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May 10, 1995

Caffeine Dependence Syndrome-Reply

Author Affiliations

Deputy Editor, JAMA

JAMA. 1995;273(18):1419. doi:10.1001/jama.1995.03520420029024

In Reply.  —Drs Adamson and Roberts imply that the high prevalence of prior substance abuse among the 16 persons with caffeine dependence described by Strain and colleagues1 invalidates the results. This overlooks the likelihood that the small proportion of regular caffeine users who develop a dependence syndrome would have associated risk factors, such as psychiatric disorders or other substance use disorders. Further research will be necessary to confirm this and to determine whether caffeine dependence is more common among women. My Editorial stressed that the consequences of caffeine dependence appear to be considerably less severe than those of other substance dependencies.The comments of Drs Olekalns and Bardsley are interesting but illustrate the difficulty of using the same terms, with very different meanings, to communicate across disciplines. The notion that addiction is "rational" is preposterous to clinicians who deal with the life-threatening effects of dependence on alcohol, tobacco, or

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