Stress and Substance Abuse: How Strong is the Connection?

 In Drug & Alcohol Addiction

Recent advances in the study of addiction and the science of recovery have delivered strong evidence that a link exists between stress, drug use, drug abuse, and addiction. Stress has long been recognized as both a necessary element for personal growth and learning as well as a significant health hazard. In order for a human being to remain healthy, happy, and productive- some degree of stress is necessary. The question is, where is the balancing point before stress becomes a hazard- and how much of a risk of addiction does stress impose on and men and women?

Stress: The Addiction Connection

The research has shown time and again, that the initiation of drug use, drug abuse, and relapse are more likely to occur in persons who exhibit signs of stress or who report feeling stressed. A number of studies are currently in circulation in addiction medicine circles which offer compelling, statistically supported arguments for this claim.

According to the National Institute on Drug Abuse, different people have different tolerances to stress or “stress thresholds.” They explain that stress has a physiological basis, and once the threshold is reached, the hypothalamus is engaged, releasing the “corticotropin-releasing hormones,” the stress hormone known more broadly as cortisol. When this happens, the individual receives a strong chemical signal within the brain that triggers pleasure and/or comfort seeing behaviors. 

How Much Stress is Too Much?

This idea has gained a great deal of traction in the world of addiction treatment. The notion that self-control can be compared to a muscle that has a limited amount of energy and a limited lifting capacity has taken root in treatment culture and practice. This is particularly true of evidence-based treatment programs. The simple reason for this that the idea is both backed up my massive amounts of statistical evidence- and it is strongly in agreement with the common intuition about self-control- ie; that it is limited.

Of course, there is no universal stress threshold that applies to everyone. One person’s resistance to stress is dependent on perceptions about one’s self, the type of stressor experienced, and underlying physiological factors rendering the individual’s capacity for self-control.

The studies promoting this view are largely unanimous in their findings. They show that persons exposed to stress;

  • Are more likely to abuse alcohol or other drugs
  • Are more likely to continue using alcohol or other drugs
  • Exhibit a decreased expressed interest in exhibiting self-control
  • Report increases ideations related to using drugs or alcohol
  • Report a sharp increase in interest in drugs which they have used before

The researchers agree that the biological mechanism that makes an individual capable of resisting temptation is a delicate one. Their findings support the notion that stress can disrupt the mechanism of self-control, deplete its chemical reserves- rendering the self-control mechanism effectively inoperative.

Addiction as a Disease Process

Over the years, the notion that addiction is not a moral failing, but the disease has received a great deal of push-back. There is some reason to resist the idea because if the moral component of drug abuse is removed, it would seem that addicts would have one less emotional resource to draw upon in their recovery.

Still, the evidence that addiction is, in fact, disease and not a character flaw is strongly supported by these findings on stress and drug use. While these developments may take some moral impetus away from the recovering addict- it is a virtual certainty that advances in addiction treatment will develop as a result of this relatively new understanding.

Evidence-Based Addiction Treatment

Divided roughly into Pharmacotherapies and Behavioral Therapies, evidence-based addiction treatment is based on empirical, statistical, and medical evidence which shows a given treatment to have the effect of reducing use, abuse, and relapse- making recovery more likely.

The scientific movement which views self-control as limited physiological research has been a big part of the rise of the evidence-based treatment model.

Possibly the greatest advance has been the reduction in the perceived stigma of entering treatment as a confession of weakness or a moral failing. Recovering from an addiction may be difficult, but it is possible. Ceasing to be a “bad” or “weak person,” on the other hand- is not so straight forward. It would appear that removing the stigma of immorality from addiction has made it easier for those who need help to seek it.

Of course, when all is said and done- we are all still responsible for our own actions. The harm done to one’s self and others as the result of addictions is still the responsibility of the person who committed harmful actions. But it is widely recognized that forgiving one’s self is an important part of overcoming addiction- and by understanding the true nature of self-control, self-forgiveness becomes much more achievable.

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