Substance Use as a Form of Coping with Stress

As a single mom and a full time mature student in university, it is quite accurate to say that at several times throughout either stage, I have encountered moments of stress. I can also accurately say, from personal experience with an addiction, that there is a correlation between stress and addiction. The relationship between stress and addiction is intertwined in that both factors influence each other. This is evident with regard to the physiological human stress response and the maintenance of addiction as well as in the changing pathways of the brain. Stressors such as pressure from work, family or school can lead to an individual’s ability to not cope as effectively as needed to handle stressful situations. If an individual is unable to adequately cope with everyday stress they are more likely to engage in substance use in an attempt to mask the feelings associated with stress. This is especially true if, previously, substance use has been sought as a form of coping.

According to Dickinson, Lars, and Oliver, “after acute stress…the habit system takes over control again. In consequence of that, the responsivity to drug-related cues increases significantly and so does the risk to relapse”. Therefore, individuals who engage in substance use as a response to extreme stressors are more likely to use substances again to cope with less extreme stressors as well. Dickenson et al (2011) also indicate that individuals who have prior substance use difficulties and experience stress are more susceptible to relapse. Adding a substance to the fight or flight response of stress seems counterintuitive in the sense that the substance has the ability to increase the magnitude of the physiological response creating a constant state of hyperawareness even to a less stressful occurrence.

A continual state of hyperawareness can also lead an individual to face difficulties with both mental and physical health as a result. Additionally, depending on the substance, the individual may lose the ability to engage in the physiological response altogether. Subsequently, the individual would be unable to sense when he or she is in danger and therefore be unable to respond appropriately. As such, it is safe to say that stress perpetuates addiction, which in turn fuels further instances of stress. Csiernik confirms the link between stress and addiction. He writes, “addiction may be a dependent state acquired over an extended period of time by a predisposed person in an attempt to correct a chronic stress condition in a conscious, deliberate, self-satisfying, selective manner”. Therefore, self-medicating, to the individual engaging in it, is viewed and received as a coping strategy.

Self-medicating a physiological response to stress affects the brain sections responsible for vital functions. For example, in university, higher stress rates are more likely to occur during midterm and end of semester exams. As such, a physiological response to stress can take the form of excessive sweating, memory fog, increased heart rate and fatigue. The physiological responses can result in individuals being unable to complete assignments or write exams altogether. The stress and pressures to succeed in post-secondary education can be overwhelming. A common occurrence for students is the need to fight the physiological stressors with amphetamines such as Speed. The misconception regarding the drug, although it does provide an extended time of alertness, in that while using it the individual will be able to think clearly to complete the assignment.

As a stimulant, amphetamine use results in the over firing of neurons in the brain, thus, resulting in the inability to think adequately enough to produce high quality assignments. The National Institute on Drug Abuse identifies “the three areas of the brain affected by use as the basil ganglia, the extended amygdala, and the prefrontal cortex”. The basil ganglia, or “reward circuit, ” is stimulated through the use of substances and produces a feeling of pleasure as a result. Continued use of substances can cause the individual to be unable to experience the feeling of pleasures without the presence of the substance. The second area of the brain affected, the amygdala, is associated with stressful feelings and according to NIDA (2018), as a result of substance use, becomes more “sensitive” to those feelings of stress. The reaction of this area of the brain further demonstrates that stress and addiction feed off of each other. As such, experiencing stress, and in turn, using a substance to cope, causes increased feelings of stress and results in further use.

The third area of the brain, the prefrontal cortex, reacts strongly to both stress and substances. Feelings of stress sends messages to the brain activating the physiological responses. Dickinson et al. found that “repeated stress impairs neuroplasticity processes in the neural circuits supporting goal-directed behavior, in particular the prefrontal cortex”. Due to this area of the brain’s inability to make new connections during stress, Dickinson et al. (2011) also notes the prefrontal cortex will reorganize itself in order to adapt to the continual stress. As a result of drug use in an effort to cope with stress, the areas of the brain affected by the use decline in terms of functioning and thus perpetuates the continuation of use. Continuation of substance abuse is required by the individual as their brain has adapted to the use and no longer reacts chemically in the manner it did initially. As a result, the increased amounts of substance required to achieve a high are now needed in order to maintain basic functioning. As such, the individual needs to maintain use and has thus developed an addiction.

Stress is a part of our everyday lives. Some individuals use stress as a motivating factor to complete tasks or assignments, and other individuals cannot use stress as productively. The difference between both groups of individuals is not whether either uses substances, but rather the bio-psycho-social environment that contributed to the growth of the individual. The use of substances provides temporary relief from instances of stress, so it is understandable when an individual engages in use as a response. It is the continuation of stress and further use that maintains the addiction. As such, both stress and addiction have a much closer relationship than I originally thought.