Stress has long been known as a significant risk factor in the development of addiction as well as in addiction relapse in vulnerable individuals. This can result in an increased need for substance abuse counseling, and during this global pandemic there are numerous reports of dramatic increases in alcohol and drug abuse, as well as worsening of depression and anxiety. There are well-known specific stressors that are predictive of substance use and abuse, and there is considerable research demonstrating that chronic stress exposure enhances drug self-administration and reinstates drug seeking behavior in susceptible people. The term “stress” refers to processes involving perception and response to harmful, threatening, or challenging circumstances. Stress experiences can be emotionally or physiologically demanding and activate stress responses and other adaptive or maladaptive behaviors. Some examples of emotional stressors include interpersonal conflict, loss of a relationship, isolation (more common in our society currently due to the ongoing pandemic) and financial distress. Common physiological stressors are hunger, sleep deprivation and drug withdrawal. While stress is often associated with negative affect and distress, it can occasionally include “good stress” which is based on external and internal stimuli that are mildly challenging but limited in duration and results in behavioral responses that generate a sense of accomplishment, and can be perceived as pleasant and exciting.
There are two types of stress which can be significant risk factors for addiction, and which frequently lead to a need for substance abuse counseling. The negative effects of early life stressors, such as child maltreatment and accumulated adversity, have been well described as risk factors for addiction. In addition, chronic emotional stress, as discussed above, can frequently lead to addiction or relapse, and a need for substance abuse counseling. The more prolonged, repeated or chronic the stress, the more out of control of the stressful situation an individual may feel which can potentially increase the magnitude of the stress response and risk for maladaptive behavior.
Stress also increases the risk of mood and anxiety disorders that are highly associated with addiction, and which may be pre-existing or new in onset. These are called dual diagnoses when they exist along with substance abuse, and frequently require dual diagnosis treatment. These mood and anxiety disorders are frequently caused by or worsened under conditions of isolation or social stress, and then lead to a worsening of concomitant substance use. This can easily lead to a circumstance in which each dual diagnosis continued to feed the other, leading to progressive worsening of each condition with associated maladaptive behaviors. Thus, it is important to intervene early in such a situation with effective dual diagnosis treatment.
Responding to stress in a healthy fashion under conditions of social isolation and financial difficulty can be extremely challenging but is critically important in order to avoid substance abuse or relapse into unhealthy behaviors. Should an individual find that they are struggling with substance abuse, effective substance abuse counseling is available and can be extremely helpful. If a co-occurring mood disorder such as depression or anxiety is also present, one should seek out professional dual diagnosis treatment in order to avoid unnecessary negative consequences. If you feel that you or a loved one is at risk, please contact an addiction professional at Resurgence Tampa Bay, so that we may help to restore the real you.
Forrest Arthur, MD, CAP received his Bachelor’s Degree from Northwestern University, followed by his Doctor of Medicine Degree from the University of Illinois at Chicago. Following this, he completed his training in General and Trauma Surgery at Wayne State University. Dr. Arthur then spent the next 15 years practicing general, vascular and trauma surgery in St. Petersburg, where he had a successful practice and functioned as the Chairman of the Department of Surgery at a major metropolitan hospital. Having experienced opioid addiction himself and learning first-hand what successful recovery involves, Dr. Arthur changed careers in order to help others deal with this deadly affliction. He has spent the last 9 years working in this field, obtaining his credentials as a Certified Addiction Professional along the way. During this period, he specialized in working with other addicted professionals, and used his experience and empathy to help this population.