Chronic Drinking Increases Cortisol Levels

Chronic Drinking Increases Cortisol Levels

 

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Alcohol and stress are connected in several ways. People often drink as a way to cope with stress, but alcohol use can also create more stress in a person's life. Alcohol can also increase cortisol levels, which is the hormone the body releases in response to stress.

Exposure to excessive cortisol can have serious effects on both mental and physical health. Finding ways to manage stress and reducing or stopping alcohol use can help minimize the negative effects that excess cortisol can have on your well-being.

At a Glance

Chronic alcohol use poses many health risks, including elevated cortisol levels. This can happen while a person is consuming alcohol regularly, but it can also occur during alcohol withdrawal. High cortisol levels can increase your risk of health issues, such as high blood pressure, diabetes, weight gain, cardiovascular disease, gastrointestinal problems, poor immunity, fatigue, and fertility problems. Taking steps to reduce your alcohol use may help lower your cortisol levels and improve your overall health.

Alcohol and Cortisol: What's the Connection?

Long-time heavy alcohol consumption can have many effects on a person's system, including cognition, emotion, reward, immune function, and energy utilization. When chronic heavy drinkers are intoxicated—and when they are withdrawing from alcohol intoxication—they can experience mood swings, diminished cognitive abilities, memory loss, and a decreased ability to learn.

Some research has found that heavy alcohol consumption can begin to cause negative health effects on the body after only several weeks or a few months of drinking.

It's not just long-term drinkers who can develop these symptoms, but also those who drink heavily for a relatively short period of time— aka, binge drinking.

What is not clear is exactly how heavy alcohol consumption can affect so many systems of the body—from brain function to the immune system to the digestive system.

Alcohol Increases Cortisol Levels

One theory about how alcohol causes these effects is that heavy alcohol consumption produces an increase in cortisol, also known as a "stress hormone." Cortisol is produced by the adrenal glands and is the body's primary glucocorticoid.

The body naturally produces more cortisol when you are affected by stressors such as fear or anxiety. It's part of the body's stress-response system.

Short-term, stress-induced cortisol can increase blood pressure, focus alertness, and attention. It helps prepare your body to deal with an immediate threat so that you can respond effectively. When you are exposed to cortisol for an extended period, however, it can adversely impact some body functions such as bone growth, digestion, reproduction, and wound repair.

Alcohol Withdrawal Increases Cortisol

Cortisol also plays an important role in regulating the body's immune, reward, cognition, and emotion systems, as well as cause sleep disruption.

Research has found that alcohol consumption also increases the body's production of cortisol, not only while the person is intoxicated, but also when the individual is withdrawing from the effects of intoxication.

Researchers believe that a high level of intoxication can cause a state of general stress, which can stimulate cortisol release. Suddenly stopping alcohol consumption is a shock to the system, which can cause an even higher level of stress for a person with an alcohol use disorder.

It is also thought that alcohol could affect brain chemicals that signal the adrenal glands to produce more cortisol.

Alcohol Use Affects the HPA Axis

Research has also shown that alcohol use also causes impairments in the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is a neuroendocrine mechanism that helps mediate the impact stressors have on the body. It does this by regulating systems such as the autonomic nervous system, immune response, metabolism, and other physiological processes.

Consuming alcohol increases activity in the HPA axis, resulting in increased cortisol production. This increase in cortisol also triggers the release of the neurotransmitter dopamine, which is associated with feelings of pleasure. Increased dopamine contributes to the enjoyable effects that people experience when consuming alcohol. 

Drinking too much alcohol over a long period creates impairments in the HPA axis. So when someone with a chronic drinking problem experiences stress, their response becomes blunted, and the body doesn't react as it should.

Researchers suggest that these changes in how the HPA axis works play a role in why people with alcohol use disorders experience negative feelings and discomfort. Alcohol then becomes a way to find relief from these unpleasant feelings, creating a cycle of further alcohol use.

Research also suggests that this dysregulation in the body's stress response can contribute to drinking behavior and alcohol cravings. In one study, binge drinkers and heavy drinkers who experienced stressful situations experienced stronger cravings and lower cortisol responses, which were linked to higher alcohol consumption.

Effects of High Cortisol Caused by Alcohol Use

Long-term alcohol use can have serious effects on mental and physical health. Its impact on the stress response and increased cortisol levels can result in numerous health consequences, including:

  • Anxiety
  • Depression
  • Cancer
  • Sleep disturbances
  • Hypertension
  • Heart disease
  • Obesity
  • Weakened immunity

The stress system is an emerging area for research into why people drink excessively, and new medications are in the works for this system.

How to Get Help

If you are struggling with an alcohol use problem that is contributing to high-stress levels, talk to your doctor about your treatment options. Treatments for chronic alcohol use may include behavioral interventions, medications, and support.

The first step is to go through the detox and withdrawal process. If you have been drinking chronically, having your detox supervised by a medical professional is important to help minimize the risk of seizures and other complications.

Therapy

Once you have completed the detox process, it is important to work with a therapist to develop coping skills that will help you stay sober. Types of therapy that can be helpful include:

Therapy can also help you learn relaxation techniques to reduce stress and lower cortisol levels. Specific techniques that can be helpful include deep breathing, mindfulness, and progressive muscle relaxation.

Medication

Your doctor can also prescribe medications that can help reduce cravings and withdrawal symptoms. Medications your doctor may prescribe include naltrexone, acamprosate, or disulfiram.

Support

Support groups like Alcoholics Anonymous and SMART Recovery can also play an important role in maintaining sobriety. They are a way to gain support, encouragement, and advice from people who have had similar experiences.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

11 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Sullivan EV, Brumback T, Tapert SF, et al. Cognitive, emotion control, and motor performance of adolescents in the NCANDA study: Contributions from alcohol consumption, age, sex, ethnicity, and family history of addiction. Neuropsychology. 2016;30(4):449-473. doi:10.1037/neu0000259

  2. Krieger H, Young CM, Anthenien AM, Neighbors C. The epidemiology of binge drinking among college-age individuals in the United States. Alcohol Res. 2018;39(1):23-30.

  3. Lu YL, Richardson HN. Alcohol, stress hormones, and the prefrontal cortex: a proposed pathway to the dark side of addiction. Neuroscience. 2014;277:139-151. doi:10.1016/j.neuroscience.2014.06.053

  4. Lee DY, Kim E, Choi MH. Technical and clinical aspects of cortisol as a biochemical marker of chronic stress. BMB Rep. 2015;48(4):209-216. doi:10.5483/BMBRep.2015.48.4.275

  5. Becker HC. Effects of alcohol dependence and withdrawal on stress responsiveness and alcohol consumption. Alcohol Res. 2012;34(4):448-458. 

  6. Sheng JA, Bales NJ, Myers SA, et al. The hypothalamic-pituitary-adrenal axis: Development, programming actions of hormones, and maternal-fetal interactionsFront Behav Neurosci. 2021;14:601939. doi:10.3389/fnbeh.2020.601939

  7. Blaine SK, Milivojevic V, Fox H, Sinha R. Alcohol effects on stress pathways: Impact on craving and relapse riskCan J Psychiatry. 2016;61(3):145-153. doi:10.1177/0706743716632512

  8. Georgakouli K, Manthou E, Fatouros IG, et al. HPA-axis activity and nutritional status correlation in individuals with alcohol use disorderNutrients. 2022;14(23):4978. doi:10.3390/nu14234978

  9. Blaine SK, Nautiyal N, Hart R, Guarnaccia JB, Sinha R. Craving, cortisol and behavioral alcohol motivation responses to stress and alcohol cue contexts and discrete cues in binge and non-binge drinkersAddict Biol. 2019;24(5):1096-1108. doi:10.1111/adb.12665

  10. American Psychological Association. How stress affects your health.

  11. Milivojevic V, Sinha R. Targeting stress pathophysiology to improve alcoholism relapse outcomes. Neuropsychopharmacology. 2017;42(5):987-988. doi:10.1038/npp.2016.234

By Buddy T
Buddy T is a writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Because he is a member of a support group that stresses the importance of anonymity at the public level, he does not use his photograph or his real name on this website.