There are a lot of factors that impact the development of substance use disorders (SUDs) or addiction. From genetics to environment to biology, all play a role in the risk of developing addiction and how it is experienced. Hormones are no exception.
This is to be expected, as hormones affect every aspect of human life. They fluctuate due to stress, life changes, physical health, menstrual cycles, and other factors. They can trigger changes that lead to SUDs. And, they are also affected by substance use.
To better understand how hormones affect substance use disorders, let’s start by taking a look at what role hormones play in the brain.
The Role of Hormones in Brain Chemistry
The brain’s reward system has a significant role in the development of SUDs. It is a network of neural pathways that releases “feel-good” chemicals like dopamine when we engage in pleasurable activities. When substances such as alcohol, opioids, or stimulants are introduced, they can hijack this system, leading to intense cravings and addiction. Hormones significantly impact how the brain’s reward system operates, often making individuals more susceptible to substance use.
Hormones like cortisol, testosterone, and estrogen all regulate the brain’s reward system. Cortisol, commonly known as the stress hormone, is released during periods of heightened stress or anxiety. When cortisol levels are elevated for long periods, they can dysregulate dopamine production, making individuals more likely to turn to substances as a means of coping. This connection between stress, cortisol, and addiction explains why people under chronic stress are at a greater risk of developing SUDs.
Sex Hormones and Gender Differences in SUDs
Sex hormones like estrogen, progesterone, and testosterone also impact how individuals experience and manage substance use. Men and women tend to experience addiction differently, largely due to hormonal influences. For instance, estrogen and progesterone levels fluctuate throughout a woman’s menstrual cycle, and these changes have been shown to affect substance use patterns, particularly with alcohol and opioids.
Women tend to be more sensitive to the effects of alcohol during certain phases of their menstrual cycle, particularly when estrogen levels are high. This heightened sensitivity can lead to increased alcohol consumption and a greater risk of developing SUDs. Similarly, women who are pregnant, postpartum, or going through menopause often experience hormonal fluctuations that increase their vulnerability to substance use. Estrogen, in particular, has been linked to increased cravings for substances, making relapse more likely during periods of hormonal change.
On the other hand, testosterone plays a significant role in addiction risk for men. Higher testosterone levels have been associated with increased risk-taking behaviors, aggression, and substance use. Men with elevated testosterone levels may be more likely to engage in behaviors that put them at risk for SUDs, particularly with substances like stimulants and alcohol. Testosterone can also impact the severity of withdrawal symptoms, with men experiencing more intense cravings and relapses.
Adolescent Development, Hormones, and SUDs
Hormones have a heightened impact on substance use disorders for those experiencing adolescence, partly due to the significant hormonal changes that occur during puberty. During this time, hormonal fluctuations increase impulsivity and risk-taking behavior, both of which are linked to early experimentation with substances. Adolescents are especially vulnerable to the long-term effects of SUDs because their brains are still developing, and exposure to substances can have lasting impacts on cognitive function and decision-making abilities.
Research shows that the earlier an individual begins using substances, the more likely they are to develop a substance use disorder later in life. Hormonal changes during puberty can amplify these risks by making adolescents more prone to sensation-seeking behaviors. This underscores the importance of early prevention and education about the risks of substance use during adolescence.
Hormonal Disorders and Substance Use
Certain hormonal disorders can also increase an individual’s risk of developing SUDs. For instance, thyroid disorders, such as hypothyroidism, are often associated with depression and mood swings. Individuals with thyroid dysfunction might start using substances as a form of self-medication to cope with their symptoms.
Polycystic ovary syndrome (PCOS), which is characterized by elevated levels of androgens (male hormones) in women, often leads to anxiety and depression. These mental health challenges, compounded by the hormonal imbalances caused by PCOS, can increase the likelihood of substance misuse as a way to manage emotional distress. Treating hormonal disorders may be an important component of preventing or managing SUDs in individuals with these conditions.
Positive Effects of Hormones on Recovery
While hormones can contribute to the development of substance use disorders, they can also play a crucial role in the recovery process. Certain hormones, when balanced and regulated, have positive effects on emotional well-being, stress management, and the brain’s ability to recover from addiction. By fostering social connections, enhancing mood stability, and reducing cravings, hormones such as oxytocin, endorphins, and serotonin are key to supporting long-term recovery.
Oxytocin and Social Connection
Oxytocin, often called the “bonding hormone,” is released during social interactions and physical touch. In recovery, oxytocin plays a vital role in rebuilding relationships and enhancing feelings of trust and empathy. Since social support is one of the most important predictors of successful recovery, oxytocin facilitates the development of meaningful connections that reduce isolation and increase a sense of belonging.
Research shows that individuals with strong social networks are more likely to stay sober and less likely to relapse. Oxytocin’s ability to strengthen bonds with family, friends, and support groups provides a buffer against stress and the temptation to return to substance use. Programs that emphasize group therapy, family counseling, or peer support can tap into the positive effects of oxytocin to help people in recovery feel more connected and supported.
Endorphins and Natural Reward Systems
Endorphins are the body’s natural painkillers, released in response to exercise, laughter, and other positive experiences. In recovery, boosting endorphin levels can help restore the brain’s reward system, which has often been disrupted by substance use. Regular physical activity, such as yoga, running, or even walking, can stimulate endorphin production, creating a natural sense of well-being and reducing the cravings for external substances.
Endorphins also play a role in alleviating withdrawal symptoms and reducing stress, which are critical in the early stages of recovery. Engaging in activities that increase endorphin levels allows individuals to experience pleasure naturally, without relying on drugs or alcohol. Over time, this can help rewire the brain’s reward pathways, making it easier to find fulfillment in everyday activities.
Serotonin and Emotional Stability
Serotonin is a neurotransmitter that helps regulate mood, sleep, and appetite. During recovery, maintaining stable serotonin levels is essential for emotional well-being and mental health. Many individuals with substance use disorders struggle with co-occurring conditions like anxiety and depression, which are linked to low serotonin levels. Supporting serotonin production through diet, exercise, or medications can improve mood stability and reduce the risk of relapse.
Recovery from addiction often requires addressing underlying mental health issues, and serotonin plays a key role in managing these conditions. By stabilizing mood and promoting feelings of calmness and contentment, serotonin helps individuals cope with the emotional challenges of sobriety. In some cases, antidepressant medications may be prescribed to boost serotonin levels and support recovery, particularly for those who are also dealing with depression or anxiety.
Hormonal Treatment Options in SUD Recovery
With this context, it’s not surprising that hormonal treatment options are emerging as an important part of SUD recovery. Hormone Replacement Therapy (HRT) has been shown to help individuals with hormonal imbalances manage their symptoms and reduce the likelihood of relapse. For instance, women going through menopause who experience heightened substance cravings due to declining estrogen levels may benefit from HRT to stabilize their hormone levels.
Additionally, medications that affect hormonal pathways in the brain, such as buprenorphine and naltrexone, are often used to treat addiction. These medications help regulate the brain’s reward system and reduce cravings, while also influencing the hormonal responses that contribute to substance use.
Conclusion
Hormones play a role in the everyday functioning of every human being. Fluctuations are a natural part of life, and most people experience them without being aware of their impact. When a person develops a substance use disorder, hormonal changes can become far more significant.
Not all hormonal fluctuations have a negative effect on SUDs. Certain hormones can help in recovery, and as such new treatments are being trialed as ways of using hormones for relapse prevention. Understanding the role of hormones in SUDs gives us even further insight into how we can leverage our physical health to improve the recovery process.
Sources
- Karger Publishers: “Role of Hormones in Substance Use Disorders.” Accessed 30 September 2024.
- Current Addiction Reports: “Hormonal Differences Between Women and Men, Their Consequences on Addiction to Substances and Considerations on the Therapeutic Approach.” Accessed 30 September 2024.
- Frontiers in Behavioral Neuroscience: “Sex Differences in Substance Use Disorders: A Neurobiological Perspective.” Accessed 30 September 2024.
