Is Coffee Addiction an Addiction for Real?

A recent study published in the Journal of Psychopharmacology provides insight into what can help kick caffeine habit. The researcher recruited 48 heavy caffeine users, consuming at least 270 mg per day of coffee, for the study to examine how knowing about dose reductions influence self-assessments of withdrawal severity, and therefore, how much of the caffeine withdrawal process was real versus imagined.

The researcher randomly assigned participants into two groups and put both the groups on the same caffeine reduction plan over a 5-day period. On the first day, participants were given one cup of coffee in the morning, and one in the afternoon with a total of 300 mg caffeine. The procedures on the second, third, fourth and fifth day was similar to the first, except that caffeine doses were gradually reduced (200 mg, 100 mg, 0 mg, and 0 mg, respectively).

However, only one of the two groups received accurate information about the caffeine reduction schedule. The other was rather (mis)informed that full 300 mg of caffeine was given to them on the first, second, and third days of the experiment and 0 mg on the fourth and fifth days.

Using the Caffeine Withdrawal Symptom Questionnaire (CWSQ), the researchers measured caffeine withdrawal symptoms every day. CWSQ is a 23-item scale that measures symptoms such as low alertness/difficulty concentrating, mood disturbances, fatigue/drowsiness, low sociability/motivation to work, flu-like feelings, nausea/upset stomach, and headache.

The respective CWSQ scores of the two groups were then compared. The researchers had predicted that caffeine withdrawal symptoms would be more in line with the information the participants received about the doses, and not the actual doses they were given. Interestingly, this was exactly what the finding revealed too.

The group that was given correct information about their dose reduction schedule exhibited caffeine withdrawal symptoms steadily increasing throughout the multi-day test period. On the other hand, the misinformed group showed flat-line CWSQ scores for the first three days and a big uptick on day four. The researchers opine, “Given that they received identical doses of caffeine, these day-to-day differences in reported withdrawal can only be explained by differences in expectancies.”

Unfortunately, however, which one of the two groups was more accurate in assessing their actual withdrawal symptoms, cannot be known for certain. It is likely that both groups were biased in reporting their symptoms. While the misinformed group responded under the influence of “placebo effect” thinking they were getting effective treatment when, in reality, none was given, the group that received correct information was likely biased by a “nocebo effect,”  manifesting the negative side-effects the treatment was known to cause.

Despite this, the study does validate that at least part of our withdrawal symptoms are based purely on our expectations. This insight can help one picture a better outcome when he or she attempts to quit or reduce his or her coffee intake next time. It also suggests that tricking oneself into thinking one is getting caffeine when the dose is actually decreasing, or conversely, thinking that one is decreasing the dose while receiving caffeine, might be a great way to give up one’s coffee habit.