Lead researcher Dr. Hering-Hanit of the Sapir Medical Center in Kfar Saba, Israel says that "caffeine abuse is probably the most common of all 'substance' abuses…[it is an] excellent candidate for producing physical dependency as manifested by biochemical, physiological, or behavioural changes when discontinued."1
Historically, caffeine has been compared to opioids, in terms of an abused substance. While drug-induced headache has been recognized as a major cause of chronic daily or almost daily headaches in adults, it has only recently been reported in children. This study looks at caffeine as a substance of abuse in children and adolescents.2-4
To study the effects of excessive caffeine consumption in children and adolescents, the researchers enrolled 19 boys and 17 girls who had been suffering from chronic headache occurring daily or at least four days a week. The average age of the patients was 9.2 years (ranging from 6-18). They had suffered from chronic headache for an average of 1.8 years. The headaches were described as constant, dull, pressure like and on both sides of the head. No patients had a history of migraine, and all physical and neurological tests were normal.
All of the patients were heavy cola drink consumers, drinking at least 1.5 liters of cola a day. Caffeine consumption averaged 192.88 mg/day, which compares to 2.33 small cups of ground coffee. The weekly average was 11 liters of cola, with average caffeine consumption equaling 17.14 cups of coffee. Very few patients consumed tea, and none drank coffee.
The patients were encouraged to gradually stop consuming cola drinks over 1-2 weeks to prevent possible abrupt caffeine withdrawal headaches. This resulted in a complete end of all headaches in 33 out of the 36 patients at the end of the two weeks, and headache cessation persisted through the 24-week follow-up period. The three patients who continued to have headaches experienced intermittent episodic migraine without aura instead of daily headache.
The researchers conclude by saying that their study "justifies taking a detailed history of caffeine intake …in youngsters with chronic daily headache. If this is found excessive, the diagnosis of caffeine-induced headache should be strongly considered." They go on to say that pediatricians and health providers should be alerted to these findings "as approximately 55% of caffeine intake in young American schoolchildren is in the form of soft drinks."5
References:
1. Griffiths RR, Woodson PP. Caffeine physical dependence: a review of human and laboratory animal studies. Psychopharmacology 1988;94:437-451.
2. Guelliot O. Du caféisme chronique. Union Med Sci Nord-est 1885;9:181-194.
3. Austin GA. Perspectives on the history of psychoactive substance abuse. Research Issues 24, DHEW Publication (ADM), 79-810. Washington, DC: US Government Printing Office, 1979:50-66.
4. Greden JF. Caffeinism and caffeine withdrawal. In: Lowinson JH, Ruiz P, editors. Substance abuse: clinical problems and perspectives. Baltimore: Williams & Wilkins, 1981:274-286.
5. Ellison RC et al. Current caffeine intake of young children: amount and sources. J Am Diet Assoc 1995;802-804.
Source:
Hering-Hanit R, Gadoth N. Caffeine-induced headache in children and adolescents. Cephalalgia 2003;23:332-335.