Stress, alcohol and drug interaction: an update of human research

Abstract

A challenging question that continues unanswered in the field of addiction is why some individuals are more vulnerable to substance use disorders than others. Numerous risk factors for alcohol and other drugs of abuse, including exposure to various forms of stress, have been identified in clinical studies. However, the neurobiological mechanisms that underlie this relationship remain unclear. Critical neurotransmitters, hormones and neurobiological sites have been recognized, which may provide the substrates that convey individual differences in vulnerability to addiction. With the advent of more sophisticated measures of brain function in humans, such as functional imaging technology, the mechanisms and neural pathways involved in the interactions between drugs of abuse, the mesocorticolimbic dopamine system and stress systems are beginning to be characterized.This review provides a neuroadaptive perspective regarding the role of the hormonal and brain stress systems in drug addiction with a focus on the changes that occur during the transition from occasional drug use to drug dependence. We also review factors that contribute to different levels of hormonal/ brain stress activation, which has implications for understanding individual vulnerability to drug dependence. Ultimately, these efforts may improve our chances of designing treatment strategies that target addiction at the core of the disorder.

Distress and drinking: Cross-cultural connections and contexts

“…Links between chronic stress and chronic drinking patterns are found more consistently than links between acute but time-limited stress and immediate drinking responses (Armeli, Todd, & Mohr, 2005;Helzer, Badger, Searles, Rose, & Mongeon, 2006;Skaff, Finney, & Moos, 1999; but see also Grzywacz & Almeida, 2008;Liu, Wang, Zhan, & Shi, 2009;Park, Armeli, & Tennen, 2004). Stressful experiences can also be a risk factor for relapse in people recovering from alcohol dependence (Breese et al, 2005;Kushner, Abrams, & Borchardt, 2000;Uhart & Wand, 2008).…”

“…The mental strategy that most consistently connects stress to drinking is selfconscious, deliberate drinking to cope with distress. Drinking to cope is associated with more hazardous drinking and the development of alcohol use disorders (Hasking & Oei, 2008;Gaher, Simons, Jacobs, Meyer, & Johnson-Jiminez, 2006;Holahan, Moos, Holahan, Cronkite, & Randall, 2001), in part because repeated heavy drinking and its effects in the brain may themselves become sources of distress, trapping the person in a vicious circle of distressdriven alcohol dependence (Koob & Kreek, 2007;Uhart & Wand, 2008). Recent findings suggest that people who are hypersensitive to stressors because of variations or changes in the chemistry of the brain may be particularly at risk of becoming "distressed drinkers" (Blomeyer et al, 2008;Enoch, 2011).…”

β-Endorphin and Alcoholism

“…Although a thorough understanding of this nebulous concept is lacking, stress has been operationally defined as activation of the hypothalamo-pituitary-adrenocortical (HPA) axis in response to both physical and psychological stressors (for example, Pacak and Palkovits, 2001;Uhart and Wand 2009). The stress response is coordinated by neuronal activation of the paraventricular nucleus in the hypothalamus leading to the release of corticotrophinreleasing hormone (CRH) into the hypothalamic-hypophyseal portal.…”

“…Like stress, alcohol also leads to CRH release from the hypothalamus, initiating activation of this system (Hsu et al, 1998;see Gianoulakis, 2009;Uhart & Wand, 2009 for reviews). Indeed, the physiological effects of alcohol are in part mediated by the HPA axis and dependent upon neuronal activation of the paraventricular nucleus, and the subsequent release of CRH, ACTH and, eventually, adrenal activation (Lee et al, 2004).…”

Ethanol Withdrawal-Induced Impaired Recognition Is Reversed by Chronic Exposure to Stress and the Acute Administration of Corticosterone in Mice

“…Many studies have reported that stressful conditions are a significant risk factor for future excessive alcohol (ethanol) consumption, and thereby increase the risk for dependence and alcoholism. 1,2) Several animal models have been used to better understand the relationship between stress and ethanol intake.…”