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
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
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
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
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.