How it can increase addiction vulnerability
OUR RESEARCHER: Carla Storr, ScD, MPH professor and director, Center for Health Outcomes Research
While the vast majority of individuals cope with stress remarkably well, some stress reactions can give rise to changes in behavior, physical and psychological well-being, and social interactions, explains Carla Storr, ScD, MPH, professor and director of UMSON’s Center for Health Outcomes Research.
“Many people self-medicate with drugs or alcohol in an effort to cope with upsetting events. While such behavior may appear to offer a quick solution, it can lead to more significant problems,” Storr explains.
For example, a stressful event may put someone at risk for continued drinking despite recurrent interpersonal problems caused or exacerbated by drinking. It could also cause additional problematic symptoms for those with pre-existing health issues related to alcohol consumption. On the other hand, increased alcohol consumption could trigger a “wake-up call” – such as someone getting fired from a job – that leads the person to recognize the problem and seek help.
“It is important to explore the impact of stressful life events on transitions across stages of alcohol use, as stress may have differential effects on subsequent alcohol use depending upon a person’s history with alcohol use,” Storr says.
Storr is a research scientist with a community and public health background who is working as a sub-contractor on a National Institute on Alcohol Abuse and Alcoholism (NIAAA) grant with a colleague at the Johns Hopkins Bloomberg School of Public Health. Because it can be difficult to survey a large number of participants for mental health studies, the team is using large databases that are population-representative samples, such as NIAAA’s National Epidemiologic Survey on Alcohol and Related Conditions.
With this data, Storr and her colleagues have been exploring whether adverse childhood experiences (ACEs) and stressful life events have an impact on transitions through increasingly progressive stages of problematic alcohol involvement over time. Simultaneously, they are examining the probability of recovery/remission to a less symptomatic alcohol involvement stage among those who already exhibit problematic symptoms.
Storr and her colleagues’ findings suggest that ACEs impact transitions in alcohol involvement, affecting both progression and remission. The association is magnified for those with multiple ACE exposures. These results highlight the need for prevention, early identification, and intervention to mitigate the risks associated with ACEs.
“As epidemiologists, we use our findings to provide data and support for clinicians who create needed interventions for substance use and psychiatric disorders, such as alcohol use disorder,” Storr says, adding that health care providers can fail to recognize psychological distress and mental disorders because individuals more readily seek help for pain and physical ailments attributed to a stressor. “But by treating just the symptoms, you might never be getting at what the real problem is.”
IN YOUR OWN PRACTICE
Storr suggests that clinicians should ask patients about life-changing events and how they are coping with those experiences, particularly relevant for clinicians working in health care settings treating patients with alcohol and other substance use disorders.
THIS ARTICLE FIRST APPEARED IN THE SPRING 2021 ISSUE OF MAGAZINE.
ILLUSTRATIONS BY DAVID PLUNKERT