Coping With Stress in the Wake of September 11

NIDA Director Dr. Alan I. Leshner, Ph.D.

As we all struggle with the emotional impact of the large-scale damage and loss of life, and the uncertainty of what may happen next, that have resulted from the terrorist attacks on New York City and Washington, D.C., we need to pay special attention to the effects of stress. These stressful times may be particularly difficult for people who are at risk for substance abuse or recovering from drug addiction. Years of research and clinical observation have shown that stress is one of the most powerful triggers for drug craving and relapse to drug abuse, even after long periods of abstinence. The evidence is particularly strong for smokers and cocaine abusers. NIDA-supported ethnographers in New York City are reporting increases in street sales of various drugs and we fear this trend might continue to grow.

Research also shows that those who have experienced or witnessed life-threatening events may develop a psychiatric condition called Posttraumatic Stress Disorder (PTSD) some time after the event. From research and clinical experience we know that PTSD is a strong risk factor for substance abuse and addiction. The events of September 11 were experienced by thousands of people in the vicinity of the attacks. Millions of others around the world witnessed these events on television. It is likely that many individuals are experiencing emotional distress and that some have developed or will develop PTSD–conditions that could lead to self-medicating with illicit drugs or alcohol.

To respond to the demands and dangers of these changed times, NIDA is assigning very high priority to research on all aspects of the relationship between stress and substance abuse. In the immediate aftermath of the attacks, we awarded several grant supplements to researchers in the New York metropolitan area to provide a rapid assessment of the impact of these events on drug abuse and addiction rates and to re-evaluate service delivery needs and opportunities. In addition, we are seeking research proposals to extend our knowledge of how stress contributes to initial drug use, to the transition from occasional use to chronic drug abuse and addiction, and to the complex phenomenon of relapse. This knowledge will enhance our prevention, assessment, and treatment efforts.

On a more personal note, I would like to emphasize how important it is during the wake of the horrific events of September 11, to focus on restoring and maintaining our emotional well-being. We must all be aware of how we and those we care about–our family, friends, and colleagues–are coping with and responding to these stressful and uncertain times.