STRESS HAS HORMONAL LINK TO ALCOHOL, DRUG ABUSE

Lawrence Kudlow is an economist, contributing editor of National Review
magazine and frequent guest on "The McLaughlin Group," where he often
argues in favor of deep tax cuts. He is also a recovering alcoholic and
cocaine addict.

Kudlow attributes his bout with drug and alcohol abuse partly to the
pressure he felt when he was chief economist and senior managing director
of Bear, Stearns & Co., a Wall Street investment firm. In the late 1980s
and early 1990s, Kudlow followed an exhausting schedule involving writing
reports, traveling and giving speeches. Although he had started drinking
regularly in the late 1970s, his drinking increased and he began bingeing
on cocaine.

Kudlow's story is not unusual. Research indicates that long-term stress
caused by work, family or combat can lead people to use alcohol, drugs and
cigarettes. A study conducted by researchers at Johns Hopkins University
and the University of Maryland found that full-time nurses who work in a
high-strain environment are 1 1/2 times as likely to use cocaine, marijuana
and other psychoactive drugs as nurses who work in a low-strain environment.

A high-strain environment was defined as one in which the psychological or
physical demands of the job were high while the amount of control a nurse
was allowed to have in the job was low.

Stress also can promote drug intake by animals. Physical stressors such as
mild, intermittent foot shocks or repeated tail pinches increase the rate
at which animals press a bar to receive an intravenous infusion of cocaine
or amphetamine. Psychological stressors, such as being the object of an
aggressive attack or witnessing another animal being subjected to repeated
foot shocks, have the same effect.

Stress promotes the intake of addictive drugs by causing the release of
hormones called glucocorticoids, according to neuroscientist Pier Vincenzo
Piazza of the French National Institute for Health and Medical Research.
These hormones are released from the adrenal glands, which sit like little
hats on top of the kidneys.

"Glucocorticoids were believed for a long time to mediate the aversive
effects of stress, so they were considered 'bad' hormones," Piazza said.
"However, there is no real evidence for that. All the evidence indicates
that glucocorticoids are experienced by the subject more like rewarding
hormones than aversive ones."

Glucocorticoids stimulate the same reward pathway in the brain that is
stimulated by drugs of abuse, Piazza said. This pathway consists of nerve
cells that release the messenger chemical dopamine. This dopamine release
often occurs in response to pleasurable events, such as eating tasty food
or seeing an appealing sexual partner, but drugs of abuse and
glucocorticoids can provoke this release as well.

Just as with drugs of abuse, animals will press a bar to receive an
infusion of a glucocorticoid, showing that these hormones are indeed
rewarding. People also sometimes find them rewarding, as shown by the fact
that patients occasionally abuse synthetic glucocorticoids, such as cortisone.

The reason that glucocorticoids are rewarding is to counter the aversive
effects of stress, thereby allowing an animal to react to a threat by doing
something other than just running away, according to Piazza.

"If the only reactions to threatening and aversive stimuli was avoidance
and flight, individuals would be severely limited in how they adapt to
environments," he said. By activating brain sites of reward,
glucocorticoids can decrease or even totally suppress the tendency to flee
and increase the tendency to try some other approach, such as fighting or
putting an obstacle in the way of the aggressor.

The problem in this day and age of psychoactive, rewarding drugs is that
high levels of glucocorticoids can sensitize the brain's reward pathway to
these drugs. As a result, when a person takes cocaine, amphetamine or some
other drug of abuse, the drug provokes more dopamine release in the reward
pathway, making the effect of the drug more pleasurable than it would be
otherwise.

People who produce large quantities of glucocorticoids in response to
stress could be particularly prone to abusing drugs because the
glucocorticoids make their reward pathways hypersensitive to any drugs of
abuse they might take, Piazza said.

In studies with rats, he found that rodents that secrete more
corticosterone, the principal glucocorticoid in rats, also learn to stick
their nose through a hole in their cage to receive intravenous infusions of
amphetamine or cocaine at lower doses than rats that secrete less
corticosterone. The fact that the high corticosterone producers make the
mental connection between nose pokes and drug infusion at lower drug doses
indicates that they find these drugs more rewarding.

Individuals could be high glucocorticoid producers because of genes or
because of chronic stress, Piazza said. This includes stress occurring in
infancy or even prenatally. In one study, his group found that placing
mother rats during their last week of pregnancy in narrow plastic cylinders
three times a day caused their offspring to grow into adults that produced
more corticosterone during stress than rats that had not been prenatally
stressed. The prenatally stressed rats were also regular drug fiends,
sticking their nose through the cage hole to receive amphetamine infusions
about 2 1/2 times more than rats that had experienced a more relaxing time
in the womb.

In terms of promoting drug intake, the key component in stress appears to
be its ability to be controlled, according to pharmacologist Nicholas
Goeders of Louisiana State University. He and colleague Glenn Guerin
demonstrated this in a study involving rats that received occasional foot
shocks while pressing a bar to receive food pellets.

The study involved three groups of rats. The first group received a food
pellet if they pressed the bar 10 times but a foot shock if they pressed
the bar an average of 15 times, which gave them some control over the foot
shocks. The second group also received a food pellet if they pressed the
bar 10 times but they had no control over their foot shocks, receiving them
at the same instant their compatriots in the first group received them. And
the third group pressed the bar for food pellets but received no foot shocks.

When the rats were later tested to see how much they would press a bar to
receive different doses of cocaine, the rats in the second group, who had
no control over their foot shocks, were found to be the most sensitive to
the rewarding effects of cocaine. These rats pressed the bar more often for
cocaine infusions and did so at lower doses of cocaine.

Goeders thinks that this study has important implications for people.

"If certain individuals are more sensitive to stress, especially if they
are in an environment where they feel that they have inadequate control
over this stress, then these individuals may be more likely to use cocaine
and other drugs of abuse," said Goeders. "This could occur whether the
person is an executive in a high-level stress position or a teenager living
in a low-income, inner-city environment with no hope of ever advancing."