A year ago this autumn, as I soldiered my way through a tough work assignment, I decided to head to the corner coffee shop and treat myself to one of those “tricked out” lattes (the trick being that you convince yourself that a drink topped with caramel, fudge, and whipped cream counts as breakfast).
This was a rare reward for me. I’d purposely resisted coffee culture throughout four decades of life. In fact, I had consumed fewer than a dozen cups since birth, preferring to chuckle bemusedly at other people’s dependence — from the grade-school teachers who kept Styrofoam cups on their desks all day, to the co-workers at my newspaper job who’d come into work sucking their Starbucks, buy two more, and quaff one on the road.
But last October, after I journeyed to the local coffee joint and tried that first “fall spice” latte with pumpkin, nutmeg, and cinnamon — plus that frothy milk and sugar — I was flooded with inspiration. Back at my desk, tapping my way through revisions to an article, I enjoyed the sweetness, the warmth, the high of the caffeine, and the fact that I could make it last longer than most treats.
I quickly careened into the coffee culture I’d condescendingly avoided: writing mainly at coffee houses, staking out the places that offered the less bitter brews, chatting with other customers in line about Haitian vs. Salvadoran blends. I’m aware it’s a relatively tame vice to have. But each morning, as soon as I woke up, I started thinking about coffee.
Now I asked myself questions: I had friends who’d cut down and gotten headaches as a result. How could I avoid becoming like those people?
What if I only let myself have it every other day — would that help me avoid dependency?
Maybe if I only had it on the toughest days at work?
What if I ordered it more often but got half-caf?
And then I wondered: If I have to be this careful about my food and coffee boundaries, was I just one venti PSL away from needing it all the time?
Where do caffeine and coffee sit when it comes to addiction?
I’ve always wondered if I have an addictive personality. I constantly lean on my favorite snacks to get through hard tasks, and I usually have to set boundaries on my guilty pleasures to avoid overindulging.
Back in college, when the dining hall offered unlimited ice cream toppings, I craved them enough that I designated two days a week “ice cream days” and two other days “chocolate days” so I wouldn’t scarf Sno-Caps through every study break.
I’m not sure whether it’s psychologically normal to strategize so much about one’s guilty pleasures, and I’ve heard more women talk about it than men. But I’ve also wondered: Does thinking about certain substances mean a person is vulnerable to dependence? What indicates an “addictive personality” anyway? Is it a slippery slope? And how does one determine if a fondness for a particular substance crosses the line into depending on it?
I think we all wonder where the line is between a guilty pleasure and a substance use disorder.
So I began reading up about dependence on legal substances, such as food and wine. I ultimately wrote an article about addiction for a major newspaper, but I didn’t focus on coffee as much. However, while I was interviewing one of the pioneers in the study of food addiction — a doctor who had created the Yale Food Addiction Scale back in 2009 — I had a question.
I asked, trying to sound as nonchalant as possible, how a person could tell if they happened to be addicted to coffee.
“Coffee isn’t classified under substance use disorders,” she told me.
I looked in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the standard compendium of mental health diagnoses and classifications used by doctors and government agencies. The DSM-5 included a list of substances that potentially cause a “substance use disorder,” whether mild or severe.
Most of the substances were what you’d expect:
- stimulants (cocaine, methamphetamines)
- hallucinogens (LSD)
But not caffeine.
That doesn’t mean it won’t be there in the future. In fact, the DSM-5 places caffeine use disorder in a category called “Conditions for Further Study.”
Similarly, food addiction — or addiction to sugar or fat — isn’t currently classified as a “use disorder” in the DSM-5, but studies continue. That’s why experts in food addiction developed the Yale Scale, their yardstick for determining dependence. They based it on the DSM-5’s criteria for other use disorders and drew up 35 questions about dependence.
The DSM-5 has its own checklist to see if an individual is heading toward a substance use disorder. There are 11 questions that ask about behavior in the last 12 months.
A person who answers “yes” to 2 of the 11 questions has a mild use disorder. Answering more questions positively means a person may have a “moderate” or “severe” disorder. This spectrum of severity is a change from the previous version of the DSM that divided substance problems into either “abuse” or “dependence.”
So I read the 11 DSM-5 criteria and applied them to my own life.
Did I keep using the substance despite adverse health effects? Did I have a problem in my relationships because of it? Do I “crave” the substance (a new category for the DSM-5)? Have I tried to quit, but failed? Looking at the list, I realized that despite my overthinking and strategizing, I couldn’t quite say that I was on the spectrum of use disorders… yet.
I have pretty good willpower and am able to maintain boundaries, although I can see myself giving into a coffee routine. But then again, I’ve been a little late for work because I stopped to grab a latte. (Perhaps that’s only because I haven’t learned one of the coffee veterans’ strategies: Stop into the office first, then leave to hunt some down.)
I read a 2015 article in Prevention magazine about an Alabama woman who needed chocolate so badly that one cold morning, she strapped her 3-year-old and 4-month-old daughters into the car to drive to the gas station just for a Snickers bar. That seemed more desperate than anything I’d done for my caffeinated treats.
Does all of this mean that using coffee as a crutch is perfectly fine?
Caffeine also has the rare distinction of being in the DSM for potentially causing a substance “related” disorder (rather than a “use” disorder). This means that, for now, the DSM recognizes caffeine as causing withdrawal symptoms following cessation. These symptoms can include:
The DSM-5 also doesn’t recognize that people may have caffeine dependence and need more and more caffeine to achieve the same high. This distinction may change as further studies on caffeine are done. A group of researchers who help edit substance use disorder information for the DSM-5 explained in one review that more studies with specifically larger samples and more diverse groups are needed.
Another 2013 review published in the Journal of Caffeine Research by researchers at Johns Hopkins and the University of Vermont came right out to say:
“Caffeine is the most commonly used drug in the world. Although consumption of low to moderate doses of caffeine is generally safe, an increasing number of clinical studies are showing that some caffeine users become dependent on the drug and are unable to reduce consumption despite knowledge of recurrent health problems associated with continued use. The World Health Organization and some health care professionals recognize caffeine dependence as a clinical disorder.”
And a Duke researcher noted in a 2014 review of caffeine use disorder that, “It may be difficult for some health professionals to accept that caffeine use can result in the same types of pathological behaviors caused by alcohol, cocaine, opiates, or other drugs of abuse. Yet there is evidence that some individuals are psychologically and physiologically dependent on caffeine, although the prevalence and severity of these problems is unknown.”
So, where does that leave us?
There’s no denying that pumpkin spice lattes are especially tricked out recipes
Fall lattes are often high in sugar and fat (depending on the toppings), two ingredients that food addiction specialists believe may cause dependence. So what if pumpkin spice lattes are a special recipe to potential cravings? I’d be curious to know how many people stagger their guilty pleasures or tie them to specific tasks, and how far they take it.
But for now, I think I’m still far enough away from dependence that I probably won’t have to quit my flavored lattes just yet. It might be more important for me to stop beating myself up over my little rewards.
In fact, a May 2017 study published by British researchers said many people falsely believe themselves to be “food addicts,” and may restrict certain foods to the point that they crave them even more.
So it seems that when it comes to “guilty” pleasures, the fact that I feel guilt at all may be the least healthy part.
Caren Lissner is a journalist and novelist who has written for the New York Times, the Atlantic, and Harper’s. Her first novel, Carrie Pilby, was turned into a movie currently on Netflix. More of her writing can be found at carenlissner.com.