CHAPTER 3

Introduction

The central nervous system stimulants include many dangerous and illegal drugs, numerous prescription medications, as well as nicotine and caffeine.

Stimulants can increase alertness and help the user to stay awake. Some stimulants also induce euphoria and a sense of well being. As with all drugs, different persons have different reactions and some people experience nervousness, decreased appetite, anxiety and paranoia in response to stimulants. Some people can react to stimulants by becoming over-active, irrational and even aggressive. Stimulants often increase blood pressure and heart rate.

Aftereffects can include depression, prolonged sleep, panic attacks, irritability, anxiety and even psychosis. Higher blood pressure and heart palpitations are also experienced, especially when the user consumes caffeine in coffee or other beverages.

Cocaine is an illegal drug which comes as a white powder that is usually inhaled or mixed with other substances and smoked or injected. Many amphetamines are legal drugs in the form of pills and capsules which are swallowed. Other amphetamines exist on the black market in the forms of pills, capsules and powders. Some stimulants are called uppers which can be legal or illicit drugs, sold on a black market. Nicotine is also classified as a stimulant and it is highly addictive.

3.1 Cocaine ~ Cocaine Hydrochloride

Cocaine is cocaine hydrochloride also know as coke, blow or snow. It is usually a white powder derived from leaves of the coco plant, which grow mainly in South America and parts of Asia. Crack cocaine is made by chemically altering cocaine powder into crystals or "rocks" which are easily smoked.

Cocaine powder can be snorted, causing a gradual effect which peaks after 15 to 30 minutes. When cocaine is smoked in the form of crack or is freebased ("freebasing" uses a flame to heat powdered cocaine to a liquid and then a gas which is inhaled), the effects come on almost immediately but wear off much more quickly than with snorted cocaine. Cocaine can also be injected, and the effects are felt immediately, more powerfully and more intensely than with snorted cocaine. Again, the effect wears off even more quickly.

Prior to the 1980's, cocaine was associated with jazz musicians, movie stars and others in the arts community. During the 1980's it became popular both among young people and among members of the middle and upper middle classes, including some members of the legal profession. Cocaine is a highly addictive drug. Overcoming addiction often requires long-term treatment and always requires a life-long program of abstinence from cocaine and from many other drugs, including alcohol.

Cocaine offers a useful example of an illegal drug which successfully gained acceptance in many areas of our society, including among educated professionals who had little or no prior experience with street drugs. Few illegal drugs can claim the personal, social, financial or professional costs associated with cocaine use by lawyers, judges, law students and by other professionals.

We will study a little of the history of cocaine use to gain a better understanding of the paths that dangerous drugs and substances can take in our communities. The lessons we learn can be applied to other drugs. For example, a century ago, the medical community embraced heroin as a less harmful alternative to opium. The "cure" was even more destructive and addictive than opium.

A century later, psychiatrists and family physicians were prescribing Valium for depression, anxiety and even alcoholism without knowing or believing that Valium itself created intense dependence and full-blown addiction and that withdrawal from Valium could be accompanied by life-threatening symptoms.

None of this is meant to criticize the medical or pharmaceutical professions or the drug manufacturers. It is a sad truth that the advancement of knowledge about drugs and addiction has often been at the expense of those of us who have fallen ill with the disease of addiction.

The Effects of Cocaine Use

Cocaine works as a powerful stimulant to the central nervous system. It stimulates the "pleasure pathway" of the brain, in a pattern similar to that of sexual stimulation and release. The drug provides an artificial high that some users find intensely pleasurable. Cocaine can lead to feelings of confidence, alertness, euphoria, and overall well-being. Cocaine is a stimulant drug like amphetamine (speed) but its effects are much shorter in duration. As a systemic stimulant, it causes a sudden increase in heart rate, blood pressure and breathing.

Cocaine is a mood altering drug that may help the user feel and perform better for a very limited period of time. Some lawyers begin to use cocaine to improve performance and concentration when they are under intense pressure or working to meet deadlines. It allows them to focus and concentrate for longer periods of time while escaping feelings of stress, depression or discontentment. Once the drug wears off, the effect wears off, often leaving the user feeling worse than before.

Perhaps the most common route to cocaine abuse and addiction by professionals has been use of the drug to combat the negative consequences of heavy alcohol use and addiction. Cocaine use seem to eliminate hangovers and improve concentration - at least at first. Any person who develops the routine or habit of using drugs to improve their abilities or to change feelings is at risk of becoming dependent and then addicted.

Some people who try cocaine are not favorably impressed and do not use it again. Still others use cocaine infrequently and never become dependent or addicted. Unfortunately, these casual users may report that the drug is harmless. Some people believe that cocaine can make them more productive at work. Others believe that it clears the mind and lifts the spirit. Some users find that it improves their sex lives' so that cocaine use is tied to sexual excitement and release. Some lawyers have tried cocaine for fun or to fit in or as a result of peer pressure.

As the effects of cocaine use wear off, the user often experiences feelings of inadequacy, fear, and depression. These negative feelings can be every bit as strong as the positive feelings or "high". This let-down sets up the urge to use cocaine again to avoid the negative feelings and to experience the positive high. As with many drugs, cocaine use develops tolerance so that more and more of the drug has to be taken to obtain the same effect.

Risks of Cocaine Use

Cocaine and crack are very short acting and can be intensely addictive. Users develop tolerance, so that they require more and more of the drug to attain the same high. The negative impact of the drug increases with the increased amount consumed.

Some individuals are extremely prone to cocaine addiction and as many as 25% of users are addicted following their very first use of cocaine. The rate of first-use addiction is even higher for crack cocaine. Other cocaine users become compulsive in their use and this too leads to addiction. In laboratory tests with mammals, cocaine has shown itself to be the most addictive substance known to science.

After-effects of cocaine use can include depression, exhaustion, disappointment, agitation, anxiety, paranoia and psychosis. Repeated snorting of cocaine can burn away the membrane of the nose and cause permanent damage. High doses of cocaine or frequent use have caused seizure, stroke, heart attack and sudden death.

High doses of cocaine or frequent use have caused seizure, stroke, heart attack and sudden death.

Adverse Effects of Cocaine

• Confusion
• Memory loss
• Restlessness and irritability
• Anxiety and paranoia
• Apathy, laziness, lethergy
• Poor job performance
• Anger and violent outbursts
• Injuries from accidents

Chronic high dose users of cocaine will invariably experience a loss of relationships, extreme agitation and discomfort, panic attacks, paranoia and sometimes a psychotic state that can be indistinguishable from schizophrenia.

Chronic cocaine abusers will lose their jobs, their families, their friends, their careers and everything of value to them.

Chronic cocaine abusers also suffer from physical fatigue, chronic low grade infection and fevers. Dry mouth and sinuous, a nagging and persistent cough will also be accompanied by changes in breathing and general poor health.

Late stage chronic cocaine users will experience seizures and convulsions, dizziness and a loss of balance, chronic headache, insomnia, nausea and vomiting.

The History of Cocaine Use

Cocaine is a very powerful stimulant made from the leaves of the coca plant which was first found in South America. Native peoples in Peru chewed coca leaves as part of religious practice and perhaps in preparation for battle. It is likely that native peoples in other South American regions used coca leaves for similar purposes. Abuse of cocaine was first reported in the sixteenth century after the Spanish conquest and the enslavement of the local indigenous population. Men, women and children were conscripted to serve in the mines and they were given coca leaves to chew, to allow them to work at high altitudes with little food and in bitter cold without resting.

In 1859, discoveries in Europe led to the separation of cocaine from the coca plant. In addition to being a stimulant, cocaine is also a topical anesthetic. In fact, cocaine was originally used in the nineteenth century as a medical anesthetic, but it has long since been replaced by safer and more effective drugs. Dr. Sigmund Freud experimented with cocaine and identified its use as an anesthetic in surgery, particularly on the eye. He also used it in efforts to treat patients with depression and psychosis.

Cocaine was an ingredient in the beverage Coca Cola until 1904, when it was replaced by caffeine in anticipation of new federal food and drug laws. By 1906, the US Federal Government had restricted cocaine (and opium) to a limited number of non-prescription drugs, and in 1914, made the sale of cocaine illegal, wrongly describing it as a narcotic.

Between 1920 and 1970, cocaine was popular among some musicians and other artists. Cocaine use and abuse was not common until the 1970's, but it then grew rapidly in the 1980's, peaking in use in 1985. Crack cocaine reached epidemic proportions in North America in the late 1980's, soon after its introduction, as it was cheap, smokeable, and highly, highly addictive.

Through the 1980's, cocaine was a "glamour drug" associated with success and enjoyment and it was even claimed by some users to be harmless and non-addictive. As its use became more prevalent, cocaine became widely available at relatively low prices. Cocaine use spread to university and college students and then to high school students and even to children in grade school. Lawyers, judges, and law students, as well as members of other professions, tried cocaine, sometimes with tragic results. The consequences of cocaine addiction among legal professionals have appeared in newspaper headlines recounting thefts, frauds, murders, homicides, disbarments, imprisonments and suicides.

In the 1990's, the true risks of cocaine use became more widely known and understood in the scientific, medical, and treatment communities and among the general public. Once rumored to be a safe drug, cocaine is now known to be highly addictive and dangerous.

In laboratory research experiments, cocaine was identified as the most addictive substance ever tested. Research studies have shown that animals will work harder for cocaine than for any other drug. For example, in studies where monkeys had an unlimited supply of cocaine available to them, they would overdose and die of convulsions. Other studies showed that monkeys would go to almost any amount of work and effort to get just one dose of cocaine. When offered a choice, monkeys preferred cocaine to sex, food, or water, and would die of starvation and thirst. Among animals and humans alike, factors such as "personality differences" or "levels of stress" seem to have nothing to do with the ability to control the craving for cocaine, once a taste for the drug has been acquired.

Withdrawal from Cocaine

The same lists of risks, dangers and symptoms that we see in the chronic use of cocaine can arise during withdrawal. These include depression, anxiety, irritability, confusion, paranoia, extreme agitation, anger and violence. Physical symptoms can include seizures and convulsions, dizziness, headaches, insomnia, nausea and vomiting. Respiratory failure, congestive heart failure, blood clots and heart attack can all arise depending upon the personal health factors of the individual. It is always recommended that a chronic cocaine user withdraw from the drug in a qualified detox centre. In this way, medical help and other assistance will be close at hand should the need arise.

Recovery from Cocaine Addiction

• Practice abstinence - stop using cocaine all at once and not over time. Any use of cocaine will trigger a relapse to continued use. Cutting back or cutting down simply does not work. Stop all at once, today.
• Discard all cocaine and your related drug paraphernalia. Destroy these items and then throw them away where they can never be retrieved.
• Break off all contact with other drug users, even close friends.
• Break off all contact with drug dealers and suppliers and sources of the drug.
• Limit your access to cash including cash itself as well as credit and debit cards and the like. Ideally, ask a Peer Volunteer to take over your money so that you no longer have access to any more cash than that what you need to get you through a single day.
• Plan your time to support abstinence. Find out what works for you, and do it and then do more of it. Plan your time to keep busy and to avoid triggers to relapse.
• Learn to know your cocaine triggers so that you can avoid them. These are the people, places and things around you that create a craving for the drug. Know what your triggers are, and then avoid them.
• Stop drinking alcohol and stop taking every other mood altering drug. Alcohol and other drugs are triggers to relapse, even in very small amounts.
• Develop a peer group that supports your recovery.
• Start to rebuild your life in a reasonable and sensible way so that you can identify goals for yourself that are reasonable.
• No matter what, no matter when, no matter where, do not use. Stay clean, keep clean, never use cocaine.

Many cocaine users will benefit from a residential or day-treatment program. Your Lawyer Assistance Program can help you choose the right rehabilitation facility.

Aftercare is extremely important and should include an ongoing relationship with a Peer Volunteer from your Lawyer Assistance Program.

Some cocaine addicts in recovery will experience relapse. It is important that no one in the process give up. The addict has to start over again, at step one, try a little harder and stay a little longer. With hard work and determination, every cocaine addict can achieve sustained recovery.

Terry Gorski has written three excellent booklets available from Hazelden (1.800.328.9000 or www.hazelden.org) including Managing Cocaine Craving (5293), Passages Through Recovery (5052), and the Relapse/Recovery Grid (5198).

Triggers to cocaine relapse are so common that the cocaine addict in recovery has to be vigilant at all times. The people, places and things that can be triggers to relapse include the part of your City where you bought or used drugs. They can include other drug users, dealers, and even a sexual partner. Movies, magazines, television, even radio and music can be triggers to relapse.

Sustained recovery requires constant vigilance, hard work, and maintenance of a recovery program. Active participation and Twelve Step Recovery Programs such as Alcoholics Anonymous, Narcotics Anonymous or Cocaine Anonymous produce the most successful outcomes.

3.2 Ecstasy ~ MDMA
(3 - 4 - Methylenedioxymethamphetamine)

Ecstasy acts as a neurotoxin and it belongs to the family of drugs called Entactogens. Other drugs in this category include MDA, MDE and MBDB.

Ecstasy was previously used by psychiatrists as a therapeutic tool, but it has been illegal since 1985 in Canada and in the United States. Unfortunately, Ecstasy use acquired some legitimacy through its psychiatric use and its use in research studies.

Ecstasy is a mood elevator that produces a relaxed euphoric state. It does not produce hallucinations. Ecstasy takes effect within 20 to 40 minutes after taking a tablet, with little "rushes" of acceleration which can be accompanied by nausea. Peek effects are experienced approximately 60 to 90 minutes after taking the drug.

Sensations are enhanced and the user experiences heightened feelings of empathy, emotional warmth and self-acceptance. The effects of Ecstasy appear to subside after 3 to 5 hours. Users report that the experience is very pleasant and highly comfortable. Even at the peak of the effect, users can appear relatively normal and even deal with important matters.

The effect that appears to have made Ecstasy popular is the experience of empathy, the sensations of understanding and accepting others.

Ecstasy is almost always swallowed as a tablet or capsule and the normal dose is about 100-125 milligrams. Black market Ecstasy tablets vary widely in strength and may often contain other drugs.

Is Ecstasy Addictive?

Ecstasy is not physically addictive but the drug can take on great importance in people's lives. Some people have become compulsive in their use of Ecstasy. Ecstasy is often used in addition to other addictive drugs, including alcohol. There is growing anecdotal evidence that combining Ecstasy with alcohol use can lead to alcohol addiction more quickly in some individuals.

Ecstasy causes the release of the brain chemical serotonin, thus elevating mood and acting as a short-term anti-depressant. Compulsive users may be unconsciously trying to self-medicate for depression.

Ecstacy ~ Taking Care

Ecstasy is illegal, and its possession and sale have been targeted by many police authorities. Frequent or high doses have been linked to psychiatric problems and even neurotoxic brain damage. Some people experience depression after taking Ecstasy rather than euphoria.

There have been some deaths associated with Ecstasy and there is a general belief that these may have been the result of heat stroke from dancing for long periods of time in hot clubs without replenishing lost body fluids. There do however appear to have been some deaths that are not explained by heat or dehydration.

Much of what is sold as Ecstasy on the black market actually contains other drugs, some of which can be considerably more dangerous than MDMA, such as PMA, speed, DXM and PCP. Mixing Ecstasy with alcohol or other drugs greatly increases the risk of adverse reactions.

3.3 Ritalin (Methylphenidate)

Ritalin is the trademark name for methylphenidate hydrochloride or MPH, which was first used medically in the 1940's. Properly classified as a stimulant, it has been primarily prescribed to control Attention Defecit Disorder (ADD), first in children and later in adults as well.

Ritalin is a mild cental nervous system stimulant manufactured by the drug company Ciba-Geigy from a white, odorless, fine crystalline powder into tablets. As a street drug, Ritalin is also called Jif, Skippy, R-Ball, Vitamin R and smart drug.

As a prescription medication, Ritalin is classified as a Schedule 2 drug in the United States, meaning that it has a high abuse potential with severe psychic or physical dependence liability. By way of comparison, cocaine and methamphetamine are other Schedule 2 drugs in the United States. Special regulations apply to Ritalin prescriptions so that refillable prescriptions are not permitted.

Ritalin has been prescribed a great deal for hyperactive children. It has also been prescribed for adults with Attention Deficit Disorder as well as for the treatment of narcolepsy. As such, it is often to be found on shelves of city and suburban pharmacists and Ritalin ranks in the top 10 most frequently reported controlled pharmaceuticals stolen from licensed handlers. Ritalin is now routinely sold by organized drug traffickers in ever-increasing quantities.

Properly prescribed, Ritalin is primarily used to treat individuals who have attention deficit-hyperactivity disorder (ADHD), or attention deficit disorder (ADD). Children with ADHD have a short attention span and are easily distracted. These children are usually in constant motion, getting up and moving around or tapping fingers or toes, wiggling in chairs, bouncing up and down during meals and darting from one activity to another. ADHD is much more common in boys and men than in girls and women and is now believed to extend into adulthood.

Clinically, Ritalin increases the available amount of neurotransmitters, including dopamine, in the brain. The increased availability of these brain chemicals improves the ability to focus, and consequentially, to work and to learn. This chemical effect of Ritalin has been called "paradoxical" because Ritalin is a stimulant that nonetheless reduces hyperactivity. However, its "paradoxical effect" on hyperactivity is in fact secondary to its effect on attention: being more focused and less vulnerable to distraction decreases hyperactive behavior.

It has been estimated that between 2 and 5 per cent of students in North America have some form of ADHD. In some centres, the use of Ritalin has become common place. Ritalin is manufactured in tablets in 5, 10 and 20 mg strengths. A newer form of sustained-release Ritalin, manufactured under the brand name Ritalin SR, is available in 20 mg amounts. A typical daily dose for a child is 10 mg, and for an adult 20 to 30mg.

Side effects of Ritalin

Side effects include decreased appetite or loss of appetite, sleep disturbances, insomnia, increased blood pressure, facial or other physical tics, nausea, hypersensitivity, anxiety, tension and nervousness. Occasionally these symptoms can expand into anxiety accompanied by paranoia. While some studies have raised a concern that Ritalin can contribute to a temporary decrease in bone growth, most or all of this effect can be eliminated by taking the drug after meals.

Ritalin as a Street drug

Ritalin is being used and abused as a street drug and a large drug traffic industry has grown up around the drug. Drug trafficking is supplied by children who may sell their own drugs or who may buy or take drugs from other children. Parents may take or steal their children's Ritalin while children may also steal or take a parent's supply of the drug. Multiple prescriptions from more than one doctor, illegal sales from pharmacies, institutions and organizations as well as break and enter theft of the drugs have become common.

As a street drug, Ritalin is taken orally, sometimes in combination with other drugs or alcohol in combination. Some users attempt to get a more intense reaction by crushing the pills or snorting the powder or by dissolving the powder into a liquid and then injecting it as an intravenous solution. It is suspected that the injected solution can cause talc deposits in the lung and serious respiratory disease and distress. With the injected solution, there is a risk of toxic overdose. While the inert ingredients in Ritalin are safe when taken orally, the abuse of Ritalin by injection or snorting makes those inert ingredients highly dangerous. These otherwise "inert" substances can cause blood clots, infections, scarring, burning of nasal tissues, open sores, internal bleeding, as well as skin and respiratory problems.

It is the simple truth that you should never take Ritalin if it has not been personally prescribed for you by your physician. You should take it in the proper dosage, at the proper time. Other use of Ritalin has resulted in sudden death.

Ritalin produces a short-term mood elevation. Some students abuse the drug by taking it to stay awake all night to study or party. As with other stimulants, the effects are short-lived and they are followed by a let-down or crash. During the crash phase of drug use, the user can feel very depressed, sleepy, sluggish or anxious.

While addiction to Ritalin is unlikely, Ritalin users develop tolerance to the drug. In other words, habitual use of Ritalin renders the existing dose ineffective so that the user has to use more and more of the drug. This increasing tolerance to a higher dose leads to an ever increasing dose requirement to obtain the same high. The increased use of Ritalin appears to increase the likelihood of side effects of increasing seriousness. Again, as with other stimulants, Ritalin abuse is often accompanied by the use and abuse of other drugs and alcohol. Using drugs in combination can be extremely serious, as the effect of each drug can be exponentially increased.

If you have been using and abusing Ritalin and then stop taking it suddenly, you will probably experience some type of withdrawal reaction, which is usually characterized by extreme fatigue, depression, and a general sense of malaise. In some cases, the depression can be accompanied by paranoia as well as a psychotic state of varying length.

3.4 Amphetamines and Methampetamines ~ Speed

1. Benzedrine, Biphetamine, Desoxyn, Dextroamphetamine, Dexedrine
   Used to treat narcolepsy (brief attacks of deep sleep) and hyperkinesis (hyperactivity) in children. Most doctors no longer use amphetamines to treat depression or for weight control. Tolerance develops and psychological dependence can occur after repeated use. Physical dependence is possible.
2. PHENMETRAZINE ~ Preludin
   Used to control appetite. Tolerance develops and psychological dependence is possible. Sudden withdrawal can cause severe depression.

Amphetamines and Meth-Amphetamines are strong stimulant drugs. They produces alertness and confidence and raises levels of energy and stamina. They reduce appetite and lessen the desire and the ability to sleep. As street drugs, they are usually called "speed".

Is Speed Addictive?

How is Speed Used?

Risks of Using Speed

Injecting speed is the riskiest method. Injection has been associated with HIV/AIDS infection and Hepatis C infection via shared needles. When injected, the dose reaches the brain almost immediately, increasing the possibility of overdose. Overdose can result in heart attack or stroke or simply a sudden cessation of breathing.

Impurities are common in speed sold for illegal use. These impurities can enter the blood stream and may cause infection, septicemia and other illnesses.

Coming down from speed can make the user tired, lethargic and depressed. Sometimes, this causes the user to take more and more of the drug, thus beginning a dangerous cycle. Speed users tend to mix speed with other drugs - particularly other stimulants - and this can increase the risk of adverse reactions. Also, users often take depressants such as alcohol or barbiturates to help them come down or to ease unwanted side-effects such as agitation, paranoia and tremors; the user then wants more speed to regain the "up" feeling. The cycle can continue, more and more rapidly. The compounding affects of neglecting to eat and sleep mean that heavy users may burn out very quickly.

As already noted, sharing syringes can cause Hepatis C and HIV. Needle use can also cause damage to the veins leading to thrombosis and abscesses. Speed can cause seizures as well as heart attacks, strokes and sudden death.

Speed users often become physically run down which leaves them susceptible to bacteria and viruses they could otherwise fight off. Extended use of speed can cause psychosis, paranoia and other mental illness. The street name for heavy users of speed is "speed freaks".

3.5 Tobacco ~ Nicotine

Tobacco comes from the tobacco plant and contains the stimulant drug nicotine. It is usually smoked in cigarettes, cigars and pipes but is also found in a powder form called snuff which is taken up the nose. It is also sold as a dip and as chewing tobacco.

The effects of smoking include increased pulse rate and blood pressure. These effects can be felt immediately and can last for up to 30 minutes from one cigarette. While first-time users can feel dizzy, nauseous and unwell after even just a few drags from a cigarette, regular users often report that smoking reduces their anxiety and helps them relax. Some smokers say nicotine reduces appetite, causing them to eat less.

Is Tobacco Addictive?

Tobacco is highly addictive. Regular use can result in physical dependency with long-lasting withdrawal symptoms. Depression, irritability, restlessness and anxiety are some of the symptoms experienced by smokers who haven't had a cigarette in a while. These symptoms are accompanied by a strong craving for another cigarette. It has often been said that tobacco and nicotine addictions are the hardest to overcome of all known addictive substances.

So you Want to Quit?

• stay away from places where other people smoke
• tell all your friends and family that you are trying to quit
• get the support of friends, family and fellow workers
• try acupuncture
• nicotine chewing gum, nicotine patches
• hypnosis
• learn and practice exercise breathing
• increase exercise
• change tobacco-related routines
• any popular remedies that work!

Spend some time with people who have successfully beaten tobacco addiction and keep their phone numbers handy when you have a craving.

Many rehabilitation facilities and hospitals now address nicotine addiction early in treatment. Physicians and other rehabilitation experts advise that the continued used of tobacco is the single most accurate predictor that an alcoholic or drug addict will relapse in recovery.

3.6 Caffeine

Caffeine is the most widely used drug in the world. It is found in many foods and beverages. Over 90% of us drink coffee and most of us drink it on a daily basis. One cup of regular coffee has all the daily caffeine that experts tell us is safe to consume in a healthy diet. A powerful stimulant, coffee gives a temporary lift followed by a drop, leaving us tired and let down and setting the stage for the next cup. Coffee users can develop tolerance for caffeine and require more and more to achieve the same effect. For some people, the use of caffeine and nicotine go hand-in-hand.

Caffeine makes our hearts beat faster as it constricts blood vessels and increases blood pressure. In increased amounts, it makes us edgy and anxious and can interfere with sleep for hours after it is consumed. It can cause stomach problems by creating too much stomach acid. Its use by pregnant women has negative effects on the deveIoping fetus. If caffeine were a newly discovered food additive, it would probably not be approved for human use!

Many lawyers, judges, and students use and abuse caffeine, consuming far more coffee, cola and chocolate than is good for them. Some practitioners drink huge quantities of coffee, at all hours of the day, leaving them constantly jittery, anxious, nervous, and uncomfortable in their own bodies. Sleep patterns are permanently disturbed and personal behaviour and outlook is affected. After a while, this discomfort feels normal and individuals lose a clear sense of themselves and their physical bodies. Caught in a cycle of long hours, hard and demanding work, little recreation or exercise, and agitation from large doses of caffeine, they become increasingly uncomfortable and dependent.

Caffeine is addictive, and persons cutting down or cutting caffeine out of their diets can experience unpleasant withdrawal symptoms that can last for a week. Long after withdrawal, caffeine cravings can continue for months or even years.

Clearly, it makes sense to limit the quantities of caffeine we consume. One or two cups of coffee in the morning is probably the right amount, although some people report feeling much, much better after cutting caffeine out of their diets. In our office, we switch to decaffeinated coffee at ten o'clock. We insisted that our favourite lunch spot add decaffeinated coffee to the menu and they started to order it just for us. Other customers then asked for it too, and the restaurant now serves about equal amounts of each.