Because stress is robustly associated with new onset and persistent SUDs across all major substances, understanding the behavioral and neurochemical mechanisms underlying stress-precipitated substance use is critical. Specifically, pharmacologic interventions targeting the brain stress systems or behavioral interventions that focus on managing or reducing stress (e.g., mindfulness training) may be of therapeutic benefit for substance use. Indeed, pharmacotherapies targeting the corticotrophin-releasing factor and norepinephrine stress systems already show promise in reducing stress-precipitated nicotine or smoking and drinking behavior in preclinical and human laboratory studies.47–53 Similarly, mindfulness-based stress reduction and mindfulness-based relapse prevention have shown promise for alcohol use, smoking cessation, and other SUDs.54–57
