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For Many, Stress Leads to the Use and Abuse of Drugs, Alcohol and Tobacco...

Some of the Basic Facts

Stressful events can have a direct affect on the use of alcohol or other drugs. Stress is a major contributor to the initiation and continuation of addiction to alcohol or other drugs, as well as to relapse or a return to drug use after periods of abstinence.

Stress is one of the major factors known to cause relapse to smoking, even after prolonged periods of abstinence.

Children exposed to severe stress may be more vulnerable to drug use. A number of clinical and epidemiological studies show a strong association between psychosocial stressors early in life (e.g., parental loss, child abuse) and an increased risk for depression, anxiety, impulsive behavior, and substance abuse in adulthood.

When We Refer to "Stress," Just What Are We Talking About?

Stress is a term we all know and use often, but what does it really mean? It is hard to define because it means different things to different people. Stress is a normal reaction to life for people of all ages. It is caused by our body's instinct to protect itself from emotional or physical pressure or, in extreme situations, from danger.
Stressors differ for each of us. What is stressful for one person may or may not be stressful for another; each of us responds to stress in an entirely different way.

How a person copes with stress--by reaching for a beer or cigarette or by heading to the gym--also plays an important role in the impact that stress will have on our bodies.

By using their own support systems, some people are able to cope effectively with the emotional and physical demands brought on by stressful and traumatic experiences. However, individuals who experience prolonged reactions to stress that disrupt their daily functioning may benefit from consulting with a trained and experienced mental health professional.

How Does the Body Respond to Stress?

The stress response is mediated by a highly complex, integrated network that involves the central nervous system, the adrenal system, the immune system, and the cardiovascular system.

Stress activates adaptive responses. It releases the neurotransmitter norephinephrine, which is involved with memory. This may be why people remember stressful events more clearly than they do nonstressful situations.

Stress also increases the production of a hormone in the body known as corticotropin releasing factor (CRF). CRF is found throughout the brain and initiates our biological response to stressors. During all negative experiences, certain regions of the brain show increased levels of CRF. Interestingly, almost all drugs of abuse have also been found to increase CRF levels, which suggests a neurobiological connection between stress and drug abuse.

Mild stress may cause changes that are useful. For example, stress can actually improve our attention and increase our capacity to store and integrate important and life-protecting information. But if stress is prolonged or chronic, those changes can become harmful.

Stress, Drugs, and Vulnerable Populations

Stressful experiences increase the vulnerability of an individual to relapse to drugs even after prolonged abstinence.

Individuals who have achieved abstinence from drugs must continue to sustain their abstinence - avoiding environmental triggers, recognizing their psychosocial and emotional triggers, and developing healthy behaviors to handle life's stresses.

A number of relapse prevention approaches have been developed to help clinicians address relapse. Treatment techniques that foster coping skills, problem-solving skills, and social support play a role in successful treatment.

Physicians and therapists should be aware of what medications their patients are taking but should not discourage the use of medical prescriptions to help alleviate stress. Some people may need medications for stress-related symptoms or for treatment of depression and anxiety.