A Quasi-Experimental Inquiry on the Effects of Caffeine Withdrawal
By Jordan Kerere
Tobacco was the most popular drug in 2018 with over 40 million users; thousands of these individuals die each year, not directly from tobacco consumption, but from the longer-lasting effects of usage, including heart disease, lung cancer, and a variety of respiratory issues. Similar heart and blood pressure diseases have also been traced to the highly addictive but often overlooked drug, caffeine (Fernau, 2013; Money, 2014). Worldwide, more people drink coffee than tap water, possibly making it the most widely used recreational drug on the planet, yet it is not regulated, and an increasing number of young people turn to the drink for energy annually (Annual Report, 2016; Kubala, 2018). The negative aspects of caffeine consumption have been extensively researched and examined, but few have focused on the differences between age ranges. This study addresses the impact of caffeine addiction between two age groups above and below eighteen, and also seeks to expand the body of knowledge on how age affects one’s ability to withdraw from an addictive substance. Both groups were deprived of their regular quantities of coffee intake for an eight-week period. The resulting data showed that 100% of participants used caffeine at some point during the study, with no statistically significant difference between adult and student groups although students did consume less caffeine and experienced less intense symptoms overall. Both groups experienced four distinct stages of withdrawal: high side-effects, acceptance, self-moderation, and return to use.
Method
Data for this quasi-experimental, descriptive statistical inquiry came from multiple ongoing assessments from two age-defined groups. One 9-member group was comprised of adult participants, with the other being 15 minors. Each participant completed one brief, electronic assessment before data collection began followed by 8 additional surveys, at a rate of once per week that described their progress of quitting caffeinated beverages and any ongoing unexpected symptoms, behaviors, reactions or challenges. This part of the data collection began on November 5, 2018 and continued through to December 21, 2018. Participants were then asked to complete an additional survey on January 2, 2019, two weeks after the monitoring period had ended, to calculate the percentage of each group that was able to remain caffeine-free over the holidays without check-ins or interventions. The intention of creating two separate time intervals was to potentially identify a difference in participant success in correlation to the presence of the researcher. This idea stemmed from the traditional methods of Alcohol and Narcotics Anonymous meetings where new members are matched with a sponsor to guide them and provide support during their stages of withdrawal. In the 8-week monitored period of this study, the presence of the researcher was intended to mimic the traditional roles of the AA sponsor, perhaps increasing rates of success in comparison to the 2 unmonitored weeks. After the first seven weeks of monitored participation, however, most members of the study had already given into caffeine use on multiple occasions, suggesting that the researcher's presence had no such intended influence on success rates, so instead the researcher modified this period to a time of reflection. The planned January 2, 2019 survey was still administered, but instead consisted of questions addressing any physical or emotional consequences of returning to caffeine and if their normal dosage had been altered by participation in this study. Previous studies noted the changes of behavior with varying degrees of caffeine intensity, but most are longitudinal studies analyzing the long-term consequences. This research, however, operated on a shorter time-frame and two comparative sample groups.
Findings
Statistics gathered from the participants suggest that both groups are highly addicted to caffeine, based on the intensity levels of reported symptoms and strong withdrawal side-effects. In the primary survey, 52.2% of participants self-reported their own addiction to caffeine, matching the national average of 54% (Fernau, 2013). During Week 1, participants from both age groups expressed what they described as severe symptoms which matched the eight most prominent caffeine-withdrawal issues (headaches, fatigue, anxiety, difficulty concentrating, depressed mood, irritability, tremors, and low energy) with intensity decreasing along the expected timeline at almost identical rates for both groups (Kubala, 2018). After the first week, 62.5% of adults remained caffeine-free; after 8 weeks, 0%. Comparatively, 81.8% of minors stayed caffeine-free for the first week, but 0% were able to do so after 8 weeks. Following the 8-week deprivation period and a 2-week unmonitored, reflective interval, 100% of participants self-reported that they had felt unsuccessful in their study participation and indicated that they would be returning to caffeine use in some capacity. Based on qualitative responses from the surveys, it could be suggested that excluding early side-effects, most of the withdrawal-related struggles were social. In late November, two participants wrote that, “at work, I am distracted, but at home it is hard to resist temptation” and “my level of self-loathing has significantly increased”; other participants wrote in early December that they “don’t need the caffeine, but miss the flavor of [their] favorite beverages” and they “gained 7 pounds when [they] gave up coffee”. It was interesting to note that comments like these became more frequent than complaints of expected, physical side-effects after the first two weeks. It was only after participants began to consistently make comments like the ones above when they began to self-regulate their own caffeine intake. Unlike the 40-60% of Americans estimated to relapse, by January, 100% of participants were reunited with caffeine (Thomas, 2019). A potential future research question could focus on the strength of effect in physical withdrawal versus its social components. The 100% failure rate does not indicate poor study design, but rather a legitimate reflection of the cycle of addiction. Participants had no real motivation for success, excluding anything intrinsic, so perhaps future research with a concrete prize would yield higher success rates.
Implications
These findings could be easily applicable to anyone trying to reduce their caffeine intake or develop a healthier lifestyle. With more in-depth analysis, these data may allow addiction treatment facilities to plan counseling and treatment options for different age groups. Although caffeine seems different from many illicit substances, the neurochemical similarities caused by both types of drugs are too striking to discredit (Kubala, 2018; Money, 2014). Since the student group consumed less caffeine during the study period than the adult group and reported easier withdrawal symptoms, it could be argued that assessing addiction and providing treatment during the earlier years of development could be successful in combating America’s caffeine dependency, and potentially other drug addictions. Due to a small body of knowledge of the importance of age in beating drug addiction, additional studies may need to be conducted to support these suggestions. These data may also address the social misconception that caffeine is not a psychoactive, addictive substance to be regulated. This particular method was solely addressing caffeine-users, but the same method structure could be applied to similar drugs. Since so many of the symptoms and side-effects are similar to currently regulated substances, future government action is necessary to reduce America’s young adult dependence on caffeine.
About the Author
Jordan Kerere is a junior at the University of Virginia majoring in Psychology and minoring in Russian Language & Literature. Her research advisor is Dr. Robert Scott.
References
Annual Report. (2016). National Coffee Association. Retrieved from http://www.ncausa.org/industry-resources/economic-impact.
Benowitz, N.L. (1990, Feb.) Clinical Pharmacology of Caffeine. Retrieved from https://www.annualreviews.org/doi/abs/10.1146/annurev.me.41.020190.001425?journalC ode=med.
Burke, Louise M. “Caffeine and sports performance.” Applied Physiology, Nutrition, and Metabolism. Volume 33, Number 6 (2008).
Chawla, Jasvinder and Amer Suleman (2018, June). Neurological Effects of Caffeine: Overview, Consumption of Caffeine, Physiological Effects of Caffeine. Retrieved from emedicine.medscape.com/article/1182710-overview.
Coffee by the Numbers. (2010). Retrieved from https://www.hsph.harvard.edu/news/multimedia- article/facts/.
Evans S.M., and Roland R. Griffiths. (1999, April) Caffeine Withdrawal: A Parametric Analysis of Caffeine Dosing Conditions. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10087016.
Fernau, Karen (2013, April) Coffee grins fuel for the nation. Retrieved from https://www.usatoday.com/story/money/business/2013/04/09/coffee-mania/2069335/.
Foster, J. (2018, July) Documented Deaths by Caffeine. Retrieved from https://www.caffeineinformer.com/a-real-life-death-by-caffeine.
Griffiths, Roland R. and Phillip P. Woodson. "Caffeine physical dependence: a review of human and laboratory animal studies." US National Library of Medicine National Institutes of Health. Psychopharmacology. 94(4) (1988): 437-51.
Jung, J.Y. “Effect of negative awareness of coffee on its preference and recommendation intention.” Academy of Entrepreneurship Journal. 19(3) (2014): 153-174. (2010).
Kubala, J. (2018, April) 8 Symptoms of Caffeine Withdrawal. Retrieved from https://www.healthline.com/nutrition/caffeine-withdrawal-symptoms#section8.
Malerba, Stefano, Federica Turati, Carlotta Galeone, Claudio Pelucchi, Federica Verga, Carlo La Vecchia, and Alessandra Tavani. (2013, August) A meta-analysis of prospective studies of coffee consumption and mortality for all causes, cancers and cardiovascular diseases. Retrieved from https://link.springer.com/article/10.1007/s10654-013-9834-7.
Money, N.P. (2014) Microbiology: A Very Short Introduction. New York, New York: Oxford University Press.
Sajadi-Ernazarova, K.R. and Richard Hamilton. (2018, Oct.) Caffeine, withdrawal. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430790/.
Savitt, R. A. “Psychoanalytic studies on addiction: Ego structure in narcotic addiction.” The Psychoanalytic Quarterly, 32(1), (1963): 43-57.
What is Caffeine? (2018, Nov.) Retrieved from https://adf.org.au/drug-facts/caffeine/.
