Is caffeine addictive? Dependence, withdrawal and what the DSM-5 says

Key takeaways

• Regular caffeine use can produce physical and psychological dependence, and caffeine withdrawal is recognized in the DSM-5.
• Caffeine use disorder, the closest thing to a formal “caffeine addiction”, is listed in the DSM-5 only for further study.
• Withdrawal symptoms typically start 12–24 hours after the last dose and last two to nine days; habits as low as 100 mg a day can produce them.
• The FDA says withdrawal is not considered dangerous but can be unpleasant, and that cutting back gradually is best.

Dependence, withdrawal and addiction are not the same thing

People use “addicted to caffeine” for three different things, and the evidence is different for each. Dependence means your body has adapted, so you feel worse without caffeine. A clinical review in StatPearls, a reference text hosted by the US National Library of Medicine, says regular use can produce physical and psychological dependence, and that stopping abruptly may bring on a clinically significant withdrawal syndrome that is recognized in the DSM-5.

Addiction in the clinical sense means continuing to use a substance despite harm and being unable to stop. For caffeine, the DSM-5 has a category called caffeine use disorder, but a 2013 review by researchers who study it describes it as a condition for further study, not an official diagnosis. The authors write that more research is needed on how reliable and valid the diagnosis is and how common it is.

MedlinePlus includes dependency, needing more caffeine to get the same result, in its list of effects of too much caffeine. So the honest short answer is: caffeine clearly causes dependence and withdrawal, while caffeine addiction as a disorder is still being studied.

Caffeine withdrawal: the clearest sign of dependence

The best-studied part of caffeine dependence is what happens when you stop. A 2004 critical review of 57 experimental and 9 survey studies confirmed ten withdrawal symptoms: headache, fatigue, decreased energy, decreased alertness, drowsiness, decreased contentedness, depressed mood, difficulty concentrating, irritability, and feeling foggy or not clearheaded. Its authors concluded there was enough evidence to include caffeine withdrawal as a disorder in the DSM.

In the experimental studies, about half of people got a headache, and about one in eight had symptoms that caused clinically significant distress or got in the way of daily life. Symptoms became more common or more severe at higher daily doses, and stopping a habit of as little as 100 mg a day still produced symptoms.

What researchers describe as problem caffeine use

The 2013 review of caffeine use disorder describes people who become dependent on caffeine and are unable to cut down even though they know it keeps causing them health problems. The authors call it a clinically meaningful disorder that affects a nontrivial proportion of caffeine users. The figures they review come from small studies and vary widely by group. In the only US general-population study, of 162 regular caffeine users in Vermont, they estimate that 9% or fewer would meet the DSM-5 research criteria, and they note that no national population-based study had been done.

Tolerance is the other piece. In a controlled study, people who took 300 mg of caffeine three times a day for 18 days stopped feeling its subjective effects, while people on placebo still felt them when given caffeine. The authors called this the clearest evidence of complete tolerance to an effect of caffeine on the brain in humans. That dose, 900 mg a day, is far above typical intake, so it does not tell you how fast tolerance builds on two coffees. Our page on caffeine tolerance covers what it means for everyday drinkers.

Am I addicted to caffeine? Questions to ask yourself

There is no validated self-test we can offer, and the DSM-5 criteria for caffeine use disorder are for research, not for labelling yourself. The questions below are not a score or a diagnosis. They simply mirror the features the sources describe: withdrawal, tolerance, and trouble cutting down despite problems.

If you answer yes to several, talk to a doctor or pharmacist, especially if caffeine is affecting your sleep, anxiety, heart or stomach and you can’t cut down. The 2013 review treats withdrawal, trouble cutting down and continued use despite problems together as the core of caffeine use disorder, which it calls a clinically important health problem.

• Do you get a headache, feel foggy or feel low if you miss your usual coffee or tea?
• Do you need more caffeine than you used to for the same lift?
• Have you tried to cut down and found you couldn’t?
• Do you keep having caffeine even though it disturbs your sleep, makes you jittery, or a doctor has advised less?
• Is your usual day above 400 mg, the amount the FDA cites for most adults?

Why your morning coffee can feel essential

Part of the pull of caffeine may come from withdrawal itself. Some researchers argue that in daily users, the boost to mood and performance from caffeine is almost entirely the reversal of withdrawal effects that come with short periods without caffeine. In a trial of 379 people, regular users who went 16 hours without caffeine and then had a placebo felt less alert and had more headaches, and caffeine returned their alertness to baseline rather than above it.

Other researchers disagree. In a study of 102 light users who were not dependent, caffeine still raised arousal and improved attention, which suggests it has real effects even without withdrawal. Either way, if your first coffee mainly makes you feel normal again, that is a typical sign of dependence. See why caffeine may not seem to affect you for more on this debate.

How to cut back on caffeine if you feel hooked

The FDA says that if you are used to caffeine every day and want to cut back, it is best to do so gradually, and that withdrawal is not considered dangerous but can be unpleasant. MedlinePlus also advises reducing intake slowly to prevent withdrawal symptoms. Neither gives a schedule, and we know of no study that sets a specific rate, so pick steps that feel manageable, such as replacing one drink at a time.

Expect some symptoms anyway. MedlinePlus says withdrawal symptoms such as headaches, drowsiness, irritability, nausea and trouble concentrating usually go away after a couple of days, while the 2004 review found they can last up to nine days. Our guides to caffeine withdrawal and the caffeine withdrawal headache cover the first week in detail.

Common questions