The timing matters. Adolescence and early adulthood are when the brain is still being built — stress-response systems are still being calibrated, and alcohol use is often beginning. A preregistered systematic review published in Neuroscience and Biobehavioral Reviews asked what happens when those two processes collide.

What they did

Researchers searched three databases — PsycINFO, PubMed, and Scopus — following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. They pulled studies using experimentally induced stress (structured lab tasks, not self-reports), tracking craving, consumption, or physiological stress markers in adolescents and young adults. Twenty-four studies met their criteria. The team evaluated methodological quality and looked at whether results differed across stress paradigm types.

What they found

One pattern held across all 24 studies: acute stress reliably increased alcohol craving, especially in heavier drinkers. The relationship between stress and actual consumption was less consistent. Whether stress led someone to drink more depended on the type of stress paradigm, the participant's drinking history, and context.

Drinking told a parallel story:

  • People who drank more heavily showed altered stress reactivity: their bodies responded to stressors differently than lighter drinkers.
  • They also showed reduced distress tolerance, meaning it was harder to sit with discomfort without reaching for relief.

Stress pushes toward alcohol. Alcohol reshapes how the stress system works. That's the feedback loop this review was built to trace.

What it means

Most coverage of this runs one direction: stress leads to drinking. This review shows the other side. Drinking patterns, over time, appear to lower a person's capacity to handle stress without alcohol. This pattern often gets established in adolescence and early adulthood, when the brain's stress-response architecture is still taking shape.

For anyone tracking their drinking: the relationship between stress and alcohol isn't fixed. How much you drink shapes how your stress system responds, which shapes how much stress-driven craving you experience later.

Caveats

All 24 studies used experimentally induced stress — structured lab tasks, not life events. That may not fully capture how real-world stressors influence drinking decisions. The studies were methodologically heterogeneous enough that direct comparisons were difficult, and 24 studies is a thin evidence base. Publication bias is the usual concern: null results that never got published could soften the picture.

Source: Neuroscience and Biobehavioral Reviews, 10.1016/j.neubiorev.2026.106763