Caffeine Withdrawal and Dependence: A Convenience Survey Among Addiction Professionals.
OBJECTIVE
Caffeine withdrawal was included in the research appendix of the DSM-IV to encourage additional research to assist with determining its status for the next version of the manual. Caffeine dependence was not included because of a lack of empirical research at the time of publication. This study assessed the beliefs of addiction professionals about the clinical importance of caffeine withdrawal and dependence.


METHODS
A 6-item survey was developed and delivered electronically to the members of six professional organizations that focus on addiction. Open-ended comments were also solicited. Five hundred members responded.


RESULTS
The majority (95%) thought that cessation of caffeine could produce a withdrawal syndrome, and that caffeine withdrawal can have clinical importance (73%); however, only half (48%) thought that caffeine withdrawal should be included in the Diagnostic and Statistical Manual of Mental Disorders (DSM). A majority (58%) believed that some people develop caffeine dependence; however, only 44% indicated that it should be in the DSM. Comments suggested that trepidation about inclusion of caffeine diagnoses was due to the concerns about the field of psychiatry being criticized for including common disorders with a relatively low clinical severity. Others, however, expressed an urgent need to take caffeine-related problems more seriously.


CONCLUSIONS
The majority of addiction professionals believe that caffeine withdrawal and dependence disorders exist and are clinically important; however, these professionals are divided in whether caffeine withdrawal and dependence should be included in DSM. Wider dissemination of the extant literature on caffeine withdrawal and additional research on caffeine dependence will be needed to provide additional guidance to policymakers and healthcare workers.
Addiction Treatment and Research Program, Department of Psychiatry, Geisel School of Medicine at Dartmouth , Lebanon, New Hampshire.
Alan J
AJ
Budney
Department of Veterans Affairs, Orlando VA Medical Center , Orlando, Florida.
Pamela C
PC
Brown
Departments of Psychiatry and Neuroscience, Johns Hopkins School of Medicine , Baltimore, Maryland.
Roland R
RR
Griffiths
Departments of Psychiatry, Family Practice and Psychiatry, University of Vermont , Burlington, Vermont.
John R
JR
Hughes
Department of Psychology, American University , Washington, District of Columbia.
Laura M
LM
Juliano