Exploring the Link between Stress and Addiction

Stress is a normal part of life, and some individuals find they can manage it with practical, easy-to-implement means, like exercise, breathing exercises, and meditation. Stress affects people differently, and some individuals may turn to unhealthy means to deal with stress. In fact, some people turn to substances, like alcohol and drugs, to escape from stress, and this abuse of substances can lead to addiction.

How Stress Affects the Body

Stress, although it is often considered a negative thing, is actually vital to existence. Without it, individuals would not have developed skills needed to survive. In fact, it can be a driving force during time-sensitive situations, such as prepping for school exams or work projects, as it can keep the individual focused on the work that needs to be done.

When individuals are under stress, their bodies will automatically trigger the brain’s classic “fight-or-flight” response. Historically, this is when individuals feel the need to either flee the situation or defend themselves. Once an individual is out of the stressful situation, the body will trigger the “rest and digest” response, so the body can recover and heal.

If an individual is under stress repeatedly, the fight-or-flight response will continue to be triggered, and it will eventually affect the prefrontal lobe – the part of the brain that deals with an individual’s higher-level thinking and impulse control. The chemicals that are associated with this response are only meant to be in the system for a short time, and if an individual is continuously under stress, it may begin to have other ramifications as well.

Stress can cause an individual to experience many symptoms, both physical and emotional. Some of the physical symptoms of stress, as listed by the American Psychological Association, include:

  • Headaches
  • Shortness of breath
  • Insomnia or excessive sleeping
  • Chest pain
  • Lower back pain
  • Stomach/gastrointestinal discomfort, including nausea, diarrhea, or constipation
  • Rapid heartbeat
  • Loss of interest in sex
  • Frequent colds

The emotional and cognitive symptoms of stress can include:

  • Memory problems
  • Moodiness
  • Difficulty with concentration
  • Irritability
  • Negative thinking
  • Depression
  • Worrying
  • Racing thoughts

Chronic stress can cause damage to the immune system – leading to frequent colds or other illnesses – because the stress-related chemicals cause the immune system to become overused. This can reduce the immune system’s effectiveness in fighting off illnesses, and it can increase the individual’s risk of heart disease and diabetes, digestive problems, and ulcers.

Fatigue and depression are common in individuals with chronic stress, as it can cause a poor state of mental health.

How Stress Can Help Create Addiction

Some individuals, when stressed, pick up certain behaviors, such as nervous habits. This might include such things as nail biting, pacing, and hair pulling. Other individuals, however, may turn to drugs or alcohol to help ease symptoms of stress. Although this outlet provides temporary relief, allowing the person to forget about the stressful situation for a short period of time, it ultimately becomes destructive. This substance use, which may begin as casual use, has the potential to lead to addiction. In fact, a study published in the Annals of the New York Academy of Sciences by Rajita Sinha states that chronic stress is a well-known risk factor for addiction and relapse vulnerability.

Certain drugs, as well as alcohol, can provide a temporary calming effect, so individuals may feel like their problems are gone. This can cause the individual to consume drugs or alcohol more, or at higher quantities, to help decrease stress levels. In reality, the substances can cause effects that are more damaging than the stress that initiated the drug or alcohol use.

The study also states that drug use can be a coping strategy to deal with stress or reduce tension, but it can also be due to changes in the brain caused by chronic stress. These changes can be similar to the changes that drug use can cause, and long-term drug use can even make users more sensitive to – and have a decrease in their ability to handle – stress. The National Institute on Drug Abuse states that when stressed, the body releases a hormone called corticotropin-releasing factor (CRF) – a hormone that can also be stimulated by drug use.

A survey by Seeman and Seeman, as published by the National Institute of Alcohol Abuse and Alcoholism, found that, in a survey of more than 500 men, alcohol dependence was very closely related to stress in the individual’s life. These stressors ranged from severe stressors – such as the death of a loved one – to chronic stressors related to work environment. The same publication states that women with a family history of alcohol dependence and/or anxiety disorders are at a greater risk for alcohol dependence, and they often partake in stress-related drinking and experience a greater effect than women without the predisposition for addiction.

Addiction can also cause individuals to perform ineffectively at work, which may lead to job loss, and this can cause more stress. Addiction can also cause individuals to lose their families, friends, and support systems, as relationships are damaged, as well as their health.

How Addiction Can Affect How the Body Responds to Stress

As previously stated, drug use can affect a drug user’s ability to handle stress, and it can essentially cause the body more stress.

When individuals first try drugs in a stressful situation, they may experience a decrease in the extreme emotions that stress can bring, according to NIDA. They may find this effect to be rewarding, but when the drugs wear off, the individual will go into withdrawal. This can trigger what the user feels are unpleasant feelings, due to the fact that the brain has increased stress-related neurotransmitters and the blood has increased levels of stress hormones. This can often trigger the stress response in the body and increase the sensitivity of the response’s trigger. This is what makes drug users more susceptible to stress; situations that would be minor to a healthy individual will cause a hyper response in drug users, states the Dana Foundation.

When drug use transitions to addiction, the reward of decreased emotions changes, turning into unpleasant feelings and even adverse effects, per the American Society of Addiction Medicine. The cause is involvement of the brain’s reward system as it floods the brain with dopamine. Drugs can change the reward system, which can lead to the compulsive drug use of addiction.

Dual Diagnosis

The term dual diagnosis is applied when both a stress disorder (or other mental health disorder, such as anxiety or depression) and drug or alcohol dependence are affecting an individual. They may be diagnosed at separate times, or at the same time. Drug or alcohol dependence, according to NIDA, can change the brain and the individual’s behaviors. Individuals who are dealing with drug or alcohol dependence develop compulsive behaviors that revolve around the drug or alcohol – either obtaining it, using it, or recovering from it.

Dual diagnosis is quite common with drug or alcohol dependence – NIDA states that individuals dealing with drug or alcohol dependence are approximately twice as likely as the general population to experience mood or anxiety disorders, and vice versa. Drug or alcohol use can exacerbate symptoms of mental illness, such as anxiety or psychosis. Mental illness can lead to drug or alcohol use, because individuals may rely on drugs or alcohol to relieve symptoms of their mental illness.

Genetic predisposition can play a large role in the development of mental illness as well as drug or alcohol dependence. Stress, emotional trauma, and exposure to drugs or alcohol at a young age can also lead to drug or alcohol dependence or mental illness.

Addressing the Issue of Stress

If individuals feel they have problems with both stress and addiction, they should seek the assistance of a professional. They can begin with their primary care physician – if their current physician does not feel comfortable with addiction, the individual may be referred to one who does – or locate an addiction specialist. A medical professional will be able to assess the individual’s situation and determine the best plan of action for that person. Most often, addiction treatment that deals with co-occurring disorders will be recommended, and this can come in many forms, from residential or inpatient treatment to outpatient treatment, including behavioral therapy and 12-Step support.

Oftentimes, treating an underlying mental illness may cause a decrease in stress. Certain mental illnesses, such as post-traumatic stress disorder, anxiety, or depression, can cause stressors that may seem minor to become unbearable for an individual. At this point, stress can impact an individual’s quality of life.


Treatment for stress and addiction varies greatly according to the individual. If the dependence is severe, and inpatient treatment is recommended, the treatment plan should focus on both the individual’s drug or alcohol dependence and stress. Therapy can help the individual focus on the disruptive thinking caused by drug dependence and modify negative thinking. Medications may be used if needed, to help the individual through any unpleasant withdrawal symptoms – for example, if anxiety is an issue contributing to the individual’s drug use and dependence, a mental health professional may prescribe an anti-anxiety medication to help with the individual’s symptoms.

No matter which therapy option clients choose, treatment plans must be tailored to each individual. No two clients are the same, and treatment plans should also be reviewed at different points during the client’s recovery and changed as needed. Factors such as age, the drug that the client has been dependent on, and certain life situations must also be considered when developing a treatment plan.

In inpatient treatment, clients will be under medical care around the clock as they undergo medical detox. Clients will be reassured that medical staff will be monitoring the medical detox process and they are in a safe facility. The medical detox process is essential, as clients cannot effectively learn new coping skills and stress management skills while under the influence of drugs or alcohol.

Behavioral therapy is a crucial part of treatment, as it helps clients recognize and change behaviors related to obtaining and using drugs or alcohol. Clients learn new coping skills to help manage stress, so they don’t turn to drugs or alcohol when they encounter stress in the future. This type of therapy will also help clients to identify both acute and chronic stressors, and find ways to deal with these stressors. Therapy will also include building problem-solving and decision-making skills.

Clients may choose to participate in family therapy sessions if a relationship is causing excessive stress. This will provide family members with stress management techniques and help to build a stronger family unit, as the family works through stressful issues for both the client and the family as a whole.

If the client’s work environment or job is causing stress, and a career change is desired, a referral to employment services may be given. These services can help clients learn new employment skills or find education services necessary to begin a new career. They can also assist individuals in applying for new jobs.

If a client has attended a rehabilitation program previously, but then relapsed, this does not indicate that the person has failed in recovery. It simply means that the person may need to either learn new skills to promote recovery or that a change to the individual’s treatment plan is needed.

Stress Self-Management Techniques

Learning effective methods to manage stress is critical to the recovery process. This ensures individuals are equipped to deal with stress in healthy ways so they don’t turn back to substances when stress hits.

Yoga is a frequently used method of stress relief, and it has been shown to be effective across various demographics. Per Psych Central, a study showed that women who practiced yoga had lower amounts of stress hormones in their blood. Yoga also provides a physical workout, causing the brain to release endorphins, which are the body’s natural painkillers and related to positive thinking. The endorphins also encourage stress relief and overall happiness.

Meditation is a stress management technique that involves mindfulness. A Harvard Health Publications article describes meditation as a process where individuals sit comfortably while focusing on their breathing and clearing their minds. Individuals bring their attention to the present situation, not worrying about the past or future, and this can help to relieve anxiety and stress.

A proper diet provides nutrients that are essential for physical health, boosting energy, emotional stability, and concentration. Since stress weakens the immune system, a balanced diet can help individuals stay healthy when under stress. Overall wellness, promoted through sufficient sleep, a healthy diet, and regular exercise, helps reduce stress levels.


Since stress and addiction have such a strong link, it is essential that clients seeking addiction treatment are assessed for stress-related issues as well as mental illness. If stress in a client’s life is both properly addressed, the person faces a higher risk of relapse. Stress may also play a role in whether or not a person stays in treatment, so it should be addressed promptly in treatment.

Research from the medical journal Neuron showed that stress was related to relapse in cocaine users. In addition, a study published in Psychopharmacology showed that stress can cause relapse even after a 4-6 week drug-free period. The bottom line is that treatment of stress is crucial to the treatment of drug or alcohol dependence and prevention of relapse.

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Editorial Staff
Editorial Staff, American Addiction Centers
The editorial staff of Greenhouse Treatment Center is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed... Read More