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Friday, May 29, 2020  Spokane, Washington  Est. May 19, 1883
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Courage, You Can Tame That Caffeine Habit

By Jane E. Brody New York Times

Given how easily I got hooked on caffeine, it is a good thing I never tried cigarettes or cocaine.

Not that I had ever been a heavy consumer of caffeine. Maybe three, four cups of coffee a day, but no tea or soft drinks or No-Doz and only an occasional indulgence in chocolate.

Through the years, I had gradually cut down to just two cups of coffee a day, usually instant coffee, one upon awakening and the other in midafternoon.

But when I tried to quit caffeine altogether, my body rebelled. I developed a headache so intense that if I had not known better I would have sworn I had a brain tumor or had suffered a stroke.

Neither aspirin nor acetaminophen made a dent in the pain. My headache was so overwhelming that I never noticed whether I suffered any of the other common effects associated with caffeine withdrawal: fatigue, depression, difficulty concentrating, stiffness and flu-like symptoms.

I kept telling myself that the pain would soon pass. But all it did was get worse. By the third day I got desperate enough to plow frantically through the painkillers in my medicine chest. Where was Excedrin when I needed it?

Finally, I turned up an antique bottle of Anacin - aspirin plus caffeine, 32 milligrams in each tablet, the amount in about two ounces of instant coffee. Just 15 minutes after I swallowed two tablets, my headache began to dissipate, then disappear.

Obviously, it was not the aspirin that worked. It was the caffeine.

That did it. No caffeine-free life for me. A headache like that, even for a day, was not worth it. It was not that I had to stop drinking coffee. I was perfectly healthy, not pregnant or trying to be, and I had no particular adverse reaction to caffeine.

I had been trying to quit on principle. I did not like the idea of being dependent upon a mind-altering drug, however socially acceptable that drug might be.

And while I thoroughly enjoyed a good cup of coffee, especially after dinner with company, I happily drank decaf since, when brewed from quality beans, it tasted as good as coffee with caffeine.

Then came an impending day of reckoning: a scheduled bicycle tour of the Yucatan. Where, I wondered, would I get my afternoon coffee while biking through the back roads of Mexico?

Since I did not consume soft drinks, Coke was not a suitable substitute. And the amount of chocolate I would have to eat to reach the caffeine level of one cup of coffee would have more than made up for all the calories I used cycling. I did not want to rely on Anacin, Excedrin, No-Doz or any other drugs that contain caffeine.

So back to the caffeine countdown.

This time I was smarter. Instead of going cold turkey from two cups to none, I first cut back to one cup, then to half a cup of coffee with caffeine a day, divided between morning and afternoon. (Experts recommend reducing one’s intake by about 20 percent a week over a period of four to five weeks to minimize withdrawal symptoms.)

By the time I left for Mexico, my caffeine intake for the previous week was about 40 milligrams a day, the amount in half a teaspoon of instant coffee.

Still, midafternoon on the first cycling day, a headache reminded me that I was overdue for a dose of caffeine. With only soft drinks available as caffeine sources, I begged to share a companion’s Coke. That did the trick. The next day, no caffeine, and no headache. It was a miracle, I thought. I was finally free of that monkey, and I was determined not to get hooked ever again.

Not that I am completely abstinent.

I now use caffeine judiciously, when I really need it. As one who has twice fallen asleep driving, I dose myself with caffeine as a safety measure before driving any distance. I also use it to avoid wasting $75 theater tickets and to be sure I will hear all the movements of a concerto or symphony.

When I was a daily caffeine consumer, the drug did little or nothing to keep me awake when I really had to stay awake. Now all it takes is the caffeine in about two ounces, or less than half a cup, of coffee to keep me alert for three or more hours.

I now appreciate an attribute of stimulants that researchers have long understood: their ability to induce tolerance. When a person regularly consumes caffeine, a tolerance to its stimulant effects commonly develops.

Those who claim they can drink coffee at night and still fall asleep easily are not kidding. Even people with high blood pressure, whose blood pressure normally goes higher after a dose of caffeine, no longer experience this effect once they develop a tolerance to the substance.

I also appreciate the fact that caffeine meets the psychiatric profession’s current criteria for a drug that can induce dependency, as Dr. Eric C. Strain and colleagues at the Johns Hopkins University School of Medicine in Baltimore pointed out in The Journal of the American Medical Association in October of 1994.

In addition to developing a tolerance to a given dose and suffering withdrawal symptoms when the drug is abruptly discontinued, some people find themselves unable to give up caffeine despite pressing health or social reasons for doing so, and some people will go to remarkable extremes to get their next dose, the researchers noted.

It is not uncommon for caffeine addicts to get into arguments with family members and friends over their caffeine use.

Strain’s team found (as I discovered so dramatically) that a diagnosis of caffeine dependency does not necessarily depend on the dose consumed. In their study of 11 caffeine addicts, the researchers said that “three subjects with a diagnosis of caffeine dependence had a daily consumption less than the average daily consumption of caffeine in the United States,” which is 280 milligrams a day for each adult who consumes caffeine, the amount in about 14 ounces, or just under three cups, of ordinary coffee.

“The recognition of syndromes of intoxication, withdrawal and dependence suggests that caffeine is like other psychoactive drugs,” the researchers concluded.

Caffeine addicts may be encouraged to learn that the drug’s positive effects - increased feelings of well-being, alertness, energy and endurance - are associated with low doses, ranging from 20 to 200 milligrams, or from the amount of caffeine in an 8-ounce soft drink to the amount in 10 ounces of ordinary coffee.

However, at higher doses, up to 800 milligrams or more, caffeine can produce negative effects like nervousness, anxiety, panic attacks and palpitations, especially in people who usually abstain from caffeine.

It can also double the adverse effects of stress, aggravate stomach ulcers, interfere with sleep and increase the side effects of certain medications.

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