Decaf: the ardent coffee drinker naturally doesn’t want to know much about that. But new research now reveals that it may be the holy grail if you really want to get rid of your coffee addiction, without suffering from withdrawal symptoms.
It is estimated that about 90 percent of all adults drink coffee every day. Caffeine is the most commonly used drug in the world. Because consumption – in low to moderate doses – is generally considered safe, coffee is available everywhere and does not have to be expensive, few see any reason to swear off this drug. But avid coffee drinkers who – for whatever reason – still intend to ignore the coffee, soon find out that this results in real withdrawal symptoms. “In the short term, it’s usually headaches and fatigue,” said researcher Llew Mills of the School of Addiction Medicinepart of the University of Sydney. “But once the acute withdrawal phase is over, the symptoms are the same as for any other drug that you can become dependent on: you become irritable, tense, anxious, depressed, have trouble sleeping and start craving coffee again.” It may sound a bit strange – or even extreme – to most coffee drinkers. But that is easy to explain. “Most people who are addicted to caffeine don’t know that because they never go off caffeine long enough to experience these symptoms.”
Decaf
So the coffee addiction really exists. And the same goes for the withdrawal symptoms. But for those who would like to no longer depend on caffeine, Mills and colleagues now have good news. They have found that decaf – or coffee without caffeine – can get rid of the withdrawal symptoms, even if people are aware that the coffee they consume does not contain caffeine.
Experiments
Mills and colleagues come to this remarkable conclusion after experiments in which 61 ‘heavy drinkers’ – people who consumed three or more cups of coffee a day – took part. They were not allowed to consume caffeine for 24 hours, after which they were examined to what extent they showed withdrawal symptoms. The coffee drinkers were then divided into three groups. Two of them were offered decaf, but only 1 group knew it was decaf – the other thought it was regular coffee. The third group served as a control group and was served water. Three quarters of an hour later, the subjects were asked again about their withdrawal symptoms.
Results
“The group we lied to (who thought they were drinking regular coffee, but drank decaf, ed.) reported a significant decrease in withdrawal symptoms,” says Mills. It is the textbook example of a placebo effect. “Because they thought their withdrawal symptoms would subside, they did.” That in itself is nothing new; this same placebo effect has also been demonstrated in previous studies. It became remarkable, however, when the researchers asked the so-called open-label placebo group – the people who knew they were drinking decaf – about their withdrawal symptoms. “What was interesting was that withdrawal symptoms also decreased when people knew they were on decaf,” says Mills. “Not as strong as in the group we lied to, but there was a significant decrease.”
No expectations of decaf
It is even more remarkable when you consider that prior to the experiment, the researchers asked the subjects to what extent they expected regular coffee, decaf or water to reduce their withdrawal symptoms. All subjects who were shortly afterwards assigned to the group that knowingly received decaf indicated that they never expected that coffee without caffeine would have a positive influence on their withdrawal symptoms. “Funnily enough, they even expected water to reduce their withdrawal symptoms more than decaf,” said Mills. But the reality was very different. “In the group that we watered, the withdrawal symptoms did not decrease at all.” And in the group that received decaf, yes. “That was at odds with what people (who received decaf, ed.) expected.”
Conditioning
So the decaf drinkers who knew they were getting decaf expected nothing from their cup of decaf, but it did reduce their withdrawal symptoms. According to the researchers, it can be traced back to conditioning. “People who drink coffee every day drink thousands of cups of coffee over their lifetime,” explains Mills Scientias.nl out. “Each cup – but especially the first cup of coffee in the morning – reduces withdrawal. So over time they come to associate coffee and all the stimuli that come with it – the taste, the smell, the warmth of the cup, the warmth of the liquid – both consciously and unconsciously, with the reduction of their withdrawal symptoms. And that means that over time those stimuli also have the power on their own – so without the caffeine – to reduce the withdrawal symptoms. Decaf – certainly a good decaffeinated coffee – has many of the same characteristics as caffeinated coffee: it tastes the same, looks the same, and feels the same. So when you drink a cup of decaf, you evoke a conditioned response that limits withdrawal symptoms.”
Temporary
The effect the researchers saw in the open-label placebo group is probably only temporary, Mills points out. “Conditioned responses fade. The placebo response competes with all the signals in your body that tell you you need caffeine. It can drown out those signals for a while, but not indefinitely (…) But a cup of decaf can help someone who is trying to cut back on their caffeine intake to suppress those first, strongest cravings and stay caffeine-free.”
Although coffee addicts can of course use the findings of Mills and colleagues to overcome their dependence on caffeine, the scientists hope that the study will also contribute to the fight against other, less harmless, addictions. “The study provides us with more evidence that cognitive factors such as conditioning and expectations – the drivers of the placebo effect – play a major role in withdrawal. Addiction specialists have been saying that for years, but it’s mostly based on observations rather than empirical evidence. Most innovations related to addiction treatment are pharmaceutical in nature, but our study suggests that it may also be useful to develop treatments that take human cognition into account. In concrete terms, we suggest, for example, that people who are coming off pain medication (e.g. methadone) can be offered alternating medication and an open label placebo during tapering, and then switch completely to the open label placebo when they are almost no longer using any medication. .” In this way, the worst withdrawal symptoms can possibly be prevented. “But more, careful research is of course necessary,” Mills emphasises. And badly needed. “People dependent on alcohol, amphetamine, heroin, etc. are among the most vulnerable and stigmatized people in our society. We cannot take the investigation of their problems lightly.”