Exploring the Link between Stress and Addiction


Stress is a normal part of life, but it’s also a risk factor for initiating substance use as well as aiding in the development of addiction, relapse, and also treatment failure.1

According to the American Psychological Association’s 2019 Stress in America survey, more than three-quarters of adults report physical or emotional symptoms of stress, such as headache, feeling tired or changes in sleeping habits.2

As stress can fuel undesirable and unhealthy behaviors, it’s important not to turn to substances like alcohol or drugs to escape it.3,4 One should instead identify alternative and healthier coping mechanisms.

How Stress Affects the Body

When individuals experience stress, levels of stress hormones like cortisol rise and blood rushes to the muscles as the body readies its fight-or-flight biological response.3

Everybody experiences normal stress at some point in their day, week, or month. In some cases, moderate and challenging stressors that have a limited duration are perceived as pleasant: rollercoasters, challenging exercise, etc.4

There’s acute stress, which is a short-term stressor that may have a bigger impact or be more distressing, like a traffic jam due to a car accident or an argument with your spouse or significant other

An individual may also suffer from chronic stress, that is, if they are under stress repeatedly, the fight-or-flight response will continually be triggered, and it can affect the brain’s prefrontal lobe which is involved in higher-level thinking and impulse control.4 Chronic stress increases the risk for developing depression, headaches, feeling tense in the neck, and even is associated with a higher risk of catching the common cold and the flu.5

How Stress May Contribute to Addiction

Trauma and major stressors in early childhood are associated with being more vulnerable to stress, as well as being more vulnerable to substance use and addiction.3,6

There is also accumulating evidence that demonstrates that both acute stress and chronic stress increase addiction vulnerability, that is, both risk of developing addiction and risk of relapse.7

The types of adverse life events, trauma, chronic stressors and individual circumstances that are predictive of individual risk include:7

  • Loss of a parent.
  • Parental divorce and conflict.
  • Isolation and abandonment.
  • Single-parent family structure.
  • Forced to live apart from parents.
  • Loss of a child by death or removal.
  • Unfaithfulness of significant other.
  • Loss of home to natural disaster.
  • Death of significant other/close family member.
  • Victim of gun shooting or other violent acts.
  • Observing violent victimization.
  • Physical neglect.
  • Physical abuse by parent, caretaker, family member, spouse or significant other.
  • Sexual abuse.
  • Rape.
  • Negative emotionality.
  • Poor behavioral control.
  • Poor emotional control.

A survey of more than 500 men showed that alcohol dependence was very closely related to stress in an individual’s life.8 These stressors ranged from severe stressors, such as the death of a loved one, to chronic stressors related to work environment.8 It’s also been noted 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.8

Healthy Ways to Deal with Stress

Many individuals find they can manage stress without turning to unhealthy coping mechanisms such as drugs or alcohol. In fact, there are many evidence-based tools that are practical and easy-to-implement ways that can help a person combat the negative effects of stress in healthy ways:

  • Enlist social support by reaching out to friends and family members.9
  • Relax your muscles and meditate.10
  • Maintain a consistent sleep routine that accommodates time to wind down.11
  • Move your body during the day and avoid caffeine and alcohol in the late afternoon and evenings.12
  • Get outside and enjoy nature.13
  • Laugh.14
  • Change your way of thinking about a stressor, and if you need more help, seek out a therapist.15

References

  1. Sinha, R., & Jastreboff, A. M. (2013). Stress as a common risk factor for obesity and addiction. Biological Psychiatry, 73(9), 827–835.
  2. American Psychological Association. (2019). Psychology Topics: Stress.
  3. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
  4. Harvard Medical School. (2018). Understanding the stress response.
  5. McEwen B. S. (2003). Early life influences on life-long patterns of behavior and health. Mental Retardation and Developmental Disabilities Research Reviews, 9(3), 149–154.
  6. Lovallo, W. R. (2013). Early life adversity reduces stress reactivity and enhances impulsive behavior: implications for health behaviors. International Journal of Psychophysiology, 90(1), 8–16.
  7. Sinha, R. (2008). Chronic stress, drug use, and vulnerability to addiction. Annals of the New York Academy of Sciences, 1141, 105–130.
  8. Brady, K. T., & Sonne, S. C. (1999). The role of stress in alcohol use, alcoholism treatment, and relapse. Alcohol Research & Health, 23(4), 263–271.
  9. Ozbay, F., Johnson, D. C., Dimoulas, E., Morgan, C. A., Charney, D., & Southwick, S. (2007). Social support and resilience to stress: From neurobiology to clinical practice. Psychiatry, 4(5), 35–40.
  10. Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., Berger, Z., Sleicher, D., Maron, D. D., Shihab, H. M., Ranasinghe, P. D., Linn, S., Saha, S., Bass, E. B., & Haythornthwaite, J. A. (2014). Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357–368.
  11. Åkerstedt, T., Kecklund, G., & Axelsson, J. (2007). Impaired sleep after bedtime stress and worries. Biological Psychology, 76(3), 170–173.
  12. Dolezal, B. A., Neufeld, E. V., Boland, D. M., Martin, J. L., & Cooper, C. B. (2017). Interrelationship between Sleep and Exercise: A systematic review. Advances in Preventive Medicine, 2017, 1364387.
  13. lrich, R.S., Simons, R.F., et al (1991). Stress recovery during exposure to natural and urban environments. Journal of Environmental Psychology, 11(3), 201-230. doi: 11016/S0272-4944(05)80184-7
  14. Savage BM, Lujan HL, Thipparthi RR, DiCarlo SE. Humor, laughter, learning, and health! A brief review. Adv Physiol Educ. 2017;41(3):341–347.
  15. Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.


About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More


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