Elucidating the Role of Trauma and Significant Life Stress in the Disease of Addiction may Provide New Targets for Medication Development

Abstract

The role of previous life stress and trauma in addiction has been understudied and underappreciated. To date, much previous research has emphasized other aspects of the disease of addiction, including the reward-based neural circuitry. While previous research has offered tremendous value and shaped human understanding of addiction, an increased emphasis on the role of stress and trauma in addiction may provide new targets for therapeutic development. Here, we review both clinical and preclinical literature in support of the hypothesis that addiction is largely initiated and driven by significant previous life stressors and traumas. We describe some of the available quantitative molecular in vitro studies, systematic literature reviews, case-control studies, and cross-sectional studies to summarize the neurobiology of the reward pathway, the influence of stress-related hormones on the brain, and the role of childhood trauma in the development of substance abuse. The current perspective highlights the importance of early intervention during stressful life events for the prevention of future addiction behavior and suggests that elucidating the neurobiology of these systems may provide new targets for medication development for addiction.

Keywords: Addiction; dopamine; reward pathway; stress; substance abuse; substance use disorder; trauma.