New findings indicate that stress and alcohol cues work on the brain differently to produce craving. Results suggest that independently addressing the effects of stress and alcohol cues on craving may improve an alcoholic's chances of remaining sober.
"Alcohol cues" are reminders of drinking. Researchers already know that both stress and alcohol cues can produce cravings and relapse in abstinent alcoholics. New findings indicate that stress and cues work on the brain differently to influence craving, perhaps producing an additive effect, which may in turn decrease the chances of treatment success.
"Alcoholics frequently cite psychological stress and cues that lead to negative mood states - such as anxiety, depression, anger and confusion - as reasons for relapse to drug use," explained Helen Fox, associate research scientist at Yale University School ofMedicine and corresponding author for the study.
However, added Suzanne Thomas, assistant professor of psychiatry at the Medical University of South Carolina, it appears that stress and cues might work differently in the brain to affect craving.
More specifically, said Fox, it is possible that two of the major causes of relapse in alcoholics have a very different psychobiological profile.
"A clarification of these differences may help to develop more tailored therapy for both the reward and distress components of craving," she said.
Both stress and alcohol cues appear able to produce increases in anxiety associated with alcohol craving.
However, said Fox, the specific psychobiology associated with each does indeed appear to be different.
"While stress-related craving was associated with an increase in negative emotions such as anxiety, anger, fear, and sadness, cue-induced craving was associated with an anxiety or fear state and a decrease in positive mood such as joy or a relaxed state," she said.
Results also indicate differences in physiological arousal.
"In the stress-imagery condition, increased alcohol craving was accompanied by an increase in blood pressure," said Fox.
"In the cue-imagery condition, increased alcohol craving was accompanied by an increase in salivary cortisol. Such differences may be important in understanding stress and alcohol-cue-related relapse susceptibility, she noted.