Caffeine, nicotine and energy drinks: the small addictions we do not count

“That’s not an addiction. It’s just coffee.” I hear this sentence often, and it almost always comes with a smile meant to close the subject before it opens. Then the conversation moves on to the real problems — the anxiety, the insomnia, the fact that for months now the person cannot switch off in the evening. And only a few sessions later does it turn out that all of these things are connected to that smile at the beginning.

Caffeine, nicotine and energy drinks are substances that almost nobody here counts as addictions. They are not illegal, they carry no shame, they do not wreck your relationships. That is precisely what makes them interesting: they show us how addiction works in a clean form, without the moral weight that usually clouds the view. If you understand why you cannot talk to people before your morning coffee, you have understood a good deal of what happens with far heavier things too.

What actually counts as addiction

In clinical terms, addiction is not defined by the substance but by the pattern. The International Classification of Diseases looks at three things: impaired control over use, use taking priority over other parts of life, and physiological features — tolerance and withdrawal. Only when these assemble into a pattern that persists and causes harm do we speak of a disorder.

By that standard nicotine is unambiguously addictive; caffeine is a special case, since the classification recognises caffeine withdrawal and intoxication, while “caffeine use disorder” as a standalone diagnosis is still under discussion and sits in DSM-5 among the conditions that need further study. That is not evasion. That is an honest level of uncertainty: physical dependence is well established, a clinically significant disorder is not present in most people.

I find this distinction useful outside the consulting room too. The word “addiction” is heavy, and we like throwing it around until it loses its meaning. More than the question “am I addicted or not”, I am interested in another one: what happens to your day when the substance is missing? And what are you actually repairing with it?

Caffeine: what happens in the brain

All day while you are awake, adenosine accumulates in the brain — a substance produced as a by-product of energy use. Adenosine binds to its receptors and acts there as a brake: it slows neural firing and creates what we call sleep pressure. The longer you stay awake, the more adenosine, the heavier the eyelids.

Caffeine has a molecular shape similar enough to adenosine that it sits on the same receptor — but does not activate it. It takes the seat and never pulls the brake. The tiredness is still there, only the signal about it does not get through. This is an important distinction: caffeine does not give you energy, it temporarily covers up the information that you have none.

With regular use the brain adapts by increasing the sensitivity and the number of adenosine receptors. Now you need caffeine simply to be as awake as you once were without it. This is tolerance in its purest form — and at the same time the reason why for many people the morning coffee is really a remedy for withdrawal rather than a stimulant.

Why the morning coffee is often not a lift

If you ever want to test this on yourself, notice how you feel an hour after waking, before any coffee. Many people find a headache across the crown of the head, difficulty concentrating, irritability and a kind of foggy slowness. That is not your personality before coffee. That is a withdrawal syndrome that developed overnight, because the last ten hours were substance-free.

Research by Roland Griffiths’s group at Johns Hopkins has described this syndrome carefully: headache, fatigue, poorer concentration, low mood, sometimes flu-like symptoms. It appears in people who take caffeine regularly, and it does not require heavy use. It lasts a few days and resolves on its own.

Why this matters to me: if you start every morning out of withdrawal, your baseline is not neutral. All day you move between two states that are neither calm nor genuine alertness. People who reduce caffeine gradually often say that mornings are a little less sharp, but afternoons are markedly more even — and that the fluctuations they used to attribute to their character are simply gone.

Energy drinks are not the same thing as coffee

Not because of the substance — because of the context. Coffee is a ritual: a cup, a pause, somebody sitting opposite. An energy drink is a product designed to replace something missing — sleep, drive, willingness. It is sold as a solution to tiredness rather than as a pleasure, and that is the difference that counts.

Data from the European Food Safety Authority show that the most frequent users are adolescents and young adults, often in combination with too little sleep. In adolescents, studies have repeatedly linked regular energy drink consumption with poorer sleep, higher anxiety and more frequent risk-taking — though here causality is genuinely hard to separate from the fact that those who reach for them are often already struggling.

One thing worries me above all: an energy drink is most effective precisely when there has been too little sleep. So it attaches itself to exactly the pattern that would need repairing. If you want to know why insomnia holds on so stubbornly, I have written about the mechanism in the piece on insomnia and the nervous system.

Nicotine: the fastest learning loop we know of

Nicotine is a distinct story because it is fast. On inhalation it reaches the brain within seconds and triggers a dopamine release in the nucleus accumbens. The short distance between action and reward is what makes the habit so firm: brains learn best when the consequence arrives immediately.

So with nicotine it is not only about the substance but about several hundred repetitions a year, each with its own cue — coffee, the car, a phone call, leaving work, the first drink. Each of those cues becomes an independent key. People who quit usually do not fall because of craving for the substance, but because they found themselves in a scene that was reliably paired with a cigarette for a decade.

Nicotine withdrawal is not dangerous, but it is unpleasant and it lasts: irritability, anxiety, restlessness, sleep problems, increased appetite, difficulty concentrating. The peak is in the first week, most physical signs pass within a few weeks, and the cues remain far longer. That is not weakness, it is the logic of learning — I have written about it in the piece on neuroplasticity and therapy.

When withdrawal is genuinely dangerous and when it is not

Here I need to be precise, because it is a matter of safety. Stopping caffeine or nicotine abruptly is unpleasant but not physically dangerous; a person can do it alone, or with a doctor’s support if they want replacement therapy.

With alcohol and with benzodiazepine tranquillisers it is different. There, abrupt cessation in a physically dependent person can be life-threatening — from seizures to delirium. If you drink daily, or have been taking tranquillisers for a longer period, always speak to a doctor before stopping and never quit overnight on your own. This is not politeness, it is a serious medical matter.

What these substances do to anxiety and sleep

Caffeine blocks adenosine, and adenosine regulates not only wakefulness but also settling down. In people prone to anxiety, caffeine often amplifies bodily signs — faster heartbeat, trembling, tightness in the chest — and those signs are exactly the ones an anxious mind reads as proof that something is badly wrong. A loop forms: the substance produces the bodily signal, the mind reads it as a threat, the threat produces more signal. I have written about what happens in the brain meanwhile in the piece on anxiety in the brain.

With sleep the effect is more insidious. Caffeine’s half-life in the body is measured in hours, which means the afternoon coffee is still present at night. Often it does not stop you falling asleep — but it reduces the share of deep sleep. In the morning you wake with the sense that sleep achieved nothing, and of course you reach for caffeine. If waking in the middle of the night is familiar to you, it is worth looking at when the last cup was.

Where this piece does not hold

Now something that argues against everything I have written so far. For the great majority of people, coffee is not a problem. It is one of the few stimulants with serious data on benefit: large observational studies link it with lower mortality and lower risk of some liver diseases and of type 2 diabetes. Caffeine dependence in most people meets no criterion for a disorder — there is no impaired control, no neglect of other things, no harm.

Nor is it true that every habit is an addiction. If you drink coffee at the same time every day and could drop it without difficulty when you are away from home, that is not addiction, that is a ritual. Rituals are good for people. Over-pathologising everyday habits is its own kind of harm — it manufactures guilt where none is needed.

And a third point: in some people caffeine or nicotine are not the cause but an attempt at treatment. Adults with attention deficit disorder often describe stimulants as helping them gather a thought; people with schizophrenia smoke far more than the general population and part of that is probably self-medication. If you take a substance because something else is going untreated, removing the substance is not the solution. The solution is to find what lies underneath — I have written about that in the piece on the symptom as a message.

What this looks like in therapy

I rarely talk with someone about coffee in order to get them to stop drinking it. I am more interested in where in the day it appears and what it is repairing at that moment. The answers are surprisingly rarely “because I am sleepy”. More often I hear: because it is the only pause I allow myself. Because I have to do something with my hands. Because otherwise I cannot start that email.

Once that becomes visible, the conversation changes. It is no longer about the substance but about the rhythm of work, the absence of breaks, the fact that a person will not let themselves stop without an excuse. Often we arrive at the theme of burnout, which began to show as increased caffeine use before it showed as anything else.

When someone genuinely decides to cut down, tapering works better than a clean break: the brain needs time to regulate the receptors back. And with nicotine we know that combining replacement therapy with behavioural support substantially increases the chance that quitting holds — more than either of them alone.

What to remember

Caffeine does not give you energy, it temporarily covers tiredness; with regular use the brain adapts its receptors, and for many people the morning coffee means clearing overnight withdrawal rather than a lift. Nicotine is, because of its speed, among the most addictive substances we know, and its power lies as much in the cues as in the substance itself. Energy drinks are risky above all because they fit so neatly onto the very pattern of insufficient sleep that would need repairing.

Stopping caffeine or nicotine abruptly is not physically dangerous. Stopping alcohol or tranquillisers abruptly in a physically dependent person can be — there the route always goes through a doctor.

And the most useful question is not “am I addicted?” but: what is this substance repairing in my day, and what would need repairing another way. The answer to that is almost always more interesting than the answer about cups.