ABSTRACT
Stress is linked to all stages of the addiction process, including initiation, maintenance, and relapse. It is widely cited by drug users as the reason they use drugs or abuse alcohol or relapse to cigarette smoking. Although it is clear that addiction is a very complex phenomenon that involves multiple pharmacological, psychosocial, and behavioral processes, there is growing evidence that suggests perceived stress and expectation of relief as important motivators for drug use. is evidence is further solidified by the discovery of multiple neurobiological pathways mediating this link between stress and drug addiction, including the hypothalamicpituitary-adrenocortical (HPA) axis and the endogenous opioid activity (Adinoff, 2004; Adinoff et al., 2005a; al’Absi, 2006; Goeders, 2007; Mendelson et al., 1988). In this chapter, we present a brief review of the biological and physiological systems involved in regulating the stress response and the psychosocial and situational determinants of this response. We then describe how these systems are involved in mediating the stress effects on drug use initiation, maintenance, and difficulties in recovery.
