Chapter 3.7 Stress and drug abuse

Abstract

Abstract Most major theories and models of addiction identify stress as an important factor in increasing drug use and in relapse. The basis for this association comes from epidemiological studies, clinical observations and survey data and some human laboratory studies. While substantial preclinical data support the notion that stress exposure enhances drug self-administration and that stress reinstates drug-seeking behavior, there is little direct evidence in humans on the interactions between stress and addictive processes, such as drug use, craving, tolerance, sensitization, withdrawal, and relapse. The purpose of this chapter is to examine the role of stress in addictive processes with a specific focus on human studies. The role of stress on additive processes is broken down into two categories: first, how stress may increase the vulnerability to drug abuse is examined, and second, the effects of chronic drug abuse on the stress response, stress-related coping and relapse are assessed. Unanswered questions and areas of future research on the association between stress and drug abuse in humans are identified. By examining the proposed mechanisms underlying the association between stress and drug abuse and the supporting empirical evidence, the goal is to expand the current knowledge base on how stress may perpetuate drug abuse. A greater understanding of this association will facilitate future research in this area, which in turn can have a significant impact on both prevention and treatment development in the field of addiction.