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

Addict Biol. 2009 Jan;14(1):43-64. doi: 10.1111/j.1369-1600.2008.00131.x. Epub 2008 Oct 9.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Alcoholism / genetics
  • Alcoholism / physiopathology
  • Alcoholism / psychology*
  • Allostasis / drug effects
  • Allostasis / physiology
  • Animals
  • Arousal / drug effects
  • Arousal / genetics
  • Arousal / physiology
  • Brain / drug effects
  • Brain / physiopathology
  • Corticotropin-Releasing Hormone / physiology
  • Cues
  • Dopamine / physiology
  • Glucocorticoids / blood
  • Humans
  • Hypothalamo-Hypophyseal System / drug effects
  • Hypothalamo-Hypophyseal System / physiopathology
  • Illicit Drugs* / toxicity
  • Macaca mulatta
  • Mice
  • Neural Pathways / drug effects
  • Neural Pathways / physiopathology
  • Pituitary-Adrenal System / drug effects
  • Pituitary-Adrenal System / physiopathology
  • Polymorphism, Genetic / genetics
  • Rats
  • Reward
  • Self Medication
  • Stress, Psychological / complications*
  • Stress, Psychological / physiopathology
  • Substance-Related Disorders / genetics
  • Substance-Related Disorders / physiopathology
  • Substance-Related Disorders / psychology*
  • gamma-Aminobutyric Acid / physiology

Substances

  • Glucocorticoids
  • Illicit Drugs
  • gamma-Aminobutyric Acid
  • Corticotropin-Releasing Hormone
  • Dopamine