Caffeine That Kills

Health Letter, September 2015

By Sarah Sorscher, J.D., M.P.H

caffeine
A serving size of powdered pure caffeine is just a rounded
1/32 of a teaspoon, pictured here. A tablespoon is enough to kill an adult. Image: Sarah Sorscher

Last summer, two young men died within a month of each other as a result of taking one of the most commonly consumed drugs in the United States: caffeine.

Logan Stiner was a LaGrange, Ohio, honors student and athlete wrapping up his senior year in high school.[1] He was found on his living room floor by his brother on May 27, 2014.[2] The coroner initially told the family that Logan had died of natural causes, but after Logan’s parents discovered a small bag that turned out to be powdered pure caffeine, the coroner confirmed that the actual cause of death was caffeine overdose.[3] Logan’s friend had purchased the powder on Amazon.com.

The following month, James Wade Sweatt, a 24-year-old, newly married electrical engineer living in Alpharetta, Ga., also died after taking powdered pure caffeine purchased on Amazon.com.[4] He bought the caffeine as a health product, seeking to avoid the additives in Diet Mountain Dew, his usual drink of choice when he needed a caffeine boost.[5]

Few would suspect such deadly effects from caffeine, a chemical consumed daily by more than eight in 10 Americans in coffee, tea and other beverages.[6] But the caffeine in these beverages is so diluted that it is nearly impossible to get a lethal dose by drinking too much. For example, to get a lethal amount, an adult would have to drink 55 eight-ounce cups of Starbucks coffee, a mind-boggling volume.[7],[8]

Yet at high concentrations, caffeine quickly becomes deadly. Powdered pure caffeine, the product that devastated two families last summer, is highly lethal. Just one teaspoon of the product is enough to kill a child, and one tablespoon can kill an adult.[9]

The dose typically recommended on the packaging of powdered pure caffeine is 200 milligrams per serving.[10] To measure this tiny amount, customers must have a digital gram weight scale or a measuring spoon that is sized to one-sixteenth of a teaspoon.[11],[12] It is easy to become confused and add too much, which appears to be what happened to Stiner and Sweatt.

Horrified that such a dangerous product is so readily available on the Internet, the parents of the two young men took their stories to the Food and Drug Administration (FDA) in December 2014. They were accompanied by staff from the Center for Science in the Public Interest (CSPI) and Public Citizen. The same day, CSPI submitted a petition to the FDA asking the agency to ban powdered pure caffeine as a dietary supplement.[13] Logan’s family also sued Amazon.com and the companies that packaged and sold the powder to consumers.[14]

The families’ advocacy has had an impact: The FDA issued a safety announcement[15] and a blog post[16] warning consumers to avoid powdered pure caffeine, leading Amazon.com to stop selling the product, although as of the date of publication of this article, the product is still available online.[17]

That may change soon, however: On August 27, 2015, the FDA issued a series of warning letters against five online sellers of pure powder caffeine.[18],[19],[20],[21],[22] The letters declare these companies’ pure powder caffeine adulterated under a rarely-used 1994 law banning unsafe supplements.[23] The only other time that the FDA has relied on this law to ban an unsafe supplement was when the agency banned ephedra in 2004.[24],[25]

It remains unclear how the supplement manufacturers will respond to the FDA warning. They may choose to challenge the FDA’s ban in court, as companies did following the FDA ban on ephedra.[26] Even if the FDA’s action is upheld, it is unclear whether the agency will stop supplement manufacturers from switching to selling highly concentrated caffeine in a more diluted, but still dangerous form.

Yet the FDA’s actions against the five manufacturers of pure caffeine products still represent a huge win for the parents of Stiner and Sweatt. The families’ advocacy hopefully will prevent other American families from experiencing another tragedy from this deadly product.

UPDATED and CLARIFIED Sept. 1, 2:45 p.m.: The article now mentions the FDA’s August 27 decision to send warning letters to five companies that manufacture pure caffeine, and language describing the scope of that action has been adjusted for accuracy.


References

[1] Carpenter M. Caffeine powder poses deadly risks. New York Times. May 18, 2015. http://well.blogs.nytimes.com/2015/05/18/caffeine-powder-poses-deadly-risks-2/. Accessed July 27, 2015.

[2] Moye D. Logan Stiner died of caffeine overdose days before graduation. The Huffington Post. July 1, 2014. http://www.huffingtonpost.com/2014/07/01/logan-stiner_n_5549206.html. Accessed July 27, 2015.

[3] Center for Science in the Public Interest. Petition to ban the retail distribution of pure and highly concentrated caffeine sold in powder form as a dietary supplement. December 9, 2014. http://cspinet.org/new/Caffeine-petition-CSPI-12-9-2014.pdf.

[4] Ibid.

[5] Carpenter M. Caffeine powder poses deadly risks. New York Times. May 18, 2015. http://well.blogs.nytimes.com/2015/05/18/caffeine-powder-poses-deadly-risks-2/. Accessed July 27, 2015.

[6] Mitchell DC, Knight CA, Hockenberry J, et al. Beverage caffeine intakes in the U.S. Food and Chem Toxicol. 2014;63:136-142.

[7] Center for Science in the Public Interest. Petition to ban the retail distribution of pure and highly concentrated caffeine sold in powder form as a dietary supplement. December 9, 2014. http://cspinet.org/new/Caffeine-petition-CSPI-12-9-2014.pdf.

[8] Blonde Roast. Starbucks website. http://www.starbucks.com/menu/drinks/brewed-coffee/veranda-blend-?foodZone=9999#size=11019773.

[9] Center for Science in the Public Interest. Petition to ban the retail distribution of pure and highly concentrated caffeine sold in powder form as a dietary supplement. December 9, 2014. http://cspinet.org/new/Caffeine-petition-CSPI-12-9-2014.pdf.

[10] Caffeine powder (synthetic). PureBulk website. http://purebulk.com/caffeine-powder-synthetic/. Accessed July 27, 2015.

[11] Ibid.

[12] Center for Science in the Public Interest. Petition to ban the retail distribution of pure and highly concentrated caffeine sold in powder form as a dietary supplement. December 9, 2014. http://cspinet.org/new/Caffeine-petition-CSPI-12-9-2014.pdf. Accessed July 27, 2015.

[13] Ibid.

[14] Ohio dad sues over caffeine powder that killed son. CBS News. March 6, 2015. http://www.cbsnews.com/news/ohio-dad-sues-over-caffeine-powder-that-killed-son/. Accessed March 6, 2015.

[15] Food and Drug Administration. FDA consumer advice on powdered pure caffeine. December 23, 2014. http://www.fda.gov/Food/RecallsOutbreaksEmergencies/SafetyAlertsAdvisories/ucm405787.htm. Accessed July 27, 2015.

[16] Landa MM. Tragic deaths highlight the dangers of powdered pure caffeine. FDA Voice website. December 16, 2014. http://blogs.fda.gov/fdavoice/index.php/2014/12/tragic-deaths-highlight-the-dangers-of-powdered-pure-caffeine/. Accessed July 27, 2015.

[17] Caffeine powder (synthetic). PureBulk website. http://purebulk.com/caffeine-powder-synthetic/. Accessed July 27, 2015.

[18] Food and Drug Administration. Warning Letter: Bridge City Bulk. August 27, 2015. http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2015/ucm460203.htm. Accessed September 1, 2015.

[19] Food and Drug Administration. Warning Letter: Hard Eight Nutrition, LLC. August 27, 2015. http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2015/ucm460200.htm. Accessed September 1, 2015.

[20] Food and Drug Administration. Warning Letter: Kreativ Health Inc. dba Natural Food Supplements. August 27, 2015. http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2015/ucm460208.htm. Accessed September 1, 2015.

[21] Food and Drug Administration. Warning Letter: Purebulk, Inc. August 27, 2015. http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2015/ucm460204.htm. Accessed September 1, 2015.

[22] Food and Drug Administration. Warning Letter: SPN, LLC dba Smartpowders. August 27, 2015. http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2015/ucm460201.htm. Accessed September 1, 2015.

[23] Nowak RE, DSHEA’s failure: why a proactive approach to dietary supplement regulation is needed to effectively protect consumers. U Ill L Rev 2010;3:1045-1081.

[24] Nowak RE, DSHEA’s failure: why a proactive approach to dietary supplement regulation is needed to effectively protect consumers. U Ill L Rev 2010;3:1045-1081.

[25] 21 C.F.R. Part 119. Dietary Supplements that present a significant or unreasonable risk. http://www.ecfr.gov/cgi-bin/text-idx?SID=78774a4fa54d766cbc12db35b55852f1&mc=true&node=pt21.2.119&rgn=div5. Accessed September 1, 2015.

[26] Nowak RE, DSHEA’s failure: why a proactive approach to dietary supplement regulation is needed to effectively protect consumers. U Ill L Rev 2010;3:1045-1081.