It is a natural reaction to a perceived threat that can make us more aware and trigger the ‘fight or flight’ response. Chronic or acute stress can be very harmful, however, and is a growing problem in our modern lives.

A nationwide survey commissioned by the Mental Health Foundation found that 74% of adults in the UK felt so stressed over the previous year that they “felt overwhelmed or unable to cope”.

The foundation’s director Isabella Goldie said: “Stress is a significant factor in mental health problems including anxiety and depression. It is also linked to physical health problems like heart disease, problems with our immune system, insomnia and digestive problems.”

As well as a range of physical issues and mental health disorders, stress has also been linked to substance misuse, drug and alcohol addiction.


The interaction between stress and addiction can be a complex one but the link is one that has been established for a long time. In the Mental Health Foundation survey cited above almost a third (29%) of respondents said they had either started to drink or increased their drinking levels due to stress, while 16% said they had started to smoke or increased the amount that they smoked.

Not everyone with a substance abuse issue ends up being treated for drug addiction of course but it is certainly a risk and numerous studies have identified a link between stress and addiction.

One study of 150 opioid addicts receiving addiction treatment at drug rehab and addiction treatment centres found that the occurrence of various psychological and social stressors was higher over the two years before their substance misuse began compared to the rest of the population. It also found that the subjects with drug addiction also tended to use less effective coping strategies to deal with their stress.

The study’s conclusion was that stressful life events and ineffective coping strategies in these drug addicts “may play a considerable role in their development of drug abuse or turning to relapse”. It suggested that it may be advisable to teach techniques related to stress prevention and coping strategies to groups considered more at risk of addiction [1]. This could potentially play a significant role in relapse prevention.


Managing your stress levels

It is impossible to avoid stress entirely, but it is more than possible to reduce and manage the stress you are exposed to. The mental health foundation lays out some tips you can follow to do just that. The three basic steps are to learn to recognise when stress is causing you a problem, to identify the underlying causes and to make changes to your lifestyle. [2]

This could involve prioritising what you want to achieve, taking on fewer commitments, eating healthily, doing more exercise, taking time out for yourself and practising mindfulness techniques. It adds that you should be aware of the amount you drink. While drinking may seem to alleviate stress at first this can be misleading as it will often make problems worse in the long run.

Learning to reduce and handle your stress can be extremely valuable but in some cases, you might still require professional help to get on top of your stress issues and develop effective coping strategies.


Substance Abuse and Mental Health Disorders

There is a definite link between high levels of stress and certain mental health issues. 51% of respondents in the Mental Health Foundation survey who reported feeling stressed also said they experienced depression, with nearly two thirds (61%) reporting feelings of anxiety

According to the mental health charity Mind, stress can cause mental health problems or existing ones worse while the opposite is also true: the symptoms of mental health conditions and factors such as managing medication and healthcare treatment can also cause more stress [3]. Treatments such as depression treatment, anxiety treatment or eating disorder treatment may also address stress levels and stress management techniques.

In a similar way to the link between stress and mental health, there is a long-established link between substance abuse, addiction and mental health. The NHS says that between a third and a half of people who access mental health services will experience co-existing mental health and alcohol or drug problem at some point in their lives [4]. This is generally known as dual diagnosis.

Substance misuse, addiction and mental health conditions can all interact with each other in different ways. A primary psychiatric illness could lead to substance misuse and this, in turn, could worsen or alter the course of the mental illness.

In other cases, intoxication, addiction and withdrawal from a drug detox can lead to psychological issues. Throw in issues with stress and there are a lot of threads to unpick.


Dual Diagnosis Treatment Options are available

Many rehabs will explore the root causes and contributory factors of a drug or alcohol addiction through a thorough screening and admissions process that may include existing mental health conditions. Where mental health issues and addictions do co-exist it is usually advisable to seek dual diagnosis treatment.

If a mental health element is not treated but the addiction is, the person is more likely to relapse and go back to drinking or using drugs, sometimes in a misguided attempt to ‘self-medicate’. Similarly, a person whose mental health is treated without addressing the addiction could find the same mental health issues recurring in the future.

Dual diagnosis treatment combines elements of mental health and addiction treatments to different degrees. This may include stabilising medications and talking therapies such as cognitive behavioural therapy (CBT), counselling and group therapy. Stress treatment might also play a valuable part in any overall treatment programme.

If you are suffering from excessive stress, mental health issues, addiction or a combination of all three, it may take expert help to address the complex interaction that can exist between them. Contact us if you need help or advice in any of these areas.