Endorsement of DSM-IV dependence criteria among caffeine users

Drug Alcohol Depend. 1998 Oct 1;52(2):99-107. doi: 10.1016/s0376-8716(98)00083-0.


The purpose of this article is to determine whether some caffeine users endorse clinical indicators of dependence and abuse. We asked 162 randomly-selected caffeine users generic DSM-IV criteria for dependence, abuse, intoxication and withdrawal pertaining to their caffeine use in the last year via a structured telephone interview. The prevalence of endorsement of dependence items was 56% for strong desire or unsuccessful attempt to stop use, 50% for spending a great deal of time with the drug, 28% for using more than intended, 18% for withdrawal, 14% for using despite knowledge of harm, 8% for tolerance and 1% for foregoing activities to use. Seven percent of users met DSM-IV criteria for caffeine intoxication and, among those who had tried to stop caffeine permanently, 24% met DSM-IV research criteria for caffeine withdrawal. Test-retest interviews for dependency agreed in 29/30 cases (97%). Eight expert substance abuse clinicians agreed with self-endorsed caffeine dependence 91% of the time. Our results replicate earlier work and suggest that a substantial proportion of caffeine users exhibit dependence-like behaviors. Further studies are needed to determine whether such users exhibit a clinically significant syndrome of drug dependence.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Caffeine* / adverse effects
  • Central Nervous System Stimulants* / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales / statistics & numerical data*
  • Psychometrics
  • Reproducibility of Results
  • Substance Withdrawal Syndrome / diagnosis
  • Substance Withdrawal Syndrome / psychology
  • Substance-Related Disorders / diagnosis*
  • Substance-Related Disorders / psychology


  • Central Nervous System Stimulants
  • Caffeine