When our findings are taken together with previous research, stress influences substance use when it directly increases the urge to use. This is consistent with previous work from Furnari and colleagues (2015) that found stress occurrence alone was an inconsistent predictor of opioid or cocaine use; however, they also found that severity of the stressor mattered. That is, the more stressful an event was, the more strongly the event predicted cocaine use. Therefore, it could be that certain types of stressful events (i.e., interpersonal stressors) that are more severe might have a direct impact on drinking. Another study from the same laboratory found that stress-related feelings was related to increased craving (Preston et al., 2018). These collective results suggest that response to event is important and the inability mount an effective response to a stressful event, and a lack of a sense of effective coping, may make addicted individuals more vulnerable to craving and drug use. Consistent with this, laboratory evidence suggests that stress may specifically act on alcohol and drug use primarily via craving. It is entirely possible that more severe stressors or stressors that elicit stronger reactions might exert their impact via increased craving or motivation to drink.
