October 23, 2006 (纽澳良) -- 根据一篇新的研究，滥用咖啡因已是年轻人间与日俱增之过量问题的因素之一，结果将导致青少年住进加护病房(ICU)，特别是同时滥用其他物品— 不论是合法或非法时。
纽澳良举行之美国急症医学会科学研讨会中发表的一篇研究指出，265位咖啡因滥用案例中有31位急诊，并回报芝加哥地区毒物中心须住院之病例，这265件案例中有8例，包含咖啡因和其他药物滥用。
根据主要研究者，芝加哥西北大学Feinberg医学院的急诊住院医师 Danielle McCarthy所述，研究结果认为，大量销售含大量咖啡因之所谓的“合法”饮食产品产生热能和欣快效果，使得那些未受良好教育的使用者遭到可怕的不良影响；近年来，网路上大力推销咖啡因是一种有效的合法的提神剂，都会区和校园四处可见提神饮料的广告。
McCarthy医师指出，许多年轻人认为咖啡因是食物而非药物，这种错误认知恶化了校园内和各地的滥用问题；许多青少年认为咖啡因是无害的，他们并不了解潜在的严重健康影响，直到过量时才猛然警觉；此一回溯研究中，265位咖啡因滥用住院案例中有21位— 单独使用或者有并用其他药物 — 最后住进ICU。
贝丝以色列女执事医院急诊医师Stephen Epstein指出，当急诊医师面对滥用案例时，若年轻病患出现心跳加快、胸痛、心悸、焦虑或其他刺激性药物滥用症状，如恶心和呕吐时，通常想到的是非法药物，如甲基安非他命，而较不会去怀疑“平凡的”咖啡因。
Epstein医师表示，在年轻病患因疑似药物滥用送来急诊时，应特别要求急诊医师不应忽略咖啡因，其间的差异处是咖啡因是社会上接受的，所以许多人不了解其危险之处— 甚至有证据显示它可能在大量过量时实际导致某一程度的心脏损害。
被报告到毒物控制中心的这些病患，平均年纪是21岁，但也有仅10岁的年轻病患接受咖啡因过量治疗；在94例咖啡因和其他物质同时滥用者之中，主要是其他药物(81 例)；其他13例则是酒精或非法药物。
McCarthy医师补充，本研究发现之贡献在提出关于未来有关咖啡因危险性的公众教育，以及进行咖啡因滥用之健康风险的前溯评估。
ACEP 37届年度科学研讨会。发表于 October 16, 2006。
Emergency Physicians Should Look for Caffeine Overdose in Concert with Other Drugs
By Bonnie Darves
Medscape Medical News
October 23, 2006 (New Orleans) — The abuse of caffeine is increasingly a factor in overdose situations among young people, and the consequences are often severe enough to land teens and college-age youth in the intensive care unit (ICU), especially when concomitant use of other substances — legal or illicit — is involved, according to new research.
In a study presented here at the American College of Emergency Medicine Scientific Assembly, 31 of 265 caffeine-abuse cases presenting to the emergency department (ED) and reported to a Chicago-area poison center necessitated hospital admission. Eighty of the 265 cases involved caffeine abuse in concert with other pharmaceutical products.
The results, according to lead researcher Danielle McCarthy, MD, an emergency medicine resident at Northwestern University's Feinberg School of Medicine in Chicago, Illinois, suggest that the aggressive marketing of high-content caffeine-containing beverages or diet as "legal" substances that deliver energy or promise euphoria may be causing dire effects among undereducated users. In recent years, Web sites that promote caffeine as "an effective, legal stimulant" have proliferated, and advertisements for "upper" beverages abound in urban areas and college towns.
"Many young people think of caffeine as a food, not a drug," Dr. McCarthy said, a misconception that is exacerbating the abuse problem on college campuses and elsewhere. As such, many adolescents consider caffeine "harmless," Dr. McCarthy noted, and do not realize the potentially severe health effects until they've overdosed. In the retrospective study, 21 of the 265 patients hospitalized for caffeine abuse — who had ingested it alone or in concert with other drugs — ended up in the ICU.
While emergency medicine physicians are attuned to looking for abuse cases involving illicit drugs such as methamphetamine, they may be less likely to suspect "garden-variety" caffeine when young patients present with rapid heart rate, chest pains, palpitations, anxiety, or other symptoms of stimulant abuse such as nausea and vomiting, said Stephen Epstein, MD, an emergency medicine physician at Beth Israel Deaconess Medical Center in Boston, Massachusetts.
"Caffeine should not be overlooked," Dr. Epstein said, and should be specifically asked about by emergency clinicians when young patients with suspected stimulant or other drug abuse present at the ED. "The difference is that caffeine is socially acceptable, so many people don't realize that it's dangerous — even though evidence suggests that it can actually can cause some heart damage," he said, in cases of major overdose.
The mean age of the patients whose cases were reported to the poison control center was 21 years, but patients as young as 10 years received treatment for caffeine overdose. In 94 of the cases caffeine was abused along with other substances, primarily other pharmaceutical products (81 cases); alcohol or illicit drugs were involved in the remaining 13 cases.
Dr. McCarthy added that the study's disturbing findings warrant further public education on caffeine's dangers and a prospective evaluation of the health risks of caffeine abuse.
ACEP 37th Annual Scientific Assembly. Presented October 16, 2006.
作者：
Bonnie Darves 2007-6-20