Mike Magee
Question: What is the most widely used psychotropic drug in the world?
A: Caffeine
In the United States, caffeine is mainly consumed in the form of coffee, tea and cola. But coffee dominates. Globally, humans consume more than 10 million tons of coffee beans each year. Americans swallowed about 16% (1.62 million tons). As shown in the figure below, the daily intake of caffeine depends on the type of beverage and brand.
On average, each American consumes about 164 mg of caffeine per day. This is about 1 cup of dunkin or (3.5) 12 ounces of diet cookies (Trump consumes at least 12 cans of diet cokes per day).
Globally, daily consumption of caffeine is close to universal. One in 10 people consume caffeine-containing beverages every day. This makes the chemical “the most common psychoactive substance in the world.” Its popularity is related to its ability to provide three useful physiological enhancements – awakening, motor performance, and cognition.
Chemically speaking, caffeine is the close cousin of adenosine and is found in brain neurons. Adenosine accumulates in synaptic connections between brain neurons. When it binds to a particular receptor, it activates neurons that promote drowsiness. The caffeine consumed is water and fat-soluble, so it can cross the blood-brain barrier. Once inside, its chemical structure mimics the chemical structure of adenosine and occupies the adenosine receptor because it has the same shape and size. When these receptors are occupied by caffeine, the adenosine molecule cannot activate the receptor. The net effect is clear.
Caffeine passes through the small intestinal cell wall and is absorbed within 45 minutes of intake. From there, it is distributed to all body cells reaching the highest concentration in 1-2 hours. The average time required to remove 1/2 of the caffeine dose (half-life) is 3 to 7 hours. Thereafter, it is broken down in the liver.
More than 30 plants produce caffeine naturally. The most common sources of caffeine are the seeds or beans of two coffee plants (Coffee Arabic and Coffee Rat), the leaves of the tea plant, the seeds of the cocoa plant (theobroma cacao) for chocolate production, and the kola nuts (used to produce cola beverages).
For chocolate lovers, caffeine levels depend on the product. A 4-ounce dark chocolate contains about 80 mg of caffeine. Night intake may be better with milk chocolate, which contains 4 ounces of 24 mg.
Pure solid caffeine is bitter, tasteless, and melts at 235 degrees C. The generation of the 1960s was familiar with various tablet forms such as No-Doz (Bristol-Myers squibb) and Vivarin (Smithkline Beecham). Each tablet contains 100 mg of caffeine. The U.S. market is estimated to be $60 million a year. The three top consumer markets are college students (for “all nights”), truckers and fitness workers.
None of this is especially news. The resilience of boiling tea leaves was first recorded in 3000 BC. The Mayans harvested cocoa beans in 600 BC. The use of coffee was recent, with the first account in the 15th century Middle East. Three centuries later, French chemists isolated the active ingredients, and the term cafe first appeared in French scientific literature in 1822.
As early as 1911, Trump might have had a problem taking 10 COKEs a day. Public officials suspect the product (and its stimulants). In fact, they caught 20 barrels of Coca-Cola syrup in Chattanooga, Tennessee, leading to a landmark case, U.S. v. 40 barrels and 20 barrels of Coca-Cola. The company passed a law in its second year to competently require the company to include the term “habit formation” on its label.
Today, caffeine consumption changes with age and gender – “2 mg/kg/day for children, 2.4 mg/kg/day for women, 2.0 mg/kg/day for men.” As for caffeine powder tablets, they are still unregulated. In the reading between this line, experts are advocating caution, as in the 2017 government summary:
“Together review, the literature conducted here shows that intake of caffeine is usually relatively safe in doses found in commercially available foods and beverages. There are some trends in the consumption of caffeine, such as alcohol-mixed energy drinks, which may increase the risk of harm. There are also some harms in shy women, mental illnesses, who may increase some harms who may cause harm to fear, and those who may suffer from shyness. It is increasingly recognized as potentially harmful by health care professionals and regulators.”
Mike Magee, MD, is a medical historian and regular contributor to THCB. He is Code Blue: Inside the American medical industry complex. (Grove/2020)
