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CoffeeRoastersClub
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Posted Thu Jun 6, 2013, 7:44am
Subject: Re: Caffeine Withdrawal and DMS-5
 

NobbyR Said:

IMHO the difference between caffeine and other drugs is that it's legal, freely available, cheap, and unlike other legal drugs like alcohol or nicotine its regular use doesn't cause any major health problems. Consumed responsibly, which even includes drinking five cups per day, coffee won't ever cause any overdosing. The DSM-5 on the other hand makes caffeine dependency a psychiatric disorder, a disease, therefore creating a need for therapy. There's money to be earned here. Next thing might be that there'll be a health warning on your espresso cup.

Posted June 5, 2013 link

+1

 
"Coffee leads men to trifle away their time, scald their chops, and spend their money, all for a little base, black, thick, nasty, bitter, stinking nauseous puddle water." ~The Women's Petition Against Coffee, 1674

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CoffeeRoastersClub
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Posted Thu Jun 6, 2013, 7:59am
Subject: Re: Caffeine Withdrawal and DMS-5
 

NobbyR Said:

Sorry, not being a native speaker I guess these (politically correct?!?) subtleties of the English language sometimes escape me. What's the difference between an illness and a disease? Aren't those words synonymous?

Posted June 6, 2013 link

The term "illness" and "disease" are synonyms for one another.  However in the context of mental health it appears that the preferance is to use "illness" to describe poor mental health.  

However, a quick cursory search on Google under the term "mental disease" actually shows more references to "mental disorder" than "mental illness".  FWIW.

Len

 
"Coffee leads men to trifle away their time, scald their chops, and spend their money, all for a little base, black, thick, nasty, bitter, stinking nauseous puddle water." ~The Women's Petition Against Coffee, 1674

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AntWilliams90
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Posted Thu Jun 6, 2013, 8:08am
Subject: Re: Caffeine Withdrawal and DMS-5
 

I think you are missing my point. I'm not saying drinking coffee is bad - I am saying that when a person becomes DEPENDENT on caffeine they have a problem - lots of people 'say' they need a coffee to get started, but I doubt very many of them are ACTUALLY dependent. True dependency on any drug is a horrible thing.

As for

the difference between caffeine and other drugs is that it's legal, freely available, cheap, and unlike other legal drugs like alcohol or nicotine its regular use doesn't cause any major health problems

the first 3 points are pretty redundant - unless you are saying that if it was made illegal, was not easily available and/or was more expensive it WOULD be a problem drug? As for the major health problems, I believe that is the very point that the DSM is making. i.e. WHEN caffeine dependency is a problem these are the symptoms/criteria

They are not saying (as the original article tries to suggest) that regular coffee use alone equals a caffeine problem. So. What are they saying?

Firstly, the only change between DSM-IV-TR and DSM-V is the Addition of criteria for Caffeine Use Disorder (NOT the addition of Caffeine Use Disorder!)

Secondly, DSM-IV-TR had separate diagnoses for "abuse" and "dependence" in people having problems with mind-altering substances. The DSM-5 workgroup decided that substance-related problems occur on a continuum, and that the abuse-dependence distinction was purely arbitrary. Hence, DSM-5 has "substance use disorders" as the diagnosis for people with such problems. Also out are physical tolerance and withdrawal symptoms as criteria for a disorder diagnosis since these reflect the body's adaptation to chemicals and are not necessary to a diagnosis.

Thirdly, the criteria are along these line (getting hold of the exact text is difficult at this time);

Five (or more) of the following signs, developing during, or shortly after, caffeine use:

-restlessness

-nervousness

-excitement

-insomnia

-flushed face

-diuresis

-gastrointestinal disturbance

-muscle twitching

-rambling flow of thought and speech

-tachycardia or cardiac arrhythmia

-periods of in inexhaustibility

-psychomotor agitation

--The symptoms in criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Now, I don't know about you guys, but if I had 5 or more of those symptoms I think I would be concerned...

 
As soon as you sit down to a cup of hot coffee, your boss will ask you to do something which will last until the coffee is cold.
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AntWilliams90
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Posted Thu Jun 6, 2013, 8:10am
Subject: Re: Caffeine Withdrawal and DMS-5
 

Oh, and as for the illness/disease - my bad! Use mental disorder. Disease has too many negative connotations and gives a misleading suggestion of how a disorder may be acquired (same goes for illness).

 
As soon as you sit down to a cup of hot coffee, your boss will ask you to do something which will last until the coffee is cold.
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NobbyR
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Posted Thu Jun 6, 2013, 8:19am
Subject: Re: Caffeine Withdrawal and DSM-5
 

AntWilliams90 Said:

Five (or more) of the following signs, developing during, or shortly after, caffeine use:
-restlessness
-nervousness
-excitement
-insomnia
-flushed face
-diuresis
-gastrointestinal disturbance
-muscle twitching
-rambling flow of thought and speech
-tachycardia or cardiac arrhythmia
-periods of in inexhaustibility
-psychomotor agitation

Posted June 6, 2013 link

IMHO most of the symptoms you list actually apply better to caffein overdose than normal consumption.

 
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"This drink of the Satan is so delicious that it would be a shame to leave it to the infidels." (Pope Clement VIII on coffee, when he was urged to ban the beverage)
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CoffeeRoastersClub
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Posted Thu Jun 6, 2013, 8:34am
Subject: Re: Caffeine Withdrawal and DMS-5
 

NobbyR Said:

IMHO most of the symptoms you list actually apply better to caffein overdose than normal consumption.

Posted June 6, 2013 link

My brother in law has at least 5 of those symptoms and he doesn't drink coffee or use any type of caffeine or other stimulant whatsoever.

WHATS UP WITH THAT?????????

LOL.

Len

 
"Coffee leads men to trifle away their time, scald their chops, and spend their money, all for a little base, black, thick, nasty, bitter, stinking nauseous puddle water." ~The Women's Petition Against Coffee, 1674

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AntWilliams90
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Posted Thu Jun 6, 2013, 8:36am
Subject: Re: Caffeine Withdrawal and DMS-5
 

Well now you're just being silly! ;)

But to answer your question, the final part of the criteria is "The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder (e.g., an anxiety disorder)."

 
As soon as you sit down to a cup of hot coffee, your boss will ask you to do something which will last until the coffee is cold.
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dana_leighton
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Posted Thu Jun 6, 2013, 8:49am
Subject: Re: Caffeine Withdrawal and DMS-5
 

NobbyR Said:

IMHO most of the symptoms you list actually apply better to caffein overdose than normal consumption.

Posted June 6, 2013 link

Precisely! Now you get it. That's why it's called "Caffeine intoxication" and not "Caffeine consumption."

 
Dana Leighton - Espresso hack and CoffeeGeek moderator
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NobbyR
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Posted Fri Jun 7, 2013, 4:50am
Subject: Re: Caffeine Withdrawal and DSM-5
 

dana_leighton Said:

That's why it's called "Caffeine intoxication" and not "Caffeine consumption."

Posted June 6, 2013 link

But the DMS-5 isn't talking about acute intoxication, but dependency/addiction.

 
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dana_leighton
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Posted Fri Jun 7, 2013, 7:10am
Subject: Re: Caffeine Withdrawal and DMS-5
 

NobbyR Said:

But the DMS-5 isn't talking about acute intoxication, but dependency/addiction.

Posted June 7, 2013 link

First, it's DSM (Diagnostic and Statistical Manual), and second, you're incorrect. These symptoms are in the diagnostic criteria for caffeine intoxication. The DSM does cover caffeine withdrawal, so you're correct that it does address dependency. The DSM uses the more general term "substance use disorders" to cover any impairment in functioning that is traced to substance use.

See this PDF of the table of contents. Also see this good summary from Live Science.

 
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