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Review
. 1999;23(4):263-71.

The role of stress in alcohol use, alcoholism treatment, and relapse

K T Brady  1 , S C Sonne
Affiliations
Review

The role of stress in alcohol use, alcoholism treatment, and relapse

K T Brady et al. Alcohol Res Health. 1999.

Abstract

Addiction to alcohol or other drugs (AODs) is a complex problem determined by multiple factors, including psychological and physiological components. Stress is considered a major contributor to the initiation and continuation of AOD use as well as to relapse. Many studies that have demonstrated an association between AOD use and stress have been unable to establish a causal relationship between the two. However, stress and the body's response to it most likely play a role in the vulnerability to initial AOD use, initiation of AOD abuse treatment, and relapse in recovering AOD users. This relationship probably is mediated, at least in part, by common neurochemical systems, such as the serotonin, dopamine, and opiate peptide systems, as well as the hypothalamic-pituitary-adrenal (HPA) axis. Further exploration of these connections should lead to important pharmacological developments in the prevention and treatment of AOD abuse. Studies indicate that treatment techniques which foster coping skills, problem-solving skills, and social support play a pivotal role in successful treatment. In the future, individualized treatment approaches that emphasize stress management strategies in those patients in whom a clear connection between stress and relapse exists will become particularly important.

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Figures

Figure 1
Figure 1
The hormone activity of the hypothalamic-pituitary-adrenal (HPA) axis. For clarity, the brain and body regions that produce the hormones appear in bold. NOTE: ACTH = adrenocorticotropic hormone; CRF = corticotropin-releasing factor; POMC = proopiome-lanocortin.
Figure 2
Figure 2
Dopaminergic pathways in the brain. Dopamine modulates such varied functions as emotion, aggression, cognition, the coordination of movement, and aspects of the development of addiction. SOURCE: Adapted from Heimer, L. The Human Brain and Spinal Cord: Functional Neuroanatomy and
See this image and copyright information in PMC

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