Caffeine is the most popular and widely consumed drug in the world. According to legend, an Arab goatherd first noticed in 850 A.D. that his goats frisked and frolicked all night after feeding on the berries of the evergreen coffee plant. When he tried it himself, he found it to be extremely stimulating. Though coffee was initially con- sidered a health hazard and orthodox priests imposed severe penalties on its use, its popularity spread rapidly. As of l976, it was estimated that over one billion kilograms of coffee were consumed annually in the United States alone. This averages out to l6 pounds of coffee per American per year! Despite what we mellow Seattleites may think, caffeine intake is higher on the West Coast of the U.S. than the East Coast (of course, it must be the Californians).

Though cocaine and the drug cartels are front page news, the red-blooded American coffee break is rarely challenged. Coffee or tea are the drug of choice even at Alcoholics Anonymous and other twelve step meetings. We tend to reserve the word "drug" for illegal narcotics or hallucinogens or for prescription medications and to forget or ignore the most common drug of all- caffeine. Most of us think pretty much exclusively of coffee and tea when we consider caffeine consumption. The following list may be an eye-opener for you.

Substance Mg of caffeine Substance Mg of caffeine

Coffee (5 oz. cup) Prescription Drugs

Brewed, drip 60-l80 per cup Cafergot l00 per capsule

Brewed, percolator 40-l70 Darvon 32

Instant 30-l20 Fiorinal 40

Decaf, brewed 2-5

Decaf, instant l-5 Over the Counter Drugs

Stimulants

Tea (5 oz. cup) No Doz l00

US brands, brewed 20-90 Caffedrine 200

Imported, brewed 25-ll0

Instant tea 25-50 Menstrual Drugs

Iced (l2 oz.) 67-76 Midol 33

Aqua-ban/plus l00/200

Chocolate and Cocoa

Cocoa (5 oz.) 2-20 Analgesics

Chocolate milk 2-7 Anacin, max. strength 32

Milk chocolate (l oz.) l-l5 Excedrin 65

l pc. cake & frosting l6 Vanquish 33

Dark chocolate (l oz.) 5-35 Cope 32

Soft Drinks (l2 oz.) Cold Tablets

Coca-Cola 45 Dristan 16

Pepsi 4l Coryban-D l0 30

Ginger ale, root beer 0 Kolephrin 65

Soda, seltzer 0 Triaminicin 30

(As cited in Are coffee, cold tablets and chocolate innocuous or is their caffeine hazardous to your patients' health ? Amer. J. Nursing, Apr. l986, pp. 423-5.)

I love my lattes! Why should I give them up? Considerable research has been done, particularly in recent years, on the hazardous health effects of caffeine. Read this and see if it makes you want to reconsider your caffeine habit.

Nervous system: Caffeine is indisputably a central nervous system stimulant and crosses the blood/brain barrier quite readily. Ingestion of 85 to 250 mg of caffeine (about 2 cups of coffee) revs up your nervous system, may allow you to think more clearly and rapidly, and reduces drowsiness and fatigue. As the dosage increases, you may also experience nervousness, restlessness, insomnia, tremors, and overall heightened sensitivity. A fascinating American Journal of Psychiatry aricle called Anxiety or Caffeinism: A Diagnostic Dilemma recounts the story of a 37 year-old Army colonel who complained of a two-year history of "chronic anxiety" including shakiness, apprehension about job performance, butterflies in his stomach, restless- ness, frequent episodes of diarrhea or loose stools, and difficulty falling and re- maining asleep. Three medical workups had found nothing. The fourth doctor, a psychiatrist, thought to ask him about his caffeine intake. He reported drinking at least 8 to l4 cups of coffee a day ("My coffeepot is a permanent fixture on my desk.") He also frequently drank hot chocolate at bedtime to relax and drank 3 to 4 cokes a day. His total caffeine intake was approximately l800 mg. per day! All of his symptoms were relieved after quitting caffeine and returned again when he briefly reintroduced the caffeine as a challenge.

Blood pressure: Blood pressure becomes elevated within 2 hours after caffeine ingestion and remains high for up to 3 hours.For those who ingest caffeine throughout the day, this means your blood pressure is continually higher than it should be.

Heart disease: Several studies have found that people who drink 6 or more cups of coffee a day are nearly twice as likely to suffer from a heart attack and those drinking l to 5 cups a day increase their risk by a factor of l.6.

Peptic ulcer: Since caffeine-containing beverages, coffee in particular, are known to be acidic, caffeine ingestion may cause or aggravate ulcers and the accompanying symptoms of heartburn and acid indigestion.

Psychiatric illness: When decaffeinated coffee was substituted for regular coffee for 3 weeks on a psychiatric ward, hostility, suspicion, anxiety, and irritability decreased, then returned again when caffeinated coffee was reintroduced.

Fibrocystic breasts (Benign breast disease): In l979 two studies by Minton described impressive improvement in breast pain, tenderness, and swelling when women eliminated all caffeine from their diets from l to 6 months. We have heard the same feedback from many patients, although some women do continue to have painful breasts even though their diet is caffeine-free and need other natural treat-ment to free them from their discomfort.

Caffeine in pregnancy: Heavy coffee drinking has been associated in various studies with low birthweight and there may be a correlation with an increased incidence of birth defects.

Cancer: Coffee has been implicated in kidney, bladder, pancreatic, breast, ovarian, and colon cancer. Although further research is necessary, our feeling is "Why take a chance?"

Coffee and homeopathy: Another incentive for our patients to give up caffeine is that the oils in the coffee antidote (deactivate) homeopathic remedies. This is true of caffeinated and water-processed decaf. Though a few of our patients continue to drink black tea (which is safe with homeopathy), most take the opportunity as an excuse to eliminate caffeine entirely and tell us they feel much better after doing so.

If I do decide to quit, will I get headaches? We've helped many of our patients through caffeine withdrawal and can promise you that your headaches, if you get them, will only last 3 to 4 days. They are not always directly associated with a high amount of caffeine. Some people who only drink two cups of coffee a day may still get withdrawal headaches. You can either cold turkey caffeine and take a pain reliever such as Tylenol, if necessary, or you can taper off caffeine gradually by

cutting your coffee or tea with decaf, progressively decreasing the amount of caffeine.

How will I get up in the morning without my hit of coffee? If you give yourself a few days to a couple weeks, you'll find that you have much more productive energy, and less jazzed, wired, artifical energy than when you were relying on caffeine as a wake-me-upper. If you need to, start your day with a cold shower, some invigorating deep breathing or a shoulder stand to bring blood to your head, or take a run around the block to get the circulation going. You'll soon find that, assuming the rest of you is balanced, you will awake alert and refreshed.

How can I keep my energy up throughout the day without caffeine? Not only will you find it easier to get up in the morning and feel good once you've kicked the caffeine habit, but you'll discover a calmer, lighter, more relaxed yet vital you. Once you're free of caffeine, you may find the desire to let go of other addictions such as smoking, and may also have less of an interest in meats, sweets, and alcohol. When our patients come in for the first visit and we inform them that they need to give up coffee for their homeopathic remedy to work, they most often respond, "Oh, that's one of the reasons I came here. I want an excuse to cut out caffeine."

What is there to drink if I can't have my expresso? We have to be honest and say that there's probably nothing that tastes quite like coffee, so you might as well give up finding an identical substitute. However, there are very tasty toasted grain beverages such as Inka, Caffix, and Pero, Postum (our favorite), and, of course,

many different flavors of herb tea, all of which are much healthier for you than caffeine. Give them a try and you'll probably find at least one flavor you really enjoy. (Be careful to select the totally decaffeinated herb teas.)

I just can't imagine life after coffee. What about decaf? Decaf coffee removes about 95% of the caffeine, which is a great improvement. Water-processed decaf is probably your best alternative unless you are under homoepathic treatment, in which case, as mentioned above, it will interfere with the remedies.

What if I just can't quit? Hypnosis, parts therapy, visualization, detoxifica- tion diets, fasting and cleansing, and supportive nutritional supplements are all therapies whch we find helpful to relieve people of their caffeine habits. By getting in touch with your inner strength and resolve and by satisying you desire for caffeine in deeper, more meaningful ways, you can become free of caffeine behind and feel better than you ever imagined!

Drs. Judyth Reichenberg-Ullman and Robert Ullman are naturopathic and homeopathic physicians and cofounders of the Northwest Center for Homeopathic Medicine in Edmonds, WA. They are coauthors of The Patient's Guide to Homeopathic Medicine and Beyond Ritalin: Homeopathic Treatment of ADD and Other Behavioral and Learning Problems. They can be reached at (206) 774-5599.