Introduction to the Special Issue on Stress and Substance Use


stress, substance use, self-medication hypothesis, drugs, substance misuse


The relationship between stress and substance use has been noted for many years; perhaps it dates back to the first time a person used an intoxicant to relax and escape the pressures of everyday life. The post-WW II prescription tranquilizer fad is merely a recent historical footnote demonstrating this relationship. Unfortunately, contemporary theories of substance use often ignore how the stresses and strains of life may motivate or magnify the use of illicit substances (Petraitas et al., 1995). A number of classical theoretical frameworks implicate stress as a key motivator of substance use, however. The self-medication hypothesis (Khantzian, 1985), for instance, suggests that substance use allows one to modulate physical or psychological pain–which may be conceptualized as a chronic stressor. Dependence often follows as one finds that additional physical stresses result from the absence of particular drug (Khantzian, 1997). A number of theories owing their linage to Durkheim, Spencer, Simmel, and Tönnies, summarized remarkably well by the quote above, view modern society as a causative factor in the development of substance use and misuse. Robert K. Merton's (1938) theory of anomie and deviant behavior exemplifies this body of theories by positing that a rejection of both cultural goals and institutionalized means results in a retreatist status that includes drug addiction and mental disorders. Young (1971) specifies this process in more detail by suggesting that some individuals with modern society have few culturally acceptable options to use when faces with stress. The only recourse available is often solitary alcohol or drug use, with misuse resulting when one discovers addictive properties of the drug that are difficult to resist. A general drawback to these theories is that they fail to specify the necessary and sufficient conditions that are required to connect stress and substance use.

Original Publication Citation

Hoffmann, John P. 2000. “Introduction to Special Issue on Stress and Substance Use.” Substance Use & Misuse 35(5): 635-641.

Document Type

Peer-Reviewed Article

Publication Date



Substance Use & Misuse




Family, Home, and Social Sciences



University Standing at Time of Publication

Full Professor