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Substance Use Disorder

Stress and Addiction: How Are They Related?

Cecilia Stonebraker, NCC, LCMHCA, LCAS, CSIEmily Guarnotta, PsyD
Written by Cecilia Stonebraker, NCC, LCMHCA, LCAS, CSI | Reviewed by Emily Guarnotta, PsyD
Published on December 8, 2021
Reviewed by Mera Goodman, MD, FAAP | June 28, 2024

Key takeaways:

  • Stress can be a healthy motivator to make positive changes.

  • But stress can make you more vulnerable to developing an addiction and relapsing.

  • Developing healthy coping skills to manage stress is an important part of a recovery plan.

Reviewed by Mera Goodman, MD, FAAP | June 28, 2024

Stress is a normal part of life. It can motivate us to make changes or achieve our goals. But too much stress can cause us to feel overwhelmed. This can harm our physical and mental health, and it can especially impact you when you are dealing with substance use disorder and recovery. 

Read on to learn more about the links between stress and addiction and how you can better manage stress on your way to recovery.

How does stress impact addiction?

Stress is a risk factor for developing an addiction. This risk is higher if you are exposed to stress in early childhood or exposed to chronic stress at any time. Stress is also a barrier to recovery for people in active addiction, and it is a risk factor for relapse.

Does chronic stress increase your risk of drug use?

Chronic stress can cause anxiety. Both chronic stress and anxiety are risk factors for developing an addiction. Experiencing early stress or chronic stress causes changes in your brain, and these changes affect your ability to manage and respond to any type of stress.

When these changes take place, they impact three parts of your brain: dopamine signaling, serotonin production, and the release of melatonin. Here’s what these three things are:

  • Dopamine is a chemical your body makes that allows you to feel good. 

  • Serotonin is what helps keep your mood balanced. 

  • Melatonin helps regulate your sleep.

Chronic stress harms your body’s natural ability to feel well, balanced, and rested. These systems are also harmed by substance use.

Does chronic stress increase risk of relapse?

Both stress and substance use cause changes in the brain. These changes impact neurotransmitters, which are how our brain sends signals. 

Stress can also damage dopamine receptors. Dopamine receptors “catch” signals that help us to feel good. When these signals or receptors are damaged, it becomes harder and harder to feel happy. This can lead to depression, anxiety, or other mood disorders.

If you feel bad, using a substance might give you a quick high, so you feel good. But this temporary relief doesn’t address the damage caused by stress or substance use. Recovery from addiction can be stressful and hard, and it might be tempting to use drugs or alcohol to have some relief. 

Also, chronic stress can lead to anxiety, which is a risk factor for relapse.

What is stress smoking?

Many cigarette smokers report that smoking reduces their stress. But smokers report higher levels of stress than non-smokers. And the stress relief from smoking can be connected to relief from nicotine cravings. There is also a strong link between anxiety and smoking tobacco.

Tobacco is a stimulant. This means it can activate the brain’s reward system so that users feel a rush of pleasure when smoking. Twenty-four hours after smoking, your body’s stress response activates. This is due to nicotine withdrawal. This stress response can lead to anxiety, or a fear of the discomfort of withdrawal symptoms. This cycle can make quitting harder and can contribute to more stress, not less.

How does smoking impact addiction recovery?

Nicotine is addictive, so smoking is an addiction in and of itself. If you have a substance use disorder, you are more likely to also use tobacco. You're also more likely to suffer from anxiety or depression. According to the National Institute on Drug Abuse (NIDA), 65% to 85% of people with an addiction are also smokers.

Studies show that people in recovery are more likely to stay sober if they also quit smoking. Also, smoking is a risk factor for relapse. People in recovery from addiction who smoke are more likely to relapse than those who don’t, so quitting nicotine and other substances at the same time can help with your recovery.

What is stress drinking?

Studies have shown a strong link between stress and alcohol use. Alcohol can blunt the effects of hormones that create the stress response. It also changes brain functions and reduces feelings of anxiety. Drinking may provide temporary relief from stress and anxiety. But long-term use can make it more difficult for the body to manage stress without the use of a drug. 

This can create a cycle where stress triggers a desire to drink. And drinking makes it harder to manage the stressful things in your regular life. This is sometimes called self-medication, and it can lead to problem drinking. 

Using alcohol to manage stress or anxiety may give you some relief. But it also makes it more difficult to manage these uncomfortable feelings in the long run.

What are some coping mechanisms for stress?

You don’t have to make huge changes to bring coping skills into your everyday life. Small changes can add up and make big differences in how you manage stress. Some coping skills for stress include:

  • Proper nutrition: Try skipping fast food a couple times a week and have a healthier option instead.

  • Regular exercise: Take a walk after dinner or at a time that makes sense with your schedule.

  • Avoid drugs and alcohol: Talk to a doctor or therapist if you need help with this.

  • Take time for leisure and rest: Don’t work through your lunch hour or skip out on time for yourself.

  • Get the sleep you need: Try going to bed 30 minutes earlier.

Regular self-care builds up your reserves of resiliency, or your ability to get through difficult times. Having more resiliency helps you perform better when you are under stress, which may in turn reduce the risk of addiction.

For self-care, it’s better to be consistent than to make big changes. For example, a spa day or a vacation is great. But it's important to take care of yourself each day in small ways too. If you don’t, then a single day off or a fancy vacation isn’t likely to reduce your stress levels.

What’s the link between stress and addiction recovery?

Avoiding stress can be an important strategy to stay on track with your recovery goals. Substance use can damage your brain, and it can do this in ways that will make small stressful events or moments feel huge. 

If you're used to dealing with stress by getting drunk or high, it can be very hard to deal with stress when you’re sober. If you are withdrawing from substances, you may have an even more difficult time. Detox is stressful on the body and the brain due to the withdrawal effects of no longer using drugs or alcohol. If you are detoxing, any stressful things can feel more challenging or overwhelming.

The people, places, and things in your life that you associate with substance use can be sources of stress. These reminders can trigger cravings, which can be intense and stressful. Here are some tips to manage cravings:

  • Consider staying away from people who are using. 

  • Try to surround yourself with people who understand and support your recovery. 

  • Think about taking a different route to avoid passing by your favorite bar. 

  • Try to explore new hobbies that don’t involve alcohol or drug use. 

  • Get rid of any paraphernalia you have that reminds you of substance use. 

And remember to be gentle with yourself. You’ll feel better able to manage these stressors as time passes.

How does stress impact your recovery? And can it cause relapse?

Relapse is most likely to occur within the first few weeks to 2 months of recovery. About 85% of people relapse within the first year. 

Cravings can be especially challenging in early recovery. This is because your ability to manage stress has been affected by the effects of past drug use. If a relapse does occur, often the stress returns at a more intense level. You may feel more stress from using drugs or alcohol when you’re trying to work on your recovery.

If you start using substances again, remember that it’s not the end of the world. Celebrate every small victory. And don’t hesitate to talk to a doctor or counselor to ensure you’re getting the help you need. You will feel better able to manage everyday stressful events or moments over time. As your recovery progresses, your resiliency also increases.

The bottom line

Stress can have a negative impact on addiction recovery. Learning how to identify triggers can help you cope with stress. Building healthy coping skills will help you manage unavoidable parts of life that are stressful. 

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Why trust our experts?

Cecilia Stonebraker, LCAS, LCMHCA, CSI, is a national certified counselor, a licensed clinical addiction specialist, and a couples therapist. She runs a private practice in North Carolina.
Emily Guarnotta, PsyD, is a licensed clinical psychologist and certified perinatal mental health professional with over 10 years of clinical experience.

References

al’Absi, M. (2018). Stress and addiction: When a robust stress response indicates resiliency. Psychosomatic Medicine.

Anthenelli, R. (2012). Effects of stress on alcohol consumption. Alcohol Research.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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