Caffeine: Composition, Therapeutic use, Treatment. Caffeine effects. Reactions with other drugs.

Last modified: Thursday, 25. December 2008 - 8:40 am

Official names: Caffeine

Street names: None

Drug classifications: Not scheduled, stimulant


Key terms

BODY MASS INDEX (BMI): A measurement of body fat based on a person’s height and weight.

ELECTROLYTE: The salts that the body requires in its fluids to function properly.

HYPERTENSION: Long-term elevation of blood pressure; defined by two readings, systolic and diastolic blood pressure, respectively, that are above the normal of 140 and 90 mm Hg. Hypertension risks damage to the blood vessels, and complications, including stroke, heart attack, and kidney failure.

OSTEOPOROSIS: A loss in total bone density that may be the result of a chronic calcium deficiency, early menopause, certain endocrine diseases, advanced age, endocrine diseases, certain medications, or other risk factors.

URINARY INCONTINENCE: Inability to retain urine in the bladder until the person chooses to empty it.



Doubtlessly the most widely used drug today, caffeine is consumed daily by 90% of the world’s people. Evidence of its use exists as far back as the Stone Age, and today, children, teens, and adults everywhere ingest it in coffee, tea, and soft drinks.

Legend has it that the stimulant effect of the coffee bean was first noted by an Ethiopian shepherd guarding his flock, a thousand years ago. Sufi monks steeped the berries in hot water and found that the brew helped them stay awake for long nights of prayer. Meanwhile, written records show that, during the Tang dynasty, which lasted from the seventh to the tenth century, the Chinese were already steeping and consuming tea as a drink believed to lengthen life.

By the Middle Ages, coffee was a popular drink of Muslims. In fact, the word coffee is derived from the Arabic, qahweh (pronounced kahveh). It was the Turks, however, who controlled much of the world’s trade in coffee by the Middle Ages. The Turkish Empire, attempting to expand into Europe, laid siege to Vienna in 1683. The war failed, but the retreating Turks left behind 500 sacks of coffee beans, which an entrepreneur used to open the first coffeehouse in Vienna. Coffee use spread throughout Europe.

In 1675, King Charles II issued an order to close the coffeehouses that were already widespread throughout England, citing idleness as the chief complaint. Two days before the proclamation was to take effect, however, Charles backed down, fearing massive protests by coffee drinkers. Ironically, in the ensuing decades, the British came to prefer tea, probably due to the acquisition of its colony in India and the establishment of the tea trade there.

The social use of coffee then spread to America. By the eighteenth century, plantations devoted to the coffee plant were actively producing the bean in Indonesia and the West Indies.

Later, during the Vietnam War, coffee also played a part in the protest movement growing at home. Coffee bars flourished near military bases across the United States, where discussions flowed, along with the coffee, over strategies to aid war protestors.

Both health claims and controversies have followed caffeine through the centuries. By the 1960s, health concerns over coffee use were raised in the medical literature as well as the popular press. Research linked coffee consumption to medical conditions such as pancreatic cancer, breast lumps, and elevated levels of cholesterol.

In 1979, a Swiss company developed a distillation method to remove the caffeine from coffee, creating decaffeinated coffee. The Swiss water process proved popular among young urban professionals as it was considered to make a more “natural” product in comparison to the earlier method of making decaffeinated coffee, which used chemicals such as methylene chloride. The Swiss method also retained more of the flavorful oils residing in the coffee bean. Caffeine-free versions of colas soon followed.

Most follow-ups to earlier studies warning of the adverse effects of caffeine have failed to duplicate the initial findings, especially for the moderate use of caffeine. However, at the start of the new millennium, youth culture thrived on the excessive use of caffeine. New drinks were purposely formulated to contain large amounts of the mild stimulant, increasing the risk of possible adverse effects.

Critics of popular beverages such as Red Bull and Adrenaline Rush suggest that the high caffeine and sugar content pose a potential risk of dehydration for athletes, and that they could also pose a significant danger for adverse effects on the heart. In addition, these high-caffeine drinks are used as mixer beverages for alcohol, a potentially dangerous combination.

Some body builders tout the combination of caffeine with the herbal stimulant ephedra as harmless, and suggest the combination helps turn fat into muscle. A study published in 2001 does support the claim that caffeine and ephedrine can boost results in laboratory attempts to mimic the tasks of competing athletes. However, ephedra, the herbal drug containing the chemical ephedrine, has been linked to several deaths.

In 1980, the Food and Drug Administration (FDA) proposed to remove caffeine from its Generally Recognized As Safe list. But the FDA concluded in 1992 that, after reviewing the scientific literature, no harm is posed by a person’s intake of up to 100 mg per day. As of 2001, the FDA recognized caffeine as a substance that is a food additive with a provisional listing status.

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