Substance Use and Psychological Distress in Disaster Contexts
Summary
Disasters triggered by natural hazards or sudden environmental events often precipitate elevated levels of psychological distress, manifesting as symptoms of anxiety, depression and post-traumatic stress. In the wake of such events, many individuals turn to substances—including alcohol, tobacco, pharmaceuticals and illicit drugs—as a maladaptive coping strategy. Patterns of use are heterogeneous: some survivors report marked increases in consumption, whereas others reduce or maintain prior levels. Risk factors that shape these trajectories include the severity of exposure, disruption to housing and services, gender, socioeconomic status and pre-existing mental health conditions. Neurobiological pathways link stress exposure to substance use via dysregulation of the hypothalamic–pituitary–adrenal axis and sensitisation of reward circuits, while social determinants—such as loss of social support, disruption to healthcare access and altered community infrastructure—further compound vulnerability. Understanding these interconnections informs the design of integrated relief strategies that combine mental health support, addiction treatment and community resilience building to mitigate long-term harms.
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Substance Use and Psychological Distress in Disaster Contexts publication trend
The graph below shows the total number of articles in substance use and psychological distress in disaster contexts across all publications each year (not limited to Nature Index journals).
Technical terms
Hypothalamic–pituitary–adrenal (HPA) axis: The hormonal system that orchestrates the body’s stress response through interactions between the hypothalamus, pituitary gland and adrenal cortex.
Post-traumatic stress disorder (PTSD): A clinical syndrome characterised by intrusive memories, avoidance behaviours, negative alterations in cognition and mood, and heightened arousal following exposure to traumatic events.
Geospatial analysis: A method that applies statistical and visual mapping techniques to explore spatial patterns and relationships within geographic data.
Sensitisation: The process by which repeated exposure to stressors or drugs enhances the reactivity of neural reward circuits, increasing vulnerability to substance use and relapse.
References
- Neurobiological intersections of stress and substance use disorders. Frontiers in Neuroscience (2025).
- Hospitalizations for Substance Abuse Disorders Before and After Hurricane Katrina: Spatial Clustering and Area-Level Predictors, New Orleans, 2004 and 2008. Preventing Chronic Disease (2016).
- Exposure to the tsunami disaster, PTSD symptoms and increased substance use – an Internet based survey of male and female residents of Switzerland. BMC Public Health (2008).
- Changes in smoking behavior among victims after the great East Japan earthquake and tsunami. Environmental Health and Preventive Medicine (2020).
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