Relationship between Stress and Addiction Recovery Success

What is Stress?

Stress is the body’s response to outside events or changes, and it may be the result of a single event or an ongoing issue. These events or changes can be good or bad, such as starting a new school, getting married, having a baby, an illness, the death of a loved one, moving, divorce, or getting into an accident.

When a person feels stressed, changes occur in the mind and body. In some cases, these changes can even be life-saving as the brain engages its “fight-or-flight” reaction in times of high stress or when it perceives itself to be in danger. Heart rate accelerates, blood pressure spikes, body temperature, and respiration rates increase, focus, attention, and the senses become dialed in. At this point, the need to sleep and eat is diminished.

There Are Three Main Types Of Stress:

• Stress from everyday events
• Stress from a sudden negative change
• Stress from a traumatic event

According to NCBI, stress is a well-known risk factor in developing addiction and in addiction relapse vulnerability. A series of population-based and epidemiological studies have identified specific stressors and individual-level variables predictive of substance use and abuse. Preclinical research also shows that stress exposure enhances drug self-administration and reinstates drug-seeking in drug-experienced animals. The harmful effects of early life stress, child maltreatment, and accumulated adversity on alterations in the corticotropin-releasing factor and hypothalamic-pituitary-adrenal axis (CRF/HPA), the extrahypothalamic CRF, the autonomic arousal, and the central noradrenergic systems are also presented [1].

Unfortunately, self-reporting is all we have to work with. According to the American Psychological Association, the mean stress rating for 2011 was 5.2, on a scale of 1-10, with more Americans reporting their stress levels to increase over time than decreasing. The endocrinologist Hans Seyle is responsible for many of the common notions of the term stress. Seyle defined stress as a nonspecific response to demands for change.

Three Potential Stages Of Stress Response

Seyle’s general adaptation syndrome defined the stress response as consisting of three potential stages:

• Alarm: The body and mind experience a stressful condition, and the body becomes mobilized to deal with a stressful situation (flight-or-fight response).
• Resistance: If exposure to stress continues, the body mobilizes resources to deal with the stress.
• Exhaustion: If the person’s stress is not resolved and the stressful situation continues, the system breaks down, and the individual becomes vulnerable to different types of diseases and other ailments.

Stress And Health

It is generally accepted that experiencing high levels of stress, such as experiencing a traumatic event or being exposed to prolonged periods of stress, is a risk factor for developing nearly every psychological disorder, including substance use disorders. However, stress can also result from prolonged exposure to what many would consider positive events, such as planning for a wedding, buying a new house, or adjusting to new living conditions. Therefore, defining precisely what constitutes stress, how to measure stress, and how stress affects different people remains a bit of a problem.

For example, it is estimated that nearly 50 percent of the population in the United States experiences a severe traumatic or stressful event; however, a tiny proportion of the population develops post-traumatic stress disorder (less than 10 percent), and few also create any substance use disorders (less than 20 percent of the entire population). Thus, it is inaccurate to say that even experiencing severe stress levels directly causes substance use disorders or any other health problem, as other interacting factors must be present in these associations.

Stress Health Risks

It’s popular to claim that stress causes or contributes to any number of diseases, from everyday colds to cancer to schizophrenia. Of course, this may not be entirely accurate. However, there’s still a consensus among medical scientists that excessive stress can be linked to many health issues, whether that “link” is a partial contributor or something that led to behavior that caused the problem, such as when “stress eating” contributes to obesity, which contributes to coronary heart disease.

Instead of being a direct causal mechanism for the development of substance use disorders, the experience of either intense or prolonged levels of stress is best described as a risk factor for the development of substance use disorders. According to the World Health Organization, a risk factor [2] is a situation or condition that increases the probability of developing a specific type of illness or condition. Either having the risk factor or not having the risk factor cannot guarantee that one will or will not develop some disorder, disease, or other condition; it is only associated with an increased probability of creating something.

Stress is also a nonspecific risk factor in that the individual exposed to the same types of stressful conditions may develop several different issues or conditions. Other nonspecific risk factors for developing psychiatric disorders include being abused as a child, experiencing some other form of a traumatic event, and having a first-degree relative diagnosed with some mental health disorder [3]. Individuals who develop substance use disorders most likely have several interacting risk factors that contribute to their issues. It is very difficult to generalize which types of risk factors are most likely to result in specific disorders; however, it is known that experiencing high levels of stress or prolonged stress is associated with several issues.

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Coping With Stress

Everyone copes with stress in different ways, and some may resort to maladaptive measures of managing stress, which may include abusing drugs. Stress can increase the odds of using drugs; in fact, those exposed to stress are more likely to use mind-altering substances. Stress is not always good. However, chronic stress can have numerous negative effects on the mind and body, including:

Stress may also magnify problematic drug use and be a contributing factor in the onset of addiction. Stress is a widely accepted risk factor for addiction. People who battle addiction may also be more vulnerable to stress. While drugs may provide a temporary respite for stress, drug abuse makes stress more pronounced in the long run. It leads to a variety of physical and emotional health issues as well as behavioral and social concerns.

Stress And Addiction

The definition of substance abuse depends on the type of substance involved. It’s generally defined as the harmful or hazardous use of an intoxicant, but this, of course, means different things for different people. However, any illicit drug use is often considered abuse, and the use of prescription medication without medical permission or beyond the prescription’s instructions is also considered drug abuse. According to the Substance Abuse and Mental Health Services Administration (SAMHSA)[4], 24.6 million Americans had used an illicit substance in the month before the survey in 2013.

Stress is a well-described risk factor associated with a higher vulnerability to the development of substance abuse. Unfortunately, there is little evidence to suggest that specific types of stressors can result in particular kinds of substance use disorders. Attempts to define relationships between the specific types of stressors and specific types of substance abuse inevitably indicate that these types of predictions are not currently possible (and may never be). However, stress and drug addiction can come with several associations.

• A broad body of research indicates that adolescents who experience negative life events demonstrate increased levels of substance use disorders. Negative life events, such as parental divorce, high levels of parental conflicts, the loss of a parent, abusive parents, or even low parental support, are associated with higher substance use disorders in adolescents.

• More specific evidence has shown a significant association between trauma and maltreatment in childhood and increased rates of substance use disorders in adolescents and adults, including physical and sexual abuse and victimization.

• Broader evidence indicates that individuals who report experiencing more stressful events over their lifetime or stressful events that are considered to be extreme in their intensity are also associated with higher rates of substance use disorders even when controlling for other risk factors, such as family histories of substance abuse, social, economic status, other psychological disorders, etc.

Impact of Stress and Addiction

Similar parts of the brain may explain why some people may be more prone to drug abuse, addiction, and high-stress levels. Stress initiates the release of the “stress hormone,” called cortisol, in the brain. Cortisol can damage healthy brain structure, connectivity, and function in the case of chronic stress. Regions of the brain related to memory and learning can be negatively affected by continual levels of high stress and cortisol.

Exposure to stress, particularly at a young age when the brain is still developing, can damage parts of the brain that make a person more vulnerable to drug abuse and addiction. Similarly, drug abuse at a young age increases the odds of a person suffering from addiction later in life, the 2013 National Survey on Drug Use and Health (NSUDH) warns.

Mental illness can be a risk factor for addiction and stress, and vice versa. Drugs may commonly be a form of self-medication for mental illness. Anxiety and Depression can cause someone who battles a mood or anxiety disorder to be between two and three times more likely to also suffer from drug or alcohol addiction at some point in life.

PTSD (post-traumatic stress disorder) is a form of anxiety disorder that occurs when a person is a victim or witness to a potentially life-threatening event and then suffers from flashbacks, reoccurrence symptoms, and an inability to turn off the stress response for an extended time afterward. PTSD is a common risk factor for drug abuse. Stress may trigger drug abuse, and regular drug abuse may induce higher levels of stress. When combined, stress and drug abuse are not a good mix. Together, they increase negative physical and emotional health outcomes and increase a person’s vulnerability to addiction, which brings a host of additional social and behavioral concerns.

Effective stress management techniques can detract from a person’s desire to use drugs and promote a better quality of life. Proper nutrition, healthy sleep patterns, exercise, and mindfulness meditation are holistic and complementary forms of managing stress. Making healthy social connections can also help to lower stress levels. Drug rehab can provide tools for learning healthy coping mechanisms through addiction and stress and stress management methods that can be beneficial in sustaining sobriety and more balanced life.

Stress and Addiction Treatment Options

Whether or not stress and addiction conditions contribute to a substance use disorder depends on several factors. Including whether an addicted person needs to enter treatment as soon as possible for detoxification and rehabilitation to avoid a myriad of potential health problems. Some of which can be permanent. Although it’s essential to address potential stressors and co-occurring mental illnesses during the treatment process, it’s much easier to manage these factors when the addicted person is off the drug.

A couple of different stress and addiction treatment options can alleviate the stress of facing withdrawal. First, for addiction to opioids such as heroin, Vicodin, and fentanyl, some medications can directly treat the disorder. 

• Methadone and buprenorphine are both medications that have been approved for use to treat opioid addiction. As opioids themselves, they reduce or eliminate cravings and withdrawal symptoms. They’re also much less potent than commonly abused opioids – the high they produce is nothing to someone with a high tolerance to this drug class; therefore, there is little temptation to abuse them. Addicted persons can be switched onto either methadone or buprenorphine and then, under the supervision of a medical professional, weaned off the medication. 

• Medically assisted detox is also an option for those who need to quit taking a substance all at once. This common program allows addicted individuals to stay in a hospital setting for the duration of the worst withdrawal symptoms – typically a few days to a week or more. Doctors remain on-site to monitor clients for any dangerous signs and immediately treat any of the uncomfortable ones.  The goal of medically assisted detox is to ensure that clients remain as comfortable as possible during the process. Signs of distress are taken as signs that the treatment is not ideal. Because stress and co-occurring mental illnesses[5] are so common in people with substance use disorders, it’s essential to participate in a rehabilitation program after detox is complete or during the weaning process. 

• Rehab for stress and addiction typically includes a psychological screening to check for severe stressors, past trauma, and co-occurring illness during the intake process. Individual and group therapy is also common to help clients get to the root of any issues contributing to substance abuse. There are also various workshops provided that can help addicted persons learn to manage or lessen stress in their lives or address the problem indirectly by teaching job skills, interview skills, communication skills, etc.

• Treatment for trauma and stress and addiction based disorders often includes cognitive restructuring from therapies, such as Cognitive Behavioral Therapy and mindfulness therapy. These cognitive restructuring techniques allow individuals to more objectively assess their responses to stressful events, objectively confront and cope with issues related to anxiety and fear, and learn to control their responses to perceived stress. When individuals have a better-developed sense of control over themselves and their reactions to environmental stressors, they perceive stressful events as less threatening. Likewise, these individuals are less apt to develop future issues with substance use disorders.

• After rehab, it’s generally recommended that recovering individuals continue treatment in some form, often referred to as aftercare. Continuing to attend therapy and addiction support group meetings can be very helpful in keeping stress levels down, reducing the risk of relapse, which is anywhere from 40 to 60 percent for substance addiction[6]. Spiking stress levels are often identified as common triggers to use, meaning that they can cause a recovering individual to experience a sudden and intense craving that often leads to a return to substance abuse.

At We Level Up Treatment Center provides world-class care with round-the-clock medical professionals available to help you cope. We offer a program that addresses the impact of stress and addiction. We understand that it must treat stress and substance abuse disorders individually to help the client recover. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists. Our professionals know what you are going through and will answer any of your questions.

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