By Michael J. Critelli | MakeUsWell Newsletter, 

Practically every morning I am up early to drink a double espresso at the local Starbucks in either Darien, CT (between July and October), or Naples, FL (November through June). On school days, teenagers and college students show up between 6:45 a.m. and 7:15 a.m. to pick up a pre-ordered drink with highly concentrated caffeine.

I can relate to them to some extent because I was a heavy consumer of either Coca Cola or Pepsi, with a small cup of coffee at breakfast when I was in college. In law school, I substituted Tab, a sugar-free cola, for either Coca Cola or Pepsi. Today, I regularly consume no more than 300mg of caffeine per day, almost always before 9 a.m. 400 mg is considered the upper safe limit. My Dad was able to drink a big cup of coffee immediately before bedtime and my daughter seems to have inherited that attribute. I have trouble drinking coffee after noon.

Behaviors of young people are quite different today from what I did to get more energy. Caffeine is increasingly packaged and marketed as energy, focus, performance and endurance. It appears not only in coffee, but in energy drinks, energy shots, pre-workout products and highly caffeinated beverages that can deliver a large dose very quickly.

The trend among teenagers deserves attention. The University of Michigan's Monitoring the Future study reports that daily energy-drink use has risen substantially since the middle of the last decade. In 2025, 17% of eighth graders, 19% of tenth graders and 23% of twelfth graders reported consuming at least one energy drink a day. For tenth and twelfth graders, those were the highest levels the survey had recorded.

At first glance, this may seem inconsistent with the newest federal data. A 2026 CDC report found that Americans ages 12–19 averaged only about 31 milligrams of caffeine on a given day. About two-thirds consumed at least some caffeine.

But averages can hide important behavior. Many teenagers consume little or no caffeine, while others may consume much larger amounts. Moreover, caffeine now comes from many sources: soda, coffee, tea, chocolate-containing foods, energy drinks and other products.

The most important issue may not simply be how much caffeine young people consume, but how and why they use it.

Caffeine works for its limited purpose, but it has downstream side effects.

Controlled research in adolescents has demonstrated that caffeine can improve sustained attention and resistance to fatigue. A teenager who is tired and drinks a highly caffeinated beverage may genuinely feel more alert and may perform better for a period of time.

But caffeine does not eliminate the biological need for sleep. It masks fatigue. Research using sleep EEGs in adolescents has found that greater caffeine consumption, particularly in the afternoon and evening, is associated with taking longer to fall asleep, less total sleep, poorer sleep efficiency and less REM sleep.

This creates an easy cycle to understand:

Too little sleep → caffeine to function → temporary alertness → poorer sleep → more fatigue → more caffeine.

The result can be a paradox. A substance used to improve concentration today may help create the sleep deficit that impairs concentration tomorrow.

Concentrated doses add another concern. In a randomized trial involving healthy children and teenagers, an energy drink containing three milligrams of caffeine per kilogram of body weight significantly increased both systolic and diastolic blood pressure compared with a placebo. 

High caffeine intake can also produce anxiety, jitteriness, palpitations, headaches and digestive problems. The FDA specifically warns that excessive caffeine in children and teenagers can affect heart rate and blood pressure and contribute to anxiety and sleep problems.

This does not mean that every caffeinated beverage is dangerous. For most healthy adults, the FDA cites 400 milligrams of caffeine per day as an amount not generally associated with negative effects. But that number is not a recommended target, and teenagers are not simply smaller adults. 

In 2025, leading pediatric, nutrition, dental and heart-health organizations jointly recommended that children and adolescents avoid beverages containing caffeine and other stimulants. While that may be the ideal result, we must recognize that young people are consuming caffeine because it does a job that they believe is needed. 

They want to improve their energy and their alertness. Is the alertness problem a result of a school experience that does not engage them sufficiently, or do they want more energy and alertness to do something they love better and at a higher level? We need to stop treating caffeine and other stimulants divorced from understanding why teenagers and young adults are consuming them.

Even if these drinks do a necessary job, do consumers understand the dosage they are consuming?

The word "energy" may appear on a brightly packaged can, but a coffeehouse beverage can deliver just as much caffeine—or considerably more. Starbucks currently lists approximately “315–390 milligrams” of caffeine in a 16-ounce Grande Blonde Roast. 

Someone can therefore consume what amounts to a substantial stimulant dose without ever purchasing an "energy drink."

That suggests that we need to change the conversation.

Instead of simply asking, "Do you drink energy drinks?" parents, physicians, coaches and young people themselves might ask:

Why am I using them? Am I drinking caffeine because I enjoy the beverage, or because I cannot function without it? Is it compensating for inadequate sleep?

How much caffeine am I consuming from all sources? How quickly am I consuming it? At what time of day? 

It is not coincidental that in college and other communities with a disproportionate percentage of young people, one of the recent additions to caffeine consumption is the introduction of three new Insomnia Cookies. This popular cookie retailer’s name signals that its appeal is to help students get an energy boost from sugar, and now caffeine, when they should be figuring out how to get back on a good sleep schedule.

Those questions are especially important for teenagers and young adults whose school, work, sports and social lives often reward staying awake longer and doing more.

The goal should not be to demonize caffeine. It should be to make caffeine visible and to understand the constructive role it should play. Young people should know the dose they are consuming, understand that timing matters and recognize fatigue as biological information rather than simply an inconvenience to be chemically overridden.

In a culture increasingly built around constant performance, perhaps one of the most important health lessons we can teach is this: More short-term energy is not necessarily the same thing as more health.