Use And Effects Of Caffeine In New Zealand

Psychoactive substances are substances that impact the working of the brain and cause variations in thoughts, mood, behaviour, awareness, and feelings (WHO, 2022). Examples are caffeine, alcohol, nicotine, certain pain medications, and marijuana. Caffeine is a chemical compound and a bitter substance that grows in more than 60 plants naturally (Cappelletti et al., 2015). These include tea leaves, kola nuts, cacao pods, and coffee beans. Apart from growing naturally, there is synthetic caffeine that is man-made and is used in some foods, drinks, and, medicines (pain relievers, OTC, and cold medicine). It is also used in energy drinks and energy booster snacks. Mostly, people consume different amounts of caffeine through drinks like tea (14-60 mg), coffee (95-200 mg), energy drink (70-100 mg), or cola (35-45 mg). Caffeine affects the metabolism process of the body and can have certain side effects such as headaches, insomnia, or restiveness (Institute of Medicine (US), 2014). The purpose of this paper is to discuss the use and effects of caffeine. For this, the essay would first explore caffeine in the context of New Zealand and then confer on the psychological and behavioural effects of caffeine. Finally, the essay will explore the addiction to the psychoactive substance and how it might be treated.

Caffeine is one of the most consumed psychoactive in New Zealand with an estimation that 73% of New Zealanders have an average daily consumption of 3.6 mg·kgbw^-1 (Stachyshyn et al., 2021). Coffee is also the most consumed beverage in New Zealand (figure 1). There is a rich history of caffeine in New Zealand. Earlier before the 1940s, New Zealand was a tea-drinking nation and coffee was introduced to the nation largely by European migrants. In 1958, Nestle started to export its instant coffee powder to New Zealand, and then in 1962, the company set up its coffee factory in Auckland. During the 1980s and 90s, New Zealanders started to buy espresso machines from Australia, and a new interest in coffee was discovered. In the mid-90s, NZ’s cafes started to grow in popularity and size (Bentham, 2020).

New Zealand has strict regulations for energy drinks and it is mandatory for the energy drinks sold in the country to comply with the Australian New Zealand Food Standards Code (NZ Beverage Council, 2022). The standard content of caffeine in energy drinks is 32 mg per 100 ml. Figure 2 shows the content of caffeine in various foods and beverages.

A survey conducted on New Zealanders’ coffee drinking habits shows that (1) 30% of men as compared to 19% of women drink 3 or more cups of coffee per day; (2) 34% of people aged between 55-73 years as compared to millennials drink 3 or more cups of coffee; (3) 31% of New Zealanders like flat white (a type of coffee drink) and 18% prefer mocha with a cappuccino (Scoop, 2019).

The coffee segment’s revenue in NZ totals 990m US dollars and this market is estimated to grow by a CAGR of 5.91% from 2022 to 2025. Most of this revenue is generated from the USA. It is also estimated that by 2025, 18% of volume consumption and 7% of spending in this segment will be from out-of-home (in restaurants and bars) consumption (Statista, 2022).

Effects of caffeine

 

Figure 1

Source: (Statista, 2021)

 

Figure 2

 Source: (Health Navigator New Zealand, 2021)

The short-term effects (increase in heart rate, breathing, physical energy, and mental alertness) of caffeine can be felt just after 5-30 minutes of its consumption. These effects can last for 12 hours depending on the person. Consuming too much caffeine can lead to frequent urination, sleeplessness, dehydration, headaches, trembling, and an increase in body temperature (Better Health Channel, 2015).

When a person consumes caffeine in moderate amounts, he or she may feel symptoms such as a reduction in fatigue and an increase in alertness. Caffeine becomes important for people when they are in low-arousing situations and are working at night. Caffeine has proved to be helpful in improving the performance of individuals in tasks that necessitate a sustained response (McLellan et al., 2016). It is argued that this effect is seen only when the person already has reduced alertness, however, benefits can still be seen even if the person is not impaired. Caffeine increases energy and people drink it to uplift their moods but too much caffeine can cause anxiety. 3 or more cups of coffee increase the heart rate but if consumed in higher doses, caffeine can significantly affect the regularity and speed of the heartbeat resulting in a serious condition called tachycardia. Caffeine can also increase blood pressure, especially in patients with hypertension. People do not disguise their consumption of coffee since its consumption is not illicit. Nevertheless, some symptoms might signal that person might be overusing it. These symptoms include depression, insomnia, tremors, or heart palpitations (Hartney, 2012).  

Caffeine stimulates the central nervous system. It boosts energy metabolism in the brain but at the same time reduces cerebral blood flow. This induces brain hypoperfusion. Additionally, caffeine contributes to the activation of noradrenaline neurons as well as the release of dopamine. Methylxanthine can increase locomotor activity in animals, however, the psychostimulant action of caffeine on man is discreet and cannot be detected easily. Moreover, methylxanthine affects a person’s fatigue, arousal, and vigilance which has a direct influence on memory, learning, coordination, and performance of a person (Fiani et al., 2021). Children are not more sensitive to the effects of methylxanthine than adults. Even though the central nervous system does not improve tolerance to caffeine’s effect, there have been reports of symptoms of withdrawal and dependence.

Caffeine gets easily absorbed in the human body with 99% of it being absorbed just after 45 minutes of consumption. When caffeine is consumed through beverages like coffee, soft drinks, or tea, it gets rapidly absorbed through the gastrointestinal tract and gets distributed across the entire body. The absorption is more rapid when the psychoactive is taken through chewing gums containing caffeine as it allows for absorption with the help of the oral mucosa (Institute of Medicine (US), 2014b).

Caffeine has lipophilic properties due to which it can cross the blood-brain barrier and biological membrane. After absorption, the hepatic portal vein transports caffeine into the bloodstream. The microsomal cytochrome P450 oversees 95% of the primary metabolism. It demethylates caffeine and transforms it into theophylline, theobromine, and paraxanthine. The metabolites of caffeine contribute to stimulating the intermediary metabolism and affect tissues like the cardiovascular, renal, central nervous system, skeletal muscle, and pulmonary tissue (Barcelos et al., 2020).

Behavioral and Psychological effects

There are various foods and lifestyle changes that people can adapt to produce the same behavioural effects ensued by consuming caffeine. These include (1) eating foods that have low sugar content because they absorb easily and will not lead to an abrupt energy drop; for this one can eat a combination of protein, fats, and carbohydrates; (2) not skipping meals and eating healthy snacks and meals throughout the day to keep steady blood sugar levels; (3) exercising, which is a way to re-energize; (4) yoga and breathing techniques that arouses the diaphragm and works as an indicator for the body to enhance alertness; (5) staying hydrated; (6) taking 20 minutes power naps in between work; (7) connecting with the nature to release stress and energise (Medicine, 2022).

Regular consumption of caffeine can lead to a person becoming psychologically and physically dependent upon it. However, caffeine does not have that strong of an effect on the brain to result in an addiction. Addiction is an uncontrollable and chronic use of a substance in spite of the substance’s negative effects. Consuming caffeine within recommended dietary doses does not generally result in any negative health concerns. In fact, since caffeine enhances analgesia, it has been shown to have clinical utility. However, some evidence suggests that consumers of caffeine sometimes experience caffeine-linked functional impairment and adverse health effects. High doses of caffeine over a long time can cause caffeine intoxication and, as discussed above, symptoms like irregular heartbeat, nervousness, insomnia, restlessness, and gastrointestinal distress. Caffeine use is also associated with anxiety, urinary incontinence, and poor outcomes during pregnancy. After discontinuing its use, people might experience withdrawal symptoms such as irritability, fatigue, headache, depression, trouble in concentration, and flu-like symptoms.

In the DSM-5 criterion, caffeine is not seen as addictive, however, its intoxication is considered a disorder. The DSM-5 recognizes the diagnosis of caffeine withdrawal, caffeine intoxication, caffeine-induced insomnia, and caffeine-induced anxiety disorder when a person is facing impairment or distress from the symptoms. Caffeine intoxication is characterized by ingesting caffeine above the level of 250 mg in addition to a minimum of 5 of the following symptoms: diuresis, excitement, restiveness, tachycardia, insomnia, and an upset stomach.

Furthermore, the DSM-5 proposes 3 important criteria for diagnosing caffeine disorder: (1) a persistent and uncontrollable urge to consume caffeine; (2) continuing to consume caffeine even after knowing about the adverse psychological and physical effects that it has caused; (3) showing withdrawal symptoms (Sweeney et al., 2020). The use of caffeine is ubiquitous, hence, to mitigate the risk of overdiagnosing, the diagnostic criteria for caffeine are more conservative than the diagnostic criteria for any other substance.

One way to treat caffeine addiction is to leave it all at once. But this method is not recommended for people who are heavy consumers of caffeine as stopping the consumption suddenly and all at once can give rise to adverse symptoms. People trying this method are advised not to drive during the quitting phase.

To avoid withdrawal symptoms that might occur as a result of abruptly stopping caffeine consumption, a strategy called caffeine fading is used that involves slowly and gradually decreasing caffeine intake. Studies have shown that the caffeine fading paradigm is very useful in helping people decrease their consumption. (Evatt et al., 2016) in their study, used a treatment session for some individuals with symptoms of caffeine disorder. During the session, the participants were provided with basic pharmacological information about caffeine. Then, the reasons behind quitting were discussed followed by the counsellor going through the pros and cons of modification in caffeine use. Post-treatment, participants were instructed to limit their caffeine consumption to 75% of their daily intake during the 1^st week, 50% during the 2^nd week, 25% during the 3^rd week, 12.5% during the 4^th week, and then after the 5^th week, participants were instructed to refrain from products that contain caffeine content above 15mg so as to reduce the consumption to 50mg a day. During the treatment, participants were also trained to maintain caffeine diaries to record their caffeine intake during the 5 weeks post-treatment. The results showed a significant reduction in the caffeine consumption habits of people who received treatment in comparison to people who did not (figure 3).

Biological working of caffeine

 

Figure 3

 Source: (Evatt et al., 2016)

The most effective way to treat caffeine use disorder is the behavioural change technique (BCT) approach in which the consumption is reduced using a particular step-wise process. In this, first, there is the pre-decisional phase in which the person seeks knowledge of caffeine and its harm, then there is the post-decisional phase in which the person sets goals and prepares an action plan to achieve those goals, after that there is the actional phase in which the person uses avoidance, substance substitution, professional support, social support, withdrawal management, fading, or behavioural substitution to reduce consumption, and finally, there is the post-actional phase in which the person reviews the goals and the outcomes (Rodda et al., 2020).

Conclusion

To conclude, caffeine is the most consumed psychoactive throughout the world and in New Zealand. It is mainly consumed through tea, coffee, and energy drinks. Most New Zealanders consume coffee as a source of caffeine and the market segment of coffee in the country is huge with scope for growth. The effects of caffeine include increased alertness and energy but too much consumption can lead to anxiety, depression, insomnia, and urinary incontinence. In this paper, the biological process of caffeine in the body was also discussed how it boosts energy and gets easily absorbed by the body.

Some lifestyle and dietary changes with exercise can serve as a substitute for caffeine. Additionally, the paper included the discussion of DSM-5 criteria for caffeine intoxication where the diagnostic criteria involve an uncontrollable urge to drink coffee along with the presence of certain symptoms which result in impairment or distress.

Furthermore, the treatment of caffeine use disorder can be done through a systematic behavioural approach wherein the consumption of caffeine is slowly and steadily decreased after counselling about the importance of caffeine reduction.

References

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