Caffeine Intoxication and Addiction

Holly Pohler


Journal for Nurse Practitioners. 2010;6(1):49-52. 

In This Article

Abstract and Introduction


Caffeine, one of the world's most popular psychoactive substances, is sought for its central nervous system stimulant effects. If coffee, tea, and soda alone do not provide the desired stimulation, some consumers are turning to the newest fad in the caffeine market, energy drinks. These beverages are loaded with caffeine and sugar, infused with herbal additives, and marketed particularly to youth. Caffeine produces dose-dependent symptoms, and intoxication may develop with overconsumption. Caffeine is also recognized for its addictive properties, and discontinuation results in a withdrawal syndrome. Nurse practitioners are encouraged to consider caffeine intoxication, addiction, and withdrawal syndrome in the differential when patients complain of characteristic symptoms. Ongoing nutritional assessment and education on moderation are key to reducing the overuse of caffeinated energy drinks.


If you have relied on an afternoon double-shot caramel macchiato or a 64-ounce Mountain Dew guzzler to get you through the day, you are not alone. People have been getting their caffeine buzz for decades. Liquid Cocaine, Rock Star, and Red Bull are examples of the newest trend for those not satisfied with soda and coffee alone. Containing caffeine levels significantly higher than the current Food and Drug Administration (FDA) caffeine restriction, these popular beverages effectively bypass the FDA caffeine restriction of 72 mg per 12 fluid ounces by virtue of the argument that they fall within the 1994 Dietary Supplement Health and Education Act (Figure 1).[1] Most contain the added ingredients high fructose corn syrup, sucrose, and herbal additives such as taurine, L-carnitine, ginseng, and milk thistle, offering the illusion of a healthy alternative for a quick-energy high.

Figure 1.

Popular energy drinks and their caffeine content.[5–11]

Energy drinks pose a unique challenge to health care providers and the community at large. More than 500 new energy drinks have been launched this year and this 3.4 billion dollar a year industry continues to grow.[2] Advertisements appeal to youth and are made attractive by claims of increased performance, attention, endurance, and weight loss. Products are printed with the logos, "zero crash," "sustained energy," and "party like a rock star." Manufacturers of the energy drink Cocaine went so far as to print the word cocaine on the can in such a manner that it resembles a line of illicit powdered cocaine.


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