The influence of stress and early life adversity on addiction: Psychobiological mechanisms of risk and resilience

Research output: Chapter in Book/Report/Conference proceedingChapter

9 Scopus citations


Preclinical, clinical, and population research demonstrates that stress and early life adversity (ELA) increase vulnerability to initiate, maintain, and relapse in addiction. Individuals with addiction problems have higher prevalence of trauma exposure than nondrug users; and this association extends to young populations (e.g., adolescents). Mechanisms for these associations likely involve multiple systems, including changes in the mesolimbic reward functions, HPA axis stress response, and other stress- and reward-related pathways. Other brain morphological and functional changes are also likely involved and directly contribute to the neurohormonal and behavioral alterations observed during adulthood in those exposed to ELA. Stress-related risk is influenced by sex, genetic factors, and resilience, among other factors. Our heuristic model proposes that long-term effects of stress and ELA on the brain contribute to dysregulation of the stress response, emotional reactivity, reward systems, cognitive dysregulation, and delay discounting that lead to impulsive and high-risk behaviors, such as drug use and relapse.

Original languageEnglish (US)
Title of host publicationStress and Brain Health
Subtitle of host publicationIn Clinical Conditions
EditorsAngela Clow, Nina Smyth
PublisherAcademic Press Inc.
Number of pages30
ISBN (Print)9780128211168
StatePublished - 2020

Publication series

NameInternational review of neurobiology
ISSN (Print)0074-7742

Bibliographical note

Funding Information:
This paper was supported in in part by National Institutes of Health grants R01DA016351 and R01DA027232.

Publisher Copyright:
© 2020 Elsevier Inc.


  • Addiction
  • Dopaminergic system
  • Genetics
  • HPA
  • Life adversity
  • Mechanisms
  • Opioid system
  • Stress
  • Trauma


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