Almost half of Americans feel that their stress keeps them lying awake at night. About three out of four American adults experience physical symptoms and/or psychological symptoms related to their stress. Even more – over 90 percent – teenagers and young adults (between ages 15 and 21) report the same, stress-related symptoms. It’s clear that stress is a growing concern among our youth – and, coupled with the fact that 25 million Americans over age 12 use illicit drugs, so is stress-induced substance abuse.

In light of Stress Awareness Month, that is recognized in April, Turnbridge dives into the unnerving relationship between stress and substance abuse.

Stress can take on a variety of forms, including acute stress, chronic stress, and distress. It can be caused by different things – such as a fight with a friend, or a big exam – and manifest in many different ways. There is short-term stress, which can actually be good for the body, and then there is long-term stress, which can cause serious health problems over time. There is also post-traumatic stress disorder (PTSD), which is triggered by traumatic events such as violence, natural disaster, and sexual abuse.

When a person feels stressed, their body releases powerful hormones and neurochemicals, so that they can effectively respond and cope. The main hormone that is released in the brain is called CRF, or corticotropin releasing factor. CRF is also released in the brain when a person abuses drugs. Thus, the connection between stress and substance abuse begins.

At the same time CRF is increasing, a person’s levels of GABA (a natural tranquilizer in the brain) and dopamine (the brain’s pleasure-producing chemical) are decreasing. This deficiency makes the person more likely to seek solace in addictive substances, such as cocaine or alcohol, to stimulate feelings of pleasure and composure once again.

According to recent research, stress is a key risk factor in the initiation of substance abuse, the cycle of addiction, and drug relapse. In fact, many clinicians and addiction specialists suggest that stress is the number one cause of relapse to substance abuse. Even more, research shows that chronic or constant stress actually causes changes in the brain, making it more susceptible to addiction.

When a person experiences short-term stress, such as being late for work or applying for a job, the body goes into “fight or flight” mode, which prepares us to react quickly. These feelings also dissipate quickly. Chronic or constant stress, however, fires this response day after day, exhausting the body over time and causing issues such as insomnia, headaches, depression, illness, and muscle tension. Over time, these negative effects can lead a person to self-medicate with drugs, as an effort to cope.

For those who are dealing with high levels of stress daily, alcohol and drugs can make a person feel happy temporarily. The problem is, the “high” is usually followed by extremely low moods once the drug wears off. This withdrawal period can also worsen stress-related symptoms, making a person want to use again. According to the U.S. Department of Veterans Affairs (VA), using drugs or alcohol as a coping mechanism for stress disorders like PTSD can delay treatment progress or make symptoms last longer.

We’ve talked previously about the relationship between PTSD and substance addiction—two chronic disorders that often co-occur. According to national statistics, more than half, and up to two-thirds, of people who battle PTSD also battle substance addiction simultaneously. According to the journal of Clinical Psychology, those afflicted by PTSD are two to four times more likely to become addicted to drugs. This is largely to the state of their mental health and their likelihood of self-medicating the pain with drugs. It’s also due to the fact that people with chronic stress, and those battling PTSD, do not have properly regulated hormonal responses to stress, and do not return to normal when the stress is over.

Unfortunately, we live in a world where stressors are surrounding us – work, family, money, politics, violence. That is why it’s so important that those battling chronic stress know how to properly cope. Drugs may be a temporary fix, but they will worsen the symptoms associated with stress over time. Drug use over time also typically leads to addiction, which leads to a vicious cycle and potentially overdose.

According to neurosurgeon and Emmy-winning Dr. Sanjay Gupta, the growing number of opioid overdoses in the country is “all a reflection of the stress, the pain that comes with that stress, and the desire to, in some ways, medicate it away, even to the point it could be dangerous and it could end your life.” Gupta explores the connection between stress, suicide, and drug overdose in his documentary One Nation Under Stress.

A Research-Based Recap of Stress and Substance Abuse

Research shows that there is a clear overlap between the brain’s neurocircuits that respond to drugs and the neurocircuits that respond to stress. As detailed by the National Institute on Drug Abuse:

• Individuals exposed to stress are more likely to abuse alcohol and drugs (and relapse)
• High stress was found to predict continued drug use, particularly among opioid abusers
• For those not previously exposed to illicit drugs, stress can increase a person’s vulnerability to self-medicate with drugs
• While acute stress can improve memory, chronic stress can impair memory and cognitive function
• Exposure to personal stress situations can lead to significant increases in drug cravings, along with the activation of emotional stress and physiological stress responses
• Proper stress coping mechanisms can help to sustain abstinence from drugs

So, what can we do about it?

Because stress and substance abuse are so intertwined, and because stress has such a powerful impact on a person’s propensity for addiction, it’s important that their treatment is integrated. When a person receives professional drug treatment, he or she must learn how to better manage stress and stressful situations. Stress management is a key modality used in many addiction treatment centers today, particularly dual diagnosis treatment centers that are equipped to treat mental health issues and PTSD.

Stress and substance abuse treatment should encourage:

• Regular exercise, which will release endorphins in the body. Endorphins can lift a person’s mood, serve as a natural painkiller, and improve quality of sleep, which can all contribute to lower amounts of stress. Yoga is a form of exercise also known to reduce stress.
• Mindfulness meditation, which can lower anxiety, depression, pain, and stress, according to an article published by the Journal of the American Medical Association
• Behavioral therapy, such as Cognitive Behavioral Therapy (CBT), which teaches a person how to recognize patterns in their behavior and appropriately respond to difficult situations with healthy coping mechanisms.
• Peer support groups and meetings, such as 12-step meetings, can also help a person to feel supported and motivated while in recovery. Peer support has been known to decrease a person’s level of perceived stress.

If you are battling chronic stress in your daily life, and have a tendency to rely on drugs to “feel better,” there may be a larger and deep-seated issue at bay. Substance abuse and stress go hand-in-hand, and can cause detrimental effects on the body if left unaddressed. Please do not hesitate to reach out for help. Call us at 877-581-1793 to learn more about the connection between stress and substance abuse, or how to get started in one of our treatment programs for young men and women.