Addiction Policy Forum Blog

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What we have learned from stress and addiction research

By Mark Gold, MD on January 2, 2020

Experts and professionals have become increasingly aware of the health effects of trauma and stress. Trauma, sexual, physical, or emotional, can change the brain and increase risks for many psychiatric conditions and diseases. Adverse Childhood Experiences (ACEs), for example, which refer to traumatic events in the lives of people under the age of 18, can negatively affect the brain and lead to addiction, academic problems, heart disease, and depression. A recent study found that ACEs and lifetime adversity exposure were significantly associated with increased risk of substance-related hospitalization, overdose, witnessing overdose, and having a friend and family member who overdosed.1 Similar data have been reported recently for suicide.2 Discussing trauma and stress can be difficult and evoke feelings of depression or shame: they are heavily stigmatized, compounding many of these potential problems and sapping individual reserves of resilience. Science shows us that stress and adversity aren’t just generally irritating aspects of everyone’s lives. In severe forms, they’re also major threats to our health and ability to think clearly and logically.3 

Not all traumatic experiences cause Post-traumatic stress disorder (PTSD) or substance use disorder (SUD). Recent research findings from the Yale group suggest that trauma in the absence of a PTSD diagnosis does not lead to a stronger craving for alcohol. 4 Yet researchers know that the risk of developing mental illness rises because of psychosocial adversity. 5 “These adverse factors,” write the authors of one recent study, “include developmental psychological trauma and adult life events (situations or occurrences that bring about a negative change in personal circumstances and involve threat).” These factors can also increase the risk of developing SUD. Researchers are investigating how various therapies, including mindfulness, modify triggers and traumatic memories. 6 But experts have not clearly identified the ways in which stress and trauma dispose people to later problems. In this recent study, researchers wondered whether stress affects dopamine levels, impairing them over a longer term. They exposed participants to stress and gauged their reactions through state-of-the art PET scans.
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