CAFFEINE WITHDRAWAL IS THE REAL THING

Addiction To Cola And Coffee Is A Biological Fact, Researcher Finds

Mark Nicholson considers himself a recovering drug addict of sorts.
His addiction?

"Coca-Cola," he says.

Or more precisely, the caffeine spike in every can. The 51-year-old
Idlewylde, Md., nurse spent years stashing sodas in his car, in his
hospital locker, even by his bed. It was frequently the last thing he
drank at night, the first when he awoke.

If he didn't get his fix, he paid: "I'd get this humongous headache
and feel like I was going to throw up."

Mr. Nicholson ultimately kicked the caffeine habit with help from a
little-known Johns Hopkins Hospital program for people hooked on the
drug.

Easily Hooked

But latte lovers, chocoholics and other caffeine junkies take heed:
While this particular case may sound extreme, mounting scientific
evidence shows that jokes about caffeine withdrawal are no joke at all
- - and it doesn't take much to get hooked.

"Some people say it's all in your head," says Roland Griffiths, a
caffeine researcher at the Johns Hopkins School of Medicine. "We're
able to show, based on a number of rigorous studies, that it's real
and biological."

In the most comprehensive survey of caffeine withdrawal research to
date, Mr. Griffiths and a colleague pored over 170 years of studies
and concluded that missing one small cup of coffee - only 100
milligrams of caffeine - is all it takes to trigger symptoms that
include headaches, fatigue and irritability.

For serious caffeine junkies, going cold turkey can be even more
traumatic. The latest analysis, published last month in the journal
Psychopharmacology, found that some experience flulike symptoms such
as muscle pain, nausea and vomiting when they go off caffeine.
Thirteen percent of people weathering withdrawal have to call off work
or cancel daily chores.

Some psychologists are even pushing the American Psychiatric
Association to classify caffeine withdrawal as a bona fide mental
disorder in the next edition of its Diagnostic and Statistical Manual
of Mental Disorders.

If that happens, it will likely be due in part to Mr. Griffiths.

The 58-year-old psychologist is regarded as one of the country's
leading investigators of caffeine and its effects.

Mind-Altering Drug

Legal and generally safe, caffeine is the most popular mind-altering
drug in the world, consumed by 80 percent of Americans. That fact
alone made it worth investigating, says Mr. Griffiths, who became
interested in the drug in the 1980s.

As a researcher who also studies nicotine, cocaine and other
often-abused drugs, he also realized that caffeine might be a good
model for analyzing the addiction process. "It's not cocaine," Mr.
Griffiths explains. Yet "it controls behavior."

Just how much remains hotly debated. The American Psychiatric
Association doesn't recognize caffeine as a drug that causes
dependence. But Mr. Griffiths says anybody who requires convincing
need only hang out at a Starbucks some morning - as Mr. Griffiths has
done - to watch the regulars roll in like clockwork.

Caffeine Dependence

"People get dependent on caffeine," says Mr. Griffiths. "The question
is: How does the drug do that? What kind of biological mechanism is it
hijacking? It becomes this really interesting puzzle to figure out
what's going on."

Once consumed, caffeine acts quickly. "This means that, soon after you
finish your cup of coffee or tea, caffeine will be present in virtually
every cell of your body," Bennett Weinberg and Bonnie Bealer note in The
World of Caffeine: The Science and Culture of the World's Most Popular Drug.

Mr. Griffiths' research has shown that people begin to feel caffeine's
mood-altering effects after ingesting as little as 10 milligrams.

"Just a sip of coffee," he says.

The drug disappears quickly - typically within 12 hours to 24 hours.
This, says Mr. Griffiths, explains why coffee is so often a morning
ritual: "People are actually waking up in withdrawal." Mr. Griffiths
and other caffeine researchers insist that they have nothing against
the drug, which has undoubtedly saved lives and careers by helping
drowsy drivers, soldiers, aviators, students and machine operators
stay awake. Recent research even hints that caffeine helps protect
against gallstones and Parkinson's disease.

"You don't lose your job, your friends, or your money by taking
caffeine," says American University psychologist Laura Juliano, who
collaborated with Mr. Griffiths on the latest review of withdrawal
research.

"That's not to say that people don't do pretty extreme things
sometimes to get it," she adds.

Just Can't Quit

Some caffeine users want to stop but can't. To understand why, Mr.
Griffiths launched a program to study and treat caffeine dependence in
2001. His little-publicized clinic may be the only one of its kind in
the nation. The 59 people enrolled in the program keep a diary of
caffeine use and have monthly sessions with a therapist. Saliva tests
help determine whether they're sticking to the program.

For many, the program works. Mr. Nicholson, the Idlewylde nurse, says
he's been clean for two years and now guzzles only caffeine-free Coke.
"The only thing I take with caffeine now is an occasional piece of
chocolate," he says.

But some people find they can't - or don't want to - quit. Mr.
Griffiths isn't surprised. After all, he says, there's a reason that
caffeine has been popular in so many cultures over the centuries.
"It's a great drug," he says.

For more information about the Johns Hopkins caffeine program, visit
www.caffeinedependence .org.