Too much, too fast? Expert sounds alarm over caffeine pouches

Dr. J. Sawalla Guseh discusses the rising popularity of caffeine pouches, and the potential health concerns of taking alternative forms of caffeine.

First came smoking and chewing tobacco, then vaping, then small pouches that seep nicotine directly into a user’s gums.

Now, yet another trend in chemical stimulants is drawing attention: Candy-flavoured pouches that don’t contain nicotine at all, but instead use the same delivery system for caffeine.

Health Canada says the products haven’t been authorized for sale, but with online orders so accessible globally, concerns have circulated about potential health impacts, especially for children and teens.

“Because they’re flavoured, I think, young people really like them,” said Dr. J. Sawalla Guseh, a cardiologist and instructor at Harvard Medical School, in a Thursday interview with CTV Your Morning.

“(Pouches are) not well-studied, and they give you a little hit of caffeine rapidly, into the bloodstream.”

Here’s what to know:

Dose and delivery

Sometimes packaged with health supplements, caffeine pouches are commonly marketed as energy-boosting productivity aids. They can come in flavours like caramel and lemonade, and can contain anywhere from 25 to hundreds of milligrams of caffeine per pouch.

For comparison, Health Canada says a standard cup of brewed coffee has around 135 mg, on average. The legal limit for a single serving of an energy drink, meanwhile, is 180 mg.

Guseh notes a caveat with that comparison -- beverages like coffee, cola or tea need to be digested and metabolized before you feel the effects, but nicotine or caffeine pouches don’t have that natural restriction.

“Because it’s absorbed orally, you don’t have to wait for it to go through your gastrointestinal tract before you start to absorb it,” he told CTV Your Morning.

“Fundamentally, the effects are fairly similar, and they’re dose-dependent. The higher the dose that you have, the more likely you are to have an adverse or side effect.”

Health concerns

While visually similar to the nicotine pouches that have sparked federal scrutiny in recent years, the story doesn’t necessarily play out the same way for a caffeine alternative.

For one thing, caffeine use is far more common in daily life. While around 13 per cent of surveyed Canadians reported recent use of any sort of tobacco or vaping product in 2022, the Centre for Addiction and Mental Health (CAMH) calls caffeine the “most widely used psychoactive substance in the world,” regularly consumed by more than 80 per cent of North American adults.

That said, there are still health issues to keep in mind.

Health Canada recommends no more than 400 mg of caffeine per day for most adults, and 300 mg for anyone who is breastfeeding, pregnant or planning to become pregnant. For children and adolescents, the department says the daily limit scales with body weight, at a ratio of 2.5 mg per kilogram.

CAMH warns that too much caffeine can cause headaches, anxiety, an upset stomach, insomnia and jitters, and in high doses, may increase heart rate, trigger convulsions and make a person delirious.

Hospitalizations for caffeine toxicity are not unheard of, and an overdose can lead to kidney, heart and even brain damage.

“The question is: How many are you having, and how fast are you having them?” Guseh said. “And, importantly: What are you using them with, and what are you using them for?”

He notes that key factors include how each person typically responds to caffeine, and also how a stimulant may interact with any medications or health conditions they may have. Psychiatric and ADHD medications in particular may have altered effects, he says.

“If (your child has) had caffeine before, what’s their prior response? Are you wired to a regular Coca-Cola? Then a rapid hit of caffeine may not quite be for you,” Guseh said.

“For most people, they know how they feel with caffeine, and so for most people, it’s probably OK; it’s probably safe.”

That said, he suggests parents consider the reason why your child may be turning to caffeine in the first place.

“Are they taking it because they’re having issues with inattention?” he said. “Is there an underlying medical condition that they might have, that needs further exploration?”

Are caffeine pouches legal for kids?

No. Caffeine pouches aren’t authorized for sale to anyone in Canada, as they haven’t gone through the regulatory steps and safety assessments required for federal approval.

In an emailed statement to CTV News, Health Canada wrote unequivocally: “The sale of caffeine pouches in Canada is illegal.”

As for international orders, Health Canada notes that it works with border officials “to prevent the commercial importation of any unauthorized health products.”

The department said that multiple compliance investigations are currently underway to “determine if federal rules are being broken,” and that if noncompliance is found, Health Canada may visit businesses, seize inventory and notify the public of unauthorized products in circulation.

“Health Canada encourages anyone with any information regarding potential sales or advertising of non-compliant or unauthorized health products to report it,” the statement reads.

You can watch the full interview with Harvard Medical School instructor Dr. J. Sawalla Guseh in the video player at the top of this article.