.wikipedia.org/wiki/Fasting_and_abstinence_of_the_...](https://en.wikipedia.org/wiki/Fasting_and_abstinence_of_the_Coptic_Orthodox_Church_of_Alexandria)

------
mcculley
I weaned myself off of caffeine entirely seven months ago. Being free of
caffeine has greatly improved the quality of my sleep and made my mood more
even throughout the day. I really appreciate being able to jump straight out
of bed in the morning without depending on that coffee to get my brain
working.

~~~
speeder
I tried a couple times to get off caffeine, never worked properly... I don't
feel obvious caffeine effects, but I need it to not be a wreck.

Later I discovered I was self-medicating my ADHD...

Now I am taking proper ADHD meds, and this allowed me to greatly reduce my
caffeine use (that was wandering into dangerous and expensive territory, with
me needing to drink litres of red-bull clones to work), still need it
sometimes though, my ADHD meds dosage is still too low it seems (my medic is
adjusting my meds still).

Without caffeine + meds I can't do anything properly, I lose random objects
(including a cup of coffee! I made myself a coffee yesterday, moved it
somewhere in the house, and could not remember where, I spent 5 minutes
wandering around looking for where I put my coffee), forget to do stuff,
including important stuff, forget to eat/drink water/sleep, and all other
sorts of not good behaviour.

~~~
swah
Do you still live in Brazil? I've read criticisms here on HN, of doctors too
eager to diagnose ADHD (specially in children) - did you felt that your doctor
was aware of those issues?

I ask because I'm not sure if I have ADHD or just regular anxiety/lack of
focus that could be fixed by exercising/meditation/finding another job. And I
don't want to go to the doctor to get hooked on drugs I don't need...

~~~
speeder
I am still in Brazil...

And I've been hearing about the ADHD overdiagnosis problem for a while, and
I've been staunch that I didn't had ADHD until my life was the shithole that
it is now (I am 28, unemployed, don't own any property, have negative net
worth, no friends, no romantic partners...)

Then what I found was the opposite, as an adult, seeking for ADHD diagnosis
(or diagnosis of whatever I had), led to most doctors spin around in circles
trying to find everything that I could have that is NOT ADHD, because they
assumed I was just some kind of junkie or someone wanting to cheat tests in
university, because here in Brazil all ADHD meds are of highly controlled
nature (ie: they are classed the same as Morphine for example).

Eventually I found my current medic... that still is going VEEEERY slow in the
dosage, the highest dosage she ever gave me was 1/5 of the maximum, and about
1/3 of what people get on average.

Still, even this low dosage helped, before I had the meds, I reached a point
where I was spending more on caffeine than food every day (and this is in a
country that exports coffee and erva mate, thus caffeine in general here is
really cheap)

~~~
callinyouin
> ...they assumed I was just some kind of junkie or someone wanting to cheat
> tests in university

I live in the US and had the same reaction from doctors. One doctor spoke with
me for a few minutes (literally like 5 minutes) and decided I was trying to
abuse uppers to gain an edge at school/work, despite having been previously
diagnosed with ADD and treated as a teenager (and despite asking for help, not
medication). It was a really, really humiliating experience. I eventually was
prescribed medication but I've since lost and regained medical insurance, so I
no longer have that prescription. I often have difficulty staying on task, but
I cope with it myself out of fear of going through that awful process again.

To me it seems that adults seeking help with ADD/ADHD are looked at with
immediate suspicion. I always assumed it was a lack of mental health education
for doctors in the US, but now I suppose it might be a global phenomenon.

------
have_faith
My old co-workers would drink coffee throughout the day and constantly
complain about not having enough energy and they would look physically
drained. They required it to feel normal. Reminds me very much of people I
know who smoke weed to feel normal because they are so used to it.

As another commenter mentioned, not drinking caffeine makes it's effects much
stronger when you actually need it. I don't drink tea/coffee/soda/energy
drinks etc. So on the rare occasion that I down an energy drink the effect is
extremely pronounced. Literally buzzing.

~~~
dikdik
I was drinking 8-10 cups of coffee a day for a couple years, but on the
weekends I wouldn't have any and I would be fine. I thankfully did not have
averse health problems, but I ended up being put on adderall as my doc thought
I might have ADD. I immediately cut my intake to 1, maybe 2 cups a day as
anymore would make me sick.

I went off adderall as it was not a great solution, turned out I was mostly
miserable and bored at that company. I was trying to keep myself engaged by
getting high on caffeine. After quitting, I drink 3-4 cups a day and some days
none.

------
danieltillett
The thing to remember with caffeine is its half-life in non-smokers is 8 hours
(it is 3 hours in smokers). I have a rule to never have any drink with
caffeine after midday - if I break this rule even by an hour I suffer that
night and the next day. Caffine is a morning drug.

~~~
AI_Overlord
I can drink coffe at night before going to bed and still sleep like a baby. I
wonder if something is wrong with me.

~~~
creshal
Built-up tolerance? After drinking triple espressos like water in university I
could drink coffee at 10 pm and still fall asleep an hour later. Of course,
I'd wake up feeling more tired than before with a splitting headache, but
that's what the triple espressos were for.

------
soft_dev_person
Excessive use of anything tends to be bad. "Normal" intake of coffee [1] may
have plenty of health benefits, so why quit? Because self control?

I'll drink my 3-4 cups of black filtered coffee a day with a good conscience.

[1] Not including other high-caffeine drinks (energy drinks) or mixing your
coffee with lots of sugar and milk, which would be bad mostly for other
reasons than the caffeine itself.

~~~
creshal
> _For healthy adults, the FDA says 400 mg a day is OK. But consuming much
> more than that can have dangerous, negative effects. And the milligrams add
> up quickly. A medium-size coffeehouse coffee can contain more than 300 mg,
> and most 16-ounce energy drinks contain between 160 and 240 mg of caffeine…_

3-4 cups might be on the high end of the safe spectrum, depending on what your
idea of a "cup" is. (For the record, 3 half-litre beer steins of coffee a day
turned out to be a spectacularly bad idea, even if hearing colours was briefly
entertaining.)

~~~
cbd1984
> (For the record, 3 half-litre beer steins of coffee a day turned out to be a
> spectacularly bad idea, even if hearing colours was briefly entertaining.)

I've consumed caffeine to the point of serious gastric distress and very mild
heart palpitations and I've never experienced synesthesia. I'm unwilling to
push beyond that to higher doses, but two or three 12-cup pots a day of light
roast filtered black coffee is about average for me, so what the Hell? Is
there just that much individual variation here?

~~~
gus_massa
IIRC, the only well documented case of synesthesia is
[https://en.wikipedia.org/wiki/Grapheme_%E2%86%92_color_synes...](https://en.wikipedia.org/wiki/Grapheme_%E2%86%92_color_synesthesia)
. It's an interesting case because the color and letter recognizing parts of
the brain are very close, so it's logic that some info may leak and get
correlated.

Perhaps someone can design an (safe) experiment to measure the effect of
caffeine in synesthesia ...

------
nabla9
Addiction is harmful when it reduces the quality of life. Caffeine is
addictive but it causes harm to only some people.

For example: If you have problems with sleep, and just can't give up caffeine
use and take sleeping pills instead, you have a drug problem.

------
strlen
Personal suggestions:

1) Dark roast coffee has less caffeine and is (in my subjective opinion)
tastier. So if one wants the taste of coffee without less of the effects,
consider an espresso or a Turkish coffee. The latter is just called "coffee"
in much of Eastern Europe, one can pick up a beautiful cezve on Amazon
[http://www.amazon.com/s/ref=nb_sb_noss_2?url=search-
alias%3D...](http://www.amazon.com/s/ref=nb_sb_noss_2?url=search-
alias%3Daps&field-keywords=cezve)

2) Yerba Mate is 75 mg of caffeine per serving: higher than tea, but less than
coffee. Can be made in an French Press or a tea pot and served like
conventional tea.

3) Caffeine gum: not particularly pleasant to chew, but comes in a more
precise dose (100mg) and is "kicks in" faster.

Personally, I'd like to see more genetic studies on this: I am not
particularly affected by caffeine: I've never experienced withdrawals (despite
consuming caffeine heavily -- from coffee and energy drinks for a long period
of time) nor do I see coffee raise itself in potency after a week or two of
abstinence. This is different for others and I would really like to understand
why.

~~~
joslin01
> I've never experienced withdrawals

I don't believe you. How long have you gone without it? When did you start
drinking caffeine? What's your definition of withdrawal?

~~~
stordoff
Different people react differently. For a variety of conditions, I take
moderate doses of opioids (tramadol 50mg qds or codeine 60mg qds) and
benzodiazepines (tamazepam 20mg daily), both of which are well-known to cause
dependence. I've abruptly stopped both a number of times (strongest example -
going without the tramadol for three months, after taking that dose for over
six months) without any ill effects or withdrawal (other than the original
conditions returning to about the same as they were before treatment).

Edit: with -> without

------
jrapdx3
Just a few thoughts to add. Living in the Pacific Northwest, home of Starbucks
and a bunch more vendors, caffeinism is nearly a way of life. Around here it's
pretty easy to find examples of the effects of overdoing caffeine intake, so
my comments are based partly on observation as well as "standard" practice.

Caffeine, like all drugs affects people differently and can cause an array of
side-effects. , Besides interfering with sleep, a few are worth mentioning.

Caffeine can cause increase in gastric reflux or other GI conditions. Anyone
who needs "acid reducers" is well-advised to avoid caffeine. Caffeine is also
notorious for increasing anxiety symptoms, those prone to panic attacks may be
more vulnerable. Cardiac effects are also a potential issue, as caffeine can
contribute to abnormally rapid heart rhythms. Naturally as always mileage
varies, universal rules don't really exist.

If a person has such conditions, no harm in reducing or avoiding caffeine for
a while. If the problem improves, then you know what to do, if not, well,
resolving the problem is going to require at least a bit more investigation.

------
facepalm
I've used occasions when I had the flu to quit, figuring that I feel shitty
anyway, so the withdrawal symptoms won't matter that much.

Of course eventually I took it up again - unfortunately after a couple of
weeks of withdrawal, it tastes really good.

But what fascinates me is that being easy to quit might be part of why it is
hard to quit. It's easy to say "heck, I'll quit tomorrow, it is so easy after
all".

~~~
toyg
Quitting an addiction is easy, any junkie can do it... several times a day ;)

I went cold-turkey a few years ago, lasted several months, helped immensely
with palpitations and sleep-pattern problems. In fact, I should probably do it
again at some point this year, but with kids and work it becomes difficult to
plan the inevitable couple of weeks of "zombie time". Maybe doctors should
start considering it a real addiction, justifying off-time for treatment.

~~~
bryanlarsen
I took leave to do it. Caffeine withdrawal head aches are nasty. Make sure you
titrate off, don't go cold turkey.

------
yeureka
As someone trying to quit caffeine for health reasons I can relate to this.

My current strategy is to replace coffee with caffeine pills so I can control
the amount exactly and reduce it slowly until it reaches zero.

Also, having to take pills when I feel bad feels rather ridiculous and makes
it obvious that I am addicted.

~~~
jjkmk
I'm also having a caffeine problem, haven't considered pills at all.

Is there a specific brand / type of pill that works well for reducing amount
over time?

~~~
InclinedPlane
I've mostly switched to caffeine pills when I need caffeine (which varies,
usually I try to go caffeine free). For me I find 100mg is a good amount,
though if I could find 50mg pills I would try that. My preferred source is
"jet alert" since I couldn't really find anything else that wasn't just 200mg.

Also, I always use an L-theanine supplement when I take caffeine, it's amazing
how much it changes things. Instead of feeling all jittery and agitated I just
feel less tired and more alert. This is roughly the equivalent of just
drinking strong green tea.

~~~
phonon
Exactly this. You can buy them combined at
[http://www.powdercity.com/products/l-theanine-caffeine-
capsu...](http://www.powdercity.com/products/l-theanine-caffeine-capsules)
It's night and day compared to caffeine only.

~~~
InclinedPlane
This is awesome! Thanks for this.

------
cosmolev
I would argue that the most commonly used drug is not caffeine, but sugar.

~~~
TACIXAT
I've cut out a ton of foods in my life to fix various issues with my body.
Sugar is one that remains because it causes me no ill effect. Caffeine was
giving me withdrawal headaches if I slept in and missed my schedule.

~~~
togedoge
On the flip side, I get tend to get inflammation when I consume too many added
sugars. This usually manifests as joint pain, headaches, and breakouts. It has
forced me to have a much healthier diet. Thanks for sharing your insights!

------
mnw21cam
I'm one of those weird people for whom caffeine doesn't really seem to do
anything. My normal daily consumption of the stuff is zero, because I don't
drink coffee or tea. Every now and again if I have an essay crisis after a bad
night's sleep, I'll pop three or four times the "don't take more than this"
dosage of Pro Plus, which seems to have a fairly minor effect. It has been a
few months since I last did this.

I prefer theobromine.

------
calebm
This reminds me of the best article I've ever read on caffeine:
[http://www.huffingtonpost.com/john-berardi-phd/coffee-
health...](http://www.huffingtonpost.com/john-berardi-phd/coffee-health-
benefits_b_3881377.html). TL;DR: There is an enzyme called CPY1A2 which
determines if caffeine is bad or good for you.

------
codingdave
If you want to give it up, and are a coder, find a few days when you don't
need to code. I tried a few times, and always went back to it because my code
sucked for a few days. I finally kicked the habit only about a month ago, when
I decided to do it during a week-long testing effort with minimal new coding
to worry about.

And the same as many others have said... I sleep better, feel better, etc,
etc.

------
rdl
I wonder if a low dose of modafinil or an amphetamine is less physically
damaging than an equivalently effective dose of caffeine.

------
Kenji
Caffeine has such a strong effect on me (physically and psychologically), I
can even tell its effect in some (not fully) decaffeinated coffees. This
started one day, I've been a regular drinker before. Since then, almost only
decaf.

~~~
mchahn
I am lucky to have a nervous disorder that keeps me from drinking caffeine.
Any amount and I get a headache. I can even tell how much is in something by
the intensity of my headache. It is surprising how many things have caffeine.

The worst soft drink is orange soda. There were orange soda ads many years ago
that used the Beach Boy's "Good Vibrations".

------
graeme
I quit coffee recently, and feel better. But I still have a single cup of tea
in the morning.

For those who have quit, am I likely to see any benefits from stopping tea as
well?

------
brianolson
moderator should add (2014) tag to title as article is fully two years old
from February 7, 2014.

------
rodionos
This discussion about coffee has become too scientific. When I was a child, my
parents would not let us drink coffee, but tea was not only allowed it was
part of daily routine as long as I remember. We didn't question. When I grew
up someone told me the story about two life-term prisoners in medieval times,
one of them allowed to drink only tea, the other coffee. The coffee-guy lived
longer. That was enough for me to stake my rights and start drinking coffee in
high school.

~~~
eterm
If you're basing decisions off a single anecdotal* data point from "medieval
times", I can see how anything else would seem "too scientific" in comparison.

* And fictitious

~~~
rodionos
I made a lot of good decisions based on incomplete data, and I'm not sure why
you labeled this story fictitious. Here's some background:
[https://en.wikipedia.org/wiki/Gustav_III_of_Sweden's_coffee_...](https://en.wikipedia.org/wiki/Gustav_III_of_Sweden's_coffee_experiment)

~~~
RankingMember
If you want to drink coffee, drink coffee. Using a goofball medieval study
(with a sample size of literally 2 people) to justify your personal choice is
pretty silly.

~~~
rodionos
Your problem with sample size in this particular case is that you fail to
account for its duration. Convert sample size to temporal units and you might
draw different conclusions since p-values might not look as bad now. An
average FDA trial is 3 years, so assuming the prisoners lived for 40 years on
their prescribed caffeine diet, you get sample size of 2*40/3 = 26.7. Not bad
for 17th century. Last but not least, turn off --verbose mode.

~~~
capnrefsmmat
This fallacy is known as "pseudoreplication": the erroneous belief that
multiple samples (or a long measurement) of dependent data (i.e. the same
person year after year) is equivalent to getting many independent samples.

If you measure the same two people year after year, you just measure their
genetic predispositions and personal habits more and more precisely. You
cannot distinguish them from the results of your coffee/tea intervention.

[http://www.statisticsdonewrong.com/pseudoreplication.html](http://www.statisticsdonewrong.com/pseudoreplication.html)

~~~
rodionos
In case of caffeine addiction tests, I would argue that a life-long trial of
fewer people over a short-term trial of many people would produce more
statistically significant results because the impact is accumulative over a
long period of time. Consider asbestos or even smoking. Compare the results of
10 lifelong smokers vs 1000 smokers who tried it just once.

Anyways, did you read the article on wikipedia? The prisoners were twins and
their rations was the same - 3 intakes per day.

~~~
capnrefsmmat
The goal of a trial is to eliminate other possible explanations for the
phenomenon in question. You take a large sample, and randomly assign people to
groups, so all the idiosyncratic variations average out.

With only one person per group, you can't eliminate many possible reasons for
their differing life spans: one may have caught a disease the other was not
exposed to, they may have had different nutrition, different amounts of
exercise, different habits, a zillion other things.

After all, do other twins die at exactly the same time? No. They die years
apart for many other reasons. Unless this twin experiment could eliminate all
those possible reasons, it shows us nothing about coffee specifically.

