Stress is something that affects everyone on a daily basis, albeit at varying levels from day-to-day, but for many it can be the trigger leading to substance abuse and addiction. Drug and alcohol addiction for instance may evolve as a coping device for stress.
Eustress is another stress factor in addiction, providing and finding that feeling of joy or happiness brought about by a substance. The effects of stress on addiction have been studied multiple times, one of which we found to particularly interesting was Dr. Gary Wand’s study titled “The Influence of Stress on the Transition From Drug Use to Addiction”.
In this study, Dr. Wand highlights 3 different stages of addiction and stress, the processes and the rewards and affects associated with each.
Stage 1: Addiction Based on Positive Reward
In this stage, Dr. Wand highlights the different influencers found early on in a drug or alcohol addiction, most of which point to the “positive reward”. This positive reward is literally the process of affect the drug has on the brain, with the release of increased dopamines in the brain activating neurons that give one a sense of calm or happiness. Some enter this stage of stress induced addiction through social drinking or occasional drug use to cope with preoccupation and anticipation caused by stress. Once these substances have been used the feeling of reward is prevalent, reducing the feeling of stress. This stage is a slippery slope when it comes to addiction, and can rapidly descend to the next stage of stress related addiction: Vulnerability.
Stage 2: The End of the Positive Reward
Stage two is a transition stage wherein the user no longer feels the same reward from the substances and amounts from casual usage. This feeling of not achieving the same level of mental and physical reward in turn causes additional stress, increasing worry and vulnerability. Now, the stress can compound, building worry and stress around the fact that the same result is not happening when trying to cope with other stresses. This loss of prominence in the result often leads to increased dosage and exploration of other substances. During this stage we see that:
Drug use escalates
Binge usage and withdrawals increase
The threshold of “reward” increases
Chronic stress increases
Going undiagnosed and more importantly untreated in the stage, rapidly evolves to the next stage: Negative Affect Use.
Stage 3: Substance Abuse Due to Negative Affect and Stress
This third and final stage of the process as studied by Dr. Want, highlights the most harmful phase of stress related substance abuse and the negative affects it has on the addiction cycle. This stage is one full of stress, where the user focuses solely on the substance in a never ending cycle of trying to cope with the withdrawal and the negative affect they feel, increasing dosages in an effort to try and find that positive reward felt in stage 1. This stage leads to the hardest phases of addiction and recovery from this phase takes a skilled team and dedication from the patient themselves. Signs of this stage include:
Psychological and physiological withdrawal symptoms
Maximum use of substances
Increased substance tolerance threshold, increasing substance use but decreasing substance affect
External and internally related stresses compound the total state of stress, increasing substance craving
While the severity of addiction found in stage 3 increases, there is still hope and possibility for recovery. As we’ve seen, the stress can lead to a path of addiction and vulnerability when not treated properly. From feeling the positive reward of casual use to the insatiable and crushing feeling of dependence, stress can lead to a life of substance abuse and addiction.