Alcohol and Stress

Last Updated: Dec. 1, 2003

The term “stress” often is used to describe the subjective feeling of pressure or tension. However, when scientists refer to stress, they mean the many objective physiological processes that are initiated in response to a stressor. The stress response is a complex process; the association between drinking and stress is more complicated still because both drinking behavior and an individual’s response to stress are determined by multiple genetic and environmental factors.

Does stress influence drinking?
Human research to clarify the connection between alcohol and stress usually has been conducted using either population surveys based on subject self-reports or experimental studies. In many but not all of these studies, individuals report that they drink in response to stress and do so for a variety of reasons.

Studies indicate that people drink as a means of coping with economic stress, job stress, and marital problems, often in the absence of social support, and that the more severe and chronic the stressor, the greater the alcohol consumption. However, whether an individual will drink in response to stress appears to depend on many factors, including possible genetic determinants of drinking in response to stress, an individual's usual drinking behavior, one’s expectations regarding the effect of alcohol on stress, the intensity and type of stressor, the individual’s sense of control over the stressor, the range of one’s responses to cope with the perceived stress, and the availability of social support to buffer the effects of stress.

Does drinking reduce or induce stress?
Much research demonstrates that alcohol actually induces the stress response by stimulating hormone release by the hypothalamus, pituitary, and adrenal glands. In addition to stimulating the hormonal stress response, chronic exposure to alcohol also results in an increase in adrenaline.

Stress, alcoholism, and relapse
Stress may be linked to social drinking, and the physiological response to stress is different in actively drinking alcoholics compared with nonalcoholics.) Nonetheless, a clear association between stress, drinking behavior, and the development of alcoholism in humans has yet to be established.

There may, however, in the already established alcoholic, be a clearer connection between stress and relapse: Among abstinent alcoholics, personally threatening, severe, and chronic life stressors may lead to alcohol relapse. Researchers found that subjects who relapsed experienced twice as much severe and prolonged stress before their return to drinking as those who remained abstinent. Those most vulnerable to stress-related relapse scored low on measures of coping skills, self-efficacy, and social support. Stress-related relapse was greatest among those who had less confidence in their ability to resist drinking and among those who relied on drinkers for social support. Although many factors can influence a return to drinking, researchers note that stress may exert its greatest influence on the initial consumption of alcohol after a period of abstinence.

Source: National Institute on Alcohol Abuse

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