A padrão of caffeine uso that has caused clinically significant harm to a person’s physical or mental health or in which caffeine-induced behaviour has caused clinically significant harm to the health of other people. The padrão of caffeine uso is evident over a period of at least 12 months if uso is episodic and at least one month if uso is continuous (i.e., daily or almost daily). Harm may be caused by the intoxicating effects of caffeine, the direct or secondary toxic effects on body organs and systems, or a nocivo route of administration.