Can holiday stress trigger substance abuse? UAB experts weigh in

The purchase and consumption of alcohol and substances often increases during the holiday season, and while some may drink to celebrate, others may drink to suppress their feelings.The holiday season is a time of fun and excitement. But for some, it can bring stress and anxiety. Long work hours, family dynamics and financial pressures can contribute to stress, which may lead to substance and alcohol abuse. The brain is impacted by these substances because it controls our thoughts, feelings and behaviors.

Experts from the University of Alabama at Birmingham provide insight and resources on how substances like drugs and alcohol can impact the brain.

The holidays and substance abuse

The purchase and consumption of alcohol and substances often increases during the holiday season. Part of this rise is due to numerous holiday celebrations where alcohol is commonly served. While some may drink to celebrate, others may drink to suppress their feelings. These feelings are often caused by stress and anxiety triggered during this time of year.

According to Karen Cropsey, Psy.D., vice chair for Clinical Research in the Department of Psychiatry and Behavioral Neurobiology and director of the Center for Addiction and Pain Prevention and Intervention, the holidays can be a time of stress and loneliness for some, even as it is a time of celebration and thanksgiving for others.

These stressors can be triggered by many factors like financial pressure, travel, meeting work deadlines, family relationships and more. Jeremy Day, Ph.D., professor and vice chair for Strategic Planning and Recruitment in the Department of Neurobiology, says these types of stressors can promote relapses for substances and alcohol, particularly for people with a history of substance use disorders.

Substance abuse on mind and body

The brain is a complex organ that controls our thoughts, feelings and behaviors. The brain is made up of billions of nerve cells called neurons, which communicate with one another through chemical transmitters called neurotransmitters.

Composed of multiple regions, the brain forms dynamic networks that are responsible for specific functions, such as attention, self-regulation, perception, language, reward, emotion and movement, along with many other functions.

Dopamine, a type of neurotransmitter, plays a crucial role in the brain's reward and pleasure systems.

"Our brains use a neurotransmitter called dopamine to help us learn about positive experiences, and as a result, dopamine plays key roles in motivation and goal-directed behaviors," Day said. "This neurochemical is also a major target of almost all drugs of abuse, which act on dopamine systems due to pharmacological actions of these drugs."

When dopamine is disrupted by stress or anxiety, the brain can become more likely to seek ways to relieve or escape these negative states. This can result in the use of substance use like alcohol and drugs.

When a substance enters the body, the brain quickly releases a chemical that affects how we feel, think and learn. Day explained that different types of substances affect different molecular targets within the brain.

"For example, alcohol and opioid drugs engage distinct proteins that are expressed in different populations of cells in the brain," Day said. "However, these targets all engage a common pathway to promote increases in the neurochemical dopamine."

This initial increase in dopamine is part of the reason that substance use results in feelings of pleasure and continued use. However, the repeated use of substances can alter the brain's motivation system, leading to negative emotional states that can be fixed only by using the substance again.

"Additionally, most drugs result in tolerance to the drug's effects, meaning people must increase the amount of drug they consume to produce the same effect. This is a dangerous combination, because higher levels of consumption are associated with drug overdoses," Day said.

Long-term use of substances can cause changes in the brain affecting functions like learning, judgment, memory and behavior.

Karen Cropsey, Psy.D., and Jeremy Day. Ph.D.
Photography: Nik Layman and Lexi CoonThe science behind addiction

Addiction is often defined as a chronic and relapsing disease. Research and scientific understanding show that substance use disorders are influenced by biological factors.

"Substance use disorders and addictions are caused by biological factors that have well-established genetic and neurodevelopmental origins," Day said. "Our genes and our early life experiences combine to create vulnerabilities that shape who may go on to develop issues with substance misuse."

This understanding helps reduce the negative stigma surrounding substance use disorders and has opened more avenues for treatment.

"We strongly believe that understanding these factors can help to reduce the stigma of addiction, because this understanding points to concrete neurobiological changes that we hope to treat," Day said. "Additionally, identifying these genetic and biochemical vulnerabilities will point us toward new avenues for therapeutic interventions that will facilitate recovery."

Resources for help and treatment

This holiday season, if you or a loved one is struggling with substance use disorder, here are ways you can provide resources and support.

• UAB Center for Addiction and Pain Prevention and Intervention (CAPPI): Offers clinical resources for treating addiction and pain. You can find additional resources here.
• Recovery Resource Center: A free resource to help individuals navigate treatment options and provide personalized referrals. Visit their site or call them at (205) 458-3377 for assistance.
• Suicide and Crisis Lifeline: For immediate help, dial 988.
• Emergency Assistance: Call 911 for emergency help, or visit your nearest Emergency Department.

Here are other practical tips that can be practiced this holiday season to help someone struggling with substance use disorder.

• Offer nonalcoholic beverages: Consider offering mocktails or other nonalcoholic options at holiday gatherings. Cropsey suggests that this can help individuals in recovery feel part of the celebration without standing out.
• Offer alcohol-free festivities: Choose to celebrate the holidays without serving alcoholic beverages.
• Respect decisions: If a friend or loved one chooses not to participate in certain activities, respect their decision.

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