Proposal for the Introduction of New ICD-10 Codes for Caffeine Addiction

Introduction and Rationale

Caffeine addiction, often referred to as caffeine dependence, manifests as a compelling urge to consume caffeine despite potential adverse health effects or disruption to daily functioning. Characterized by symptoms of tolerance, withdrawal, and an inability to control use, caffeine addiction significantly impacts individuals' physical and psychological well-being. While the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes caffeine withdrawal, it does not formally acknowledge caffeine addiction as a disorder. Given the widespread consumption of caffeine and evidence suggesting a subset of individuals experience problematic use, there is a critical need for the ICD-10 to include specific codes for caffeine addiction. This inclusion would aid in diagnosis, treatment, and research, fostering a deeper understanding of its prevalence and impact.

Proposal for New ICD-10 Codes

We propose the introduction of specific ICD-10 codes under the category of “Mental and Behavioral Disorders Due to Psychoactive Substance Use,” (specifically, under code F15.929 for caffeine intoxication and code F15.93 for caffeine withdrawal), focusing on caffeine addiction. These codes would enhance the ability of healthcare providers to identify and treat individuals suffering from this condition, promoting more targeted and effective interventions.

Criteria for Caffeine Addiction

The proposed diagnostic criteria for caffeine addiction include experiencing at least three of the following over a 12-month period:

· Increased tolerance to caffeine.

· Withdrawal symptoms upon cessation.

· Consumption of larger amounts or over a longer period than intended.

· Persistent desire or unsuccessful efforts to cut down use.

· Significant time spent in activities necessary to obtain, use, or recover from caffeine's effects.

· Continued use despite knowledge of adverse physical or psychological problems.

· Sacrifice of social, occupational, or recreational activities.

Prevalence and Need for Recognition

Studies indicate that a significant percentage of caffeine users exhibit dependence criteria, with estimates suggesting up to 30% of users demonstrating problematic use. The varied prevalence rates underscore the necessity for formal recognition and coding within the ICD-10 to accurately reflect the disorder's impact and guide healthcare strategies.

Current ICD-10 Coding Limitations

Although the ICD-10 includes codes for caffeine intoxication and withdrawal, the absence of codes for caffeine addiction limits comprehensive care and research. By introducing specific codes for caffeine addiction, healthcare professionals can better document, study, and address this condition.

Proposed Benefits

· Enhanced Clinical Recognition and Treatment: Specific ICD-10 codes will enable healthcare providers to accurately diagnose and treat caffeine addiction, leading to improved patient outcomes.

· Facilitated Research: Standardized diagnostic criteria will promote research into caffeine addiction, advancing understanding of its epidemiology, etiology, and treatment.

· Informed Public Health Strategies: Better data on caffeine addiction will inform public health initiatives aimed at reducing the prevalence and impact of this condition.

Conclusion

The introduction of ICD-10 codes for caffeine addiction is a necessary step toward recognizing the significant health implications of problematic caffeine use. By formalizing these diagnostic criteria, we can improve patient care, enhance research capabilities, and inform more effective public health strategies. We urge the adoption of these proposed codes to address the growing concern over caffeine addiction and its consequences on individual and public health.

References

Addicott, M. A. Caffeine Use Disorder: A Review of the Evidence and Future Implications. Current Addiction Reports 1(3), 186-192.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Juliano, L. M., & Griffiths, R. R. A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features. Psychopharmacology 176(1), 1-29.

Meredith, S. E., Juliano, L. M., Hughes, J. R., & Griffiths, R. R. (2013). Caffeine use disorder: a comprehensive review and research agenda. Journal of Caffeine Research 3(3), 114–130.

Striley, C. W., Griffiths, R. R., & Cottler, L. B. Caffeine Use Disorder: An Item Response Theory Analysis of DSM-IV/ICD-10 Criteria. American Journal of Addiction 20(1), 72–81.

Sweeney, M.M., Griffiths, R.R. (2023). Disorders Due to Substance Use: Caffeine. In: Tasman, A., et al. Tasman’s Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-42825-9_49-1

World Health Organization. (1993). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organization