Category: F10 F11 F12 F13 F14 F15 F16 F17 F18 F19

F15 — Mental and behavioural disorders due to use of other stimulants, including caffeine: facilitator sheet

Teaching objective

For amphetamine-type stimulants, the classification approach mirrors F14 closely: distinguish transient intoxication phenomena from a more sustained substance-induced psychotic disorder by timing and persistence. For caffeine specifically, the central question is different and more basic: does a genuine six-criteria dependence cluster exist, or is this simply regular, unproblematic daily use that happens to involve a psychoactive substance?

Choose material

Worked example · Case: Just her morning coffee? · Case: Which stimulant, and does it matter?

Worked example

Show scenario

A 33-year-old drinks two cups of coffee every morning, has done so for years, and reports a mild headache on the rare day she skips it, which resolves once she has a cup later that day. She has never tried to cut down, has no difficulty controlling her intake, and reports no harm of any kind from her coffee habit. She specifically asks whether this means she is "dependent on caffeine."

1. Reveal step 1

   Step 1 — Check for control difficulty: she reports no difficulty controlling her intake and has never needed or wanted to cut down.

2. Reveal step 2

   Step 2 — Check for tolerance: no mention of escalating amounts needed for the same effect over the years.

3. Reveal step 3

   Step 3 — Check for harm: she reports no harm of any kind — physical, social, or occupational — from her coffee habit.

4. Reveal step 4

   Step 4 — Weigh the mild withdrawal-type headache alone: an occasional mild headache resolved by a cup of coffee is a minor physiological accompaniment, not evidence of the fuller dependence cluster by itself.

5. Reveal step 5

   Conclusion — This is best understood as ordinary, unproblematic caffeine use, not dependence syndrome (F15.2), because only a single, mild criterion is present and none of the others — control difficulty, tolerance, neglect of alternatives, or harm despite continued use — are met.

Comparison points

F15's amphetamine-type presentations parallel F14 closely (intoxication versus a more sustained substance-induced psychotic disorder); its caffeine presentations instead test whether the learner distinguishes ordinary regular use from a genuine dependence-syndrome cluster.

Misconception prompt

Treating any regular use of a psychoactive substance as automatic dependence: "They use it every day, so they must be dependent on it."

Ask the class why this reasoning fails before revealing the explanation below.

Reveal why it fails

Frequency of use, by itself, is only ever consistent-not-decisive evidence. Dependence syndrome requires three or more of six specific criteria together: desire/compulsion, control difficulty, tolerance, withdrawal, neglect of alternatives, and continued use despite harm. Many people use a substance daily for years with no control difficulty, no escalating tolerance, and no harm — this is ordinary, unproblematic use, not a disorder.

Discussion prompts

1. Prompt 1

   Without looking back at the page, state why caffeine's inclusion in this category is a deliberate teaching point rather than a claim that coffee drinking is a disorder.

2. Prompt 2

   Name the feature that most distinguishes ordinary regular caffeine use from caffeine dependence syndrome.

3. Prompt 3

   Explain in one sentence how amphetamine-type stimulant intoxication and psychosis parallel cocaine's.

Summary

Amphetamine-type stimulants parallel cocaine's intoxication/psychotic-disorder boundary closely; caffeine's inclusion tests whether ordinary daily use is mistaken for dependence syndrome.

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