Substance abuse disorder, typically referred to as drug and alcohol addiction, affects millions of Americans aged 12 and up. With some studies showing that 1 in 10 Americans will suffer a substance use disorder during their lifetime, addiction affects a shockingly large number of Americans. At the same time, opioid use disorder is responsible for the death of over 130 Americans each day.
While addiction statistics and deaths are on the rise, most data links these increases to two factors. The first is the increasing potency of medical opiates. The second is a large amount of stress most Americans face as part of their daily lives. Stress is widely recognized as one of the largest contributing factors to substance abuse, addiction, and relapse. This has led many rehabilitation facilities to introduce stress management as part of addiction treatment, because it’s often a large part of the problem.
What is Addiction?
Addiction involves both substance use disorder and substance use dependence, where individuals show 2 or more symptoms from the DSM-5 criterion. DSM-5 blends substance use dependence and substance-use disorder into one, meaning that individuals who are not specifically “addicted” can qualify as having a substance-use disorder. Criterion includes:
- Taking a substance in larger amounts or for longer than intended
- Wanting to cut down or stop but being unable to
- Experiencing cravings relating to the substance
- Spending a significant amount of time getting, using, or recovering from substance use
- Not managing responsibilities at work, home, or school because of substance use
- Continuing use despite recognizing problems in interpersonal relationships because of the substance
- Giving up social, occupational, or recreational activities because of the substance
- Using the substance even when it puts you in danger such as when driving a car
- Continuing use even when it exacerbates or causes physical or psychological problems
- Needing more and more of the substance to achieve the same effect
- Developing withdrawal symptoms on the cessation of use
Individuals who show 2-3 of these symptoms are considered to have a substance use disorder, which means that they need treatment. However, none of these symptoms are caused by stress, only by prolonged exposure to a substance. Stress, however, contributes to prolonged exposure to a substance by encouraging repeat use.
How Stress Contributes to Substance Use Disorder
Stress contributes to individual decisions to use substances and to return to substance use, typically through self-medication and sensation seeking. These behaviors typically feed into each other, creating a fallout or drop, resulting in increased substance use to relieve that negative feeling, resulting in a negative and recurring cycle. Of these, self-medication is the more common problem, and one that affects an estimated 30%+ of all substance abusers.
Self-Medication – Self-medication is defined as the individual use of a substance such as drugs or alcohol to deal with stress, pain, or negative emotions. Here, the individual uses a substance as a temporary release or coping mechanism. For example, people who have a drink to “unwind” after work. Using substances as a coping mechanism extends to a wide range of situations, from individuals taking more than a prescription to deal with physical pain, individuals using benzodiazepines to relax, people who binge drink on weekends to manage stressful lives, and people who consistently drink to numb negative emotions such as pain, loneliness, or hurt. Self-medication is problematic because it is unregulated, often worsens problems, and results in a negative cycle of more and more use. Rather than solving underlying problems, self-medication serves to temporarily numb problems, preventing individuals from dealing with them in a healthy way or learning to cope in any way.
Sensation-Seeking – Stress also contributes to sensation seeking by increasing risk-taking and sensation behaviors. Persons under a great deal of stress are significantly more likely to behave impulsively, to do things they know they shouldn’t, to take risks, to break the law, and to seek release in the form of a good time, including drugs and alcohol. This can be extremely problematic over time, because it increases long-term exposure to substances and therefore the likelihood of addiction.
Stress correlates to decreases in bodily health, immune system response, and emotional reaction. Persons under a high amount of stress will respond by secreting hormones through the central nervous system, adrenal system, and creating changes in the cardiovascular system, all of which affect a person’s responses and their ability to make good decisions. As a result, people are more likely to look for a release through pleasure-seeking and escapism, which drugs and alcohol provide.
Does Stress Cause Addiction?
Stress can contribute to an individual picking up drugs or alcohol on a regular basis, but it doesn’t cause addiction. The only significant recurring factor in addiction is prolonged exposure to a substance. In addition, most people won’t start drinking or start using drugs for the first time because they are stressed. Instead, environmental factors and exposure must play a part to introduce and expose this person to those substances first.
Finally, an individual who is under a severe amount of stress can seek out many alternative coping mechanisms such as therapy, mindfulness, exercise, or changing their environment. While not always possible, they are often as accessible as drugs and alcohol for many. So, stress can contribute to addiction, but it does not cause it. At the same time, anyone who already uses a substance is statistically likely to increase their consumption when stressed.
Stress and Relapse
Stress is also very well-correlated with relapse. Individuals who leave rehabilitation but who do not work to manage stress or who return to a stressful environment are statistically more likely to relapse. Individuals who seek out stress management courses, who manage their environment, and who work to cope with or decrease stress in their lives are less likely to relapse.
For this reason, it’s important that anyone who seeks out a drug and alcohol rehab center also seeks out stress management and mitigation or spends a significant amount of time learning stress coping techniques.
Stress Management in Addiction Treatment
Addiction treatment centers increasingly integrate stress management courses and programs into addiction treatment. Mindfulness-Based Stress Reduction is one of the most common of these. Here, individuals learn to manage stress by adjusting focus, living in the moment, and developing coping mechanisms that shift attention away from attention-bias and internal thoughts.
Some individuals with a dual diagnosis disorder benefit from mental health treatment for addiction.
Substance use disorder affects millions of Americans and the reasons behind it are complex and diverse. With factors including stress, environment, nurture, and even genetics playing into how and why a person becomes addicted, most people need a personalized approach to addiction treatment. However, working to manage and cope with stress during recovery will reduce chances of relapse and will improve your recovery outlook.
Please contact Beginnings Treatment Centers today for an honest talk about addiction or alcoholism with one of our experienced and professional addiction treatment team. We can answer any questions you may have with no cost or obligation.