What is Amotivational Syndrome?

By David Joel Miller.

Have you lost your drive or your desire to do something?

unmotivated

Low Motivation.
Photo courtesy of Pixabay.com

Amotivational Syndrome is often connected with the smoking of marijuana.  This is something quite different from what we see in depression.  In depression, people lose the desire to do things they use to make them happy.  We call that loss of pleasure anhedonia.

In Amotivational Syndrome people seem to spend more time looking inward and contemplating things and less time actively doing them.  This syndrome was originally recognized in younger, marijuana smokers who were heavier daily users.

Does marijuana smoking cause loss of motivation?

Things that are, or were, associated with Amotivational Syndrome include the development of apathy and loss of ambition.  Heavy smokers just seem to become indifferent and stop caring about anything except smoking.  They seem to have fewer goals and decreased effectiveness.  Problems with attention and concentration have also been attributed to heavy marijuana smoking and Amotivational Syndrome.

Many of these characteristics are seen in daily, heavy, marijuana smokers.  What is unclear is whether the marijuana smoking causes this cluster of symptoms or whether those people who are low in motivation like to smoke marijuana.  At one point it was commonly accepted that some marijuana smokers are likely to suffer from Amotivational Syndrome.

Not all marijuana smokers are low in motivation.

Because of the many famous, popular people, who have been reported to be regular marijuana smokers, the connection between smoking marijuana and low motivation has come into question. It is unclear how common this condition is, or even if this is a valid syndrome.  Amotivational Syndrome has not been reported in countries other than the United States.  There’s some question whether Amotivational Syndrome is, in fact, a cultural rather than a mental condition.

Animals on marijuana don’t lose motivation.

Laboratory studies of both humans and animals have not found evidence of the Amotivational Syndrome for those using marijuana.  Amotivational Syndrome or loss of goals and direction has been found in many groups of young people who are not using marijuana on a regular basis.  This has led some writers to conclude that Amotivational Syndrome is a personality characteristic rather than the result of smoking marijuana.  It may be that those people with low motivation are attracted to using marijuana and other intoxicating substances.

One other possibility that has been suggested is that those people who are under the influence of drugs and alcohol or other substances may have low motivations to do anything while under the influence.  What we may be seeing in those people who were described as having Amotivational Syndrome may, in fact, be the effects of intoxication and withdrawal from marijuana or other substances.

As with the other things we are calling a mental illness or symptoms of a mental illness Amotivational Syndrome would need to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress for it to be the focus of clinical attention. Otherwise, while you may have lost some motivation you will not be identified as someone needing clinical assistance.  If the only time you have low motivation is when you are under the influence of marijuana or another drug this would be diagnosed as drug intoxication.

For more on this and related topics see the other posts on counselorssoapbox.com under        Drug Use, Abuse, and Addiction

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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What is Polydrug or Polysubstance use?

By David Joel Miller.

Polydrug use is common.

Drugs

What is Polydrug or Polysubstance use?
Photo courtesy of Pixabay.com

Polydrug use, sometimes referred to as multiple drug use, is an increasingly common pattern. Diagnosis of Substance Use Disorders used to be divided along the lines of the particular substance that someone used or abused. Treatment systems separated the alcoholics from the Heroin users and so on. There was a lot of validity to that model but it is becoming less and less possible as more people are using combinations of many drugs.

Most drug users have a preferred “High.” Stimulant users like being way up. Depressant users like the falling asleep, passing out kind of high. Hallucinogen users are chasing an altered reality. Some people dabble in all three types and their pattern of addiction is more to the process of using drugs than to any one particular substance.

I have heard people with a history of polysubstance use describe themselves as “trashcan junkies” just open the lid and throw something in. When asked what drugs they do, the standard answer is “What have you got?”

Drugs of abuse have cultures.

Alcohol users and abusers tend to hang out together. They have their preferred beverage of choice and their favorite method of consumption. If you drink the way others in your social circle drink then you can maintain the illusion that your drinking is under control. Some drinking groups divide up a 12 or 24 pack, some pass around a bottle of wine or a paper bag containing the hard stuff. Other groups order fancy mixed drinks from the cocktail waitress. Alcohol is everywhere and most people develops some familiarity with this culture.

Weed smokers have their culture also. They pass around the blunt, smoke a bowl or roll a joint. They have particular names for the varieties of marijuana they smoke or those they disdain. Most drink alcohol from time to time. Many weed smokers also have cultural decorations, tribal music and cultural heroes who smoked a lot of weed. But in a group of consistent marijuana users, it is likely that most primarily smoke marijuana.

Heroin users develop their own special culture. They know the process of making a rig. Users learn the concepts of going to the cotton and cotton fever. They also know the struggles of kicking and going cold turkey.

Some of the younger opiate abusers believe they are from a different tribe. They do their opiates as pills and liquids, obtained from doctors, pharmacies and diverted medical supplies. They may even hold fast to the myth that they are not addicts because they do not use needles. That myth gets shattered when their supply is interrupted and they have to kick along with the heroin addicts.

Polysubstance users move between cultures.

Increasingly we are seeing those whose allegiance is not to one drug of choice but to the process of doing drugs of any and every kind. The use of multiple substances is the norm rather than the exception. Most people in drug treatment and a major part of our jail and prison populations have long histories of using a wide variety of substances.

Polysubstance dependence is a problem without a diagnosis.

The most recent edition of the DSM eliminated the diagnosis of polysubstance dependence. We never did use polysubstance abuse. From here on the plan is to list each drug someone may have developed a problem with and then rate each use disorder as mild, moderate or severe.

For those working in the Substance Use Disorder field, this is problematic. While a client may have a mild problem with each of eight or ten different drugs, overall they can have a significant problem living life without using drugs or destructive behaviors.

My own experience has been that when someone has this “polysubstance dependence” problem, there are usually some other significant mental health issues going on.  The best treatment when polysubstance abuse or dependence are encountered is treatment of the mental health issues and the substance use issues at the same time.

Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs and AOD professionals and the terms and descriptions used in the DSM.

FYI. These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What are Bath Salts?

By David Joel Miller.

How come people are abusing Bath Salts?

Bath Salts

Bath Salts
Photo courtesy of Pixabay.com

There is a growing tidal wave of use and abuse of Bath Salts. These are not the kind of Bath Salts you would ever put in water and soak in. Bath Salts are also sold under a number of other names including Plant Food, Water Pipe Cleaner as well as a host of brand and product names.

These products made use of a loophole in the laws of the U. S. and other countries, which exempted chemicals from regulation as drugs if they were “Not for Human Consumption.” These drugs were imported without restriction because of being labeled for uses other than human consumption. Here in the U. S. they were then repackaged in small amounts and sold in small stores. While labeled “not for human consumption” it has always been clear that users were buying these packages to consume them.

The primary ingredients in many of these products are amphetamine-like chemicals in the Cathinone Family. Cathinones are synthetic versions of a drug originally found in the Khat plant from north-eastern Africa. Before becoming popular as drugs of abuse these drugs were primarily used to kill insects hence the name “plant food.” The name “bath salts” is reported to come from the way these drugs are often packaged to look like bath salts.

Bath Salts can be consumed by snorting, swallowing, smoking or injecting. Other possible routes of administration are sure to be attempted.

Use of Bath Salts has resulted in a significant number of admissions to hospital emergency rooms. Symptoms of Bath Salt intoxication include a number of serious symptoms including agitation, violent behaviors, heart palpitations and psychotic symptoms. There are reports of these symptoms, particularity psychosis, lasting long after the drugs have been metabolized. At high doses, these drugs can be fatal.

The Synthetic Drug Abuse Act of 2012 was intended to reduce the problems with Bath Salts. Some particular ingredients have been made illegal. Unfortunately, this is a very large family of synthetic chemicals and many have never been tested. As fast as one chemical has been tested, found to be harmful to humans and banned, other chemicals have been substituted.

More and more synthetic chemicals are being sold and experimented with by drug users. The line between Bath Salts, Synthetic Cannabinoids, and other research chemicals has become fuzzy. New formulations are appearing so rapidly they are now being referred to as NPS (New Psychoactive Substances.) Expect Bath Salts of new formulations and other synthetics to become and increasing problem.

For more on these topics see:    Drug Use, Abuse and Addiction             Recovery         What is

Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs and AOD professionals and the terms and descriptions used in the DSM.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What is Cannabis (Marijuana) Withdrawal?

By David Joel Miller.

Is there really such a thing as Marijuana Withdrawal?

Withdrawal from marijuana.

Cannabis (Marijuana) Withdrawal?
Photo courtesy of Pixabay.com

Marijuana withdrawal is real and a lot more common than many people think. Among heavy marijuana smokers who enter residential treatment up to 95% experience very real symptoms of marijuana withdrawal. This set of symptoms is so significant that it was included in the new DSM-5 under the name Cannabis Withdrawal (F12.288.)

Cannabis covers a number of preparations made from the Cannabis Sativa plant including Marijuana, Hashish, and Hash Oil. There are hundreds of different chemicals in the cannabis plant, though current thinking is that the primary psychoactive chemical is THC (tetahydrocanibinoid.)

When we say withdrawal many people think of severe physical symptoms the way someone might experience withdrawal from Heroin. The symptoms of cannabis withdrawal while more subtle than that can be very problematic.

Back in the 1960’s the thinking was that there were no withdrawal symptoms from marijuana. Some people still think that. One difference then to now is that the levels of THC are higher now. There are also a much larger number of people smoking marijuana on a regular daily basis.

SAMHSA published a treatment guide titled “Brief Counseling for Marijuana Dependence” based on studies of people who voluntarily requested treatment for a Marijuana Use Disorder. One of their conclusions was that people who experience this problem smoked marijuana 28 days a month or more. In other words, daily smoking is much more likely to result in a use disorder and withdrawal disorder than the occasional one-time user.

Cannabis Withdrawal, according to the DSM-5, is only diagnosed if you have a moderate to severe cannabis use disorder. This requires smoking most days for two months or more. Symptoms customarily start 24 to 72 hours after you last smoked. Symptom peak at one week and most are gone by two weeks. Sleep problems may continue for 30 days or more.

Cannabis withdrawal can also occur when people reduce their consumption of cannabis even when they do not completely stop. Family members or others living with the heavy weed smoker may recognize the symptoms of cannabis withdrawal before the smoker does.

In Cannabis Withdrawal seven signs or symptoms have been described as significant enough that they are common features of withdrawal from Marijuana and or other forms of Cannabis. Each of these symptoms might better be called a category of symptoms. For example, emotional issues list three possible emotions and physical symptoms list seven. To get diagnosed with Cannabis withdrawal you need to have one of the signs or symptoms from 3 or more of the categories.

The seven signs or symptoms of Marijuana Withdrawal.

1. Negative, Grouchy emotions during marijuana withdrawal.

Irritability, anger or aggression are common during marijuana withdrawal.

2. High Anxiety during marijuana withdrawal.

During withdrawal from marijuana, people can become nervous, anxious or fearful.  It is common for marijuana smokers to conclude that the marijuana was helping them control anxiety and return to smoking before the withdrawal is completed.

3. Messed up sleep during marijuana withdrawal.

During the initial withdrawal from marijuana, you may experience difficulty falling asleep, staying asleep or you may have bad disturbing dreams. This initial period of poor sleep might also be followed by a period of rebound sleep during which you will experience an increased need for sleep.

4. You may lose your appetite during marijuana withdrawal.

Early in the withdrawal from marijuana you may lose your appetite or even lose some weight. This period of poor appetite may be followed by a rebound of hunger.

5. Restlessness accompanies withdrawal from cannabis.

6. Depressed mood is common during marijuana withdrawals.

This is one of the more common symptoms of giving up almost all drugs. Regular users get close to their drug of choice. Most miss the drug and the related rituals when they stop. Many become depressed or grieve for the loss of the drugs companionship.

7. Physical symptoms can accompany Marijuana withdrawal.

Symptoms commonly reported during marijuana withdrawal include: Abdominal pain, shakiness, tremors, sweating, fever, chills, and headache.

These signs or symptoms need to happen during the first 3 weeks of abstinence otherwise we begin to look for other possible cases. Many marijuana smokers are using other drugs which obscure the signs of the cannabis withdrawal.

Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs, AOD professionals and the terms and descriptions used in the DSM.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What is an Alcohol Use Disorder?

By David Joel Miller.

How is Alcohol Use Disorder different from Alcoholism?

Alcohol

What is an Alcohol Use disorder?
Photo courtesy of Pixabay.com

Used to be a time when doctors treated medical issues, Therapists treated mental illness, Social services treated poverty related issues and – well – no one exactly wanted to do anything with drug addicts and alcoholics. Times are changing.

Turns out that no matter where you are and who you work with there is a good chance that people around you are being affected by chemicals, alcohol in particular, long before they reach the “alcoholic” or “Chemically Dependent” stage.

In Drug and Alcohol counseling we used to spend a lot of time debating what made you an alcoholic or addict. Turns out the lines are fuzzy. One estimate is that 90% of alcoholics have full-time jobs. Some people do not drink that often. Half the adult U. S. population did not drink in the last thirty days.

Even if you only drink once a year, say for New Years, if you have gotten into fights while drinking, gotten DUI’s several times, then your only drink once a year is not of much import. If when you drink, bad things happen, then you have an Alcohol Use Disorder. The DSM uses the expression “Problematic Pattern of Alcohol Use.”

What we discovered was that it was not so much what you drink or when you drink that matters when it comes to Alcohol Use Disorders, it is what happens when you drink that is significant.

The Symptoms of Alcohol Use Disorder.

The new DSM-5 has switched to the use of the term “Alcohol Use Disorder” to indicate someone whose use of alcohol is causing them problems whether they are “Alcoholic” or not and lists 11 criteria for Alcohol Use being a problem. Here is my plain language version of those Criteria.

  1. Once you start drinking you drink more than you planned on and/ or keep drinking longer than planned.
  2. You keep trying to cut down on your drinking. In other Alcoholism texts, this is also described as efforts to control your drinking or to quit drinking. See, people do not try to cut down, control or quit drinking unless it is a problem.
  3. Drinking eats up a lot of your time.
  4. You have cravings for alcohol when you are not drinking.
  5. Drinking gets in the way of work, school, home life or recreation. A real Alcoholic cuts out this other stuff so they can concentrate on their drinking.
  6. You know that when you drink bad stuff happens but you keep drinking anyway.
  7. You start cutting out other parts of your life to spend more time drinking.
  8. You try to get away with drinking even when you know it makes the situation dangerous.
  9. You keep drinking even though you now realize it is causing you problems.
  10. Your body starts building up tolerance. (See post “What is Tolerance” in the “What is” section.)
  11. You experience “withdrawal” when you stop drinking and the blood alcohol level starts dropping. (See post “What is Withdrawal” in the “What is” section.)

These problems with Alcohol can come in mild, moderate or severe. Mild Alcohol Use Disorder would have 2-3 of these symptoms, Moderate has 4-5 symptoms and severe has 6 or more.

If you or someone you know is exhibiting these symptoms think about treatment and or self-help groups. The sooner Alcohol Use Disorder gets treated the better the life prognosis. While sooner is better it is never too late to get treatment for an alcohol use disorder as long as you are alive.

Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs, AOD professionals and the terms and descriptions used in the DSM.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What is Drug Withdrawal?

By David Joel Miller.

You’re more likely to have a drug withdrawal than you might think.

Drugs

What is Drug Withdrawal?
Photo courtesy of Pixabay.com

When people think of drug withdrawal the picture they see is the one of classic heroin withdrawal. Someone coming off heroin or other opiates does some “kicking” both drug wise and legs wise. They also have diarrhea and “goose bumps.” Because opiates are pain relievers during withdrawals people can experience high levels of pain.

That dramatic type of withdrawal is not the only kind you might have. Each drug you might take can have some effects when the level in your body, principally in your bloodstream, begins to drop.

Drug Withdrawal Defined.

Drug withdrawal is an identifiable illness or syndrome that happens when someone stops taking a drug or reduces the amount they are using significantly. The symptoms begin when the level of a drug in the blood drops. Withdrawal symptoms can vary in severity and each drug has its own pattern of withdrawal symptoms. An alternative name for withdrawal is Abstinence Syndrome.

In the early stages of drug use, withdrawal symptoms may be minimal and go unnoticed. Once the body has adjusted to having that drug present and made adaptations the symptoms become more pronounced. Symptoms may not be entirely physical. For some drugs the primary withdrawal symptoms are psychological.

Withdrawal symptoms make it harder to stop using drugs.

The more severe the withdrawal symptoms the more likely the user is to pick that drug backup to reduce those symptoms. A withdrawal symptom of drugs taken to reduce anxiety, prescribed or self-medicated ones, is an increase in anxiety. People who smoke marijuana to reduce anxiety report that the anxiety gets really bad after they discontinue smoking it. This results in a return to marijuana use.

Getting rid of withdrawal symptoms is a strong motivator to resume drug use again.

The DSM-5 lists withdrawal effects for eight of the eleven classes of substances.

I find it interesting that some drugs such as Inhalants and Hallucinogens have no withdrawal symptoms specified. We also have only one diagnosis and F code for the group of drugs, Sedative, Hypnotic or Anxiolytic Drugs. Withdrawal from these drugs can be different with different drugs. Stimulant Withdrawal is separated and has one code for Cocaine and another for Amphetamines and other stimulants. These DSM-5 codes are a rough sketch. For the full details consult the DSM-5 text. Also, note that there are well-defined withdrawal criteria for Cannabis (Marijuana) and Caffeine.

Alcohol Withdrawal (F10.239 or F10.232)

Caffeine Withdrawal (F15.93)

Cannabis (Marijuana) Withdrawal (F12.288)

Opioid Withdrawal (F11.23)

Sedative, Hypnotic or Anxiolytic Withdrawal (F13.239, F13.232)

Stimulant Withdrawal

Amphetamine or other stimulant (F15.23)

Cocaine Withdrawal (F14.23)

Tobacco Withdrawal (F17.203)

Other (or Unknown) Substance Withdrawal (F19.239)

For more on drugs and recovery see:

Drug Use, Abuse, and Addiction      Recovery

Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs, AOD professionals and the terms and descriptions used in the DSM.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What is Caffeine Withdrawal?

By David Joel Miller.

You can get sick when you stop caffeine.

Caffeine Withdrawal

Caffeine Withdrawal
Photo courtesy of Pixabay.com

There are five distinct symptoms that people often develop when they suddenly stop taking in caffeine, and yes those symptoms can get severe enough that the person reports they are sick. Caffeine withdrawal is extremely common. With about 70% of those who try to permanently stop consuming caffeine experiencing this illness.

Caffeine is used more commonly than any other psychoactive drug. By psychoactive we are talking about a drug that changes the way you think, feel and behave. Increasingly counselors in the substance use disorder field are looking at commonly used drugs like tobacco and caffeine and their impact on client’s recovery from alcohol and other drugs.

Absolutely your body can get used to having caffeine in your system and there are physical withdrawal symptoms when you stop using caffeine. This problem is severe enough that in the DSM-5 it is a specific diagnosis Caffeine Withdrawal (F15.93.)

Caffeine use is more common than one might think. It is not just adults who are using caffeine and experiencing caffeine withdrawal. The DSM-5 reports that 85% of U. S. adults and CHILDREN use caffeine daily.

Drug and alcohol texts (Maisto, Galizio & Connors, 2015) report that worldwide 90% of the population uses caffeine. Aside from adults, the group receiving the highest daily dose are young preschool children. Caffeine is commonly found in sodas and energy drinks, both favored beverages among the very young. One has to wonder how this universal use of caffeine is affecting children’s thinking, feeling, and behavior.

Caffeine withdrawal sneaks up on you.

Many people are surprised when they experience caffeine withdrawal. Most likely times to have this disorder are when there is a sudden change in your routine. Weekends, vacation times, hospitalizations, travel, all are potential caffeine withdrawal experiences.

Caffeine withdrawal starts twelve to twenty-four hours after your last dose. The worst of the symptoms peak one or two days after you stop taking in the caffeine. Headaches from caffeine withdrawal have been reported up to three weeks after the last dose.

You do not have to be a daily or heavy caffeine consumer to experience caffeine withdrawal, though the more caffeine you take in each day the more likely you are to experience caffeine withdrawal. More important than your daily intake in the equation is how regularly you use caffeine and the suddenness of your stopping.

People experiencing caffeine withdrawal are likely to misattribute their symptoms and think it is the flu or another illness. The result is those withdrawing from caffeine use a lot more pain relievers than normal.

How do you know you have caffeine withdrawal?

To receive this diagnosis you need to have 60% or three of five of the possible symptoms, though each person may have a different group of symptoms. The hard part sometimes is to be sure all of these symptoms are the result of caffeine withdrawal and not some other issue.

One way to be sure your problem is caffeine withdrawal is to take in some more caffeine. That should work in an hour or less.

What are the five symptoms of caffeine withdrawal?

  1. Headaches
  2. Tired, fatigue or drowsiness.
  3. Bad mood, unhappy, depressed, irritable. As a side note, people who consume a lot of caffeine can become very anxious.
  4. Concentration or attention issues.
  5. Is this a virus? Caffeine withdrawal can include the muscle pain, nausea and even vomiting that are characteristic of the flu.

As with all the other things that make it into the DSM, Caffeine intoxication only gets diagnosed if it interferes with your work, school, relationship with family and friends, causes you excessive discomfort or makes you give up things you used to like to do. You also should not blame it on not having your coffee if this is better explained by another mental illness or the effects of another drug.

Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs, AOD professionals and the terms and descriptions used in the DSM.

FYI, these “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books