Making Connections: Chronic Stress, Pain, & Addiction

“Stress” is such a seemingly small, simple word. People use it every day. “The morning commute is causing me stress.” “I’m so stressed out because I have a heavy patient load and not enough time in the day.” Both of these are valid, but the average person experiencing these types of stressors typically knows how to manage the weight of anxiety, knows how to self-soothe—by taking a walk, meditating, and/or practicing some simple self-care.

For the patient with addiction or persistent pain, however, stress may have become chronic, meaning the effect of a stressor on the body persists long after the initial insult has passed.¹ Perhaps this individual’s self-soothing mechanisms were never developed in childhood—or they’ve been long abandoned. Whatever the reason, the fight or flight response simply will not turn off. Here, we are talking about persistent stress and traumatic stress—stress that is integrated into the bodily systems so seamlessly that one might not even realize it’s there. Yet studies have shown that the human experience of stress is mediated on multiple levels—genetic, biological, and cognitive.²

What is the role of stress in increasing the risk of chronic pain and maladaptive behaviors such as addiction? How can primary care clinicians help patients manage present-day anxiety and unravel the stressful patterns of childhood? Functional Medicine teaches clinicians how to help patients develop healthy coping mechanisms through lifestyle modifications like exercise, meditation, an anti-inflammatory diet, and more. Working together with patients, this therapeutic relationship has the power to change the trajectory of pain and addiction in a patient’s life.

In the following video, Henri Roca, MD, talks about the complexity of brain plasticity in patients struggling with stress, pain, and addiction, and describes how interventions can support healing.

Stress & addiction

Stress is a key risk factor for addiction and also plays a role in its maintenance.¹ Prefrontal circuits involved in adaptive learning and executive function play a critical role in both stress and addiction, in their ability to control distress as well as desires/impulses.³ Stress also has a cumulative effect in the body as it relates to addiction; the greater number of stressors an individual is exposed to throughout the course of their lives, the greater their chances of addiction.³