OCD and Substance Abuse

Unfortunately, OCD and substance use often co-occur. It is likely that this happens because individuals with symptoms of OCD use drugs or alcohol to cope and to try to suppress negative, obsessive thoughts.

Living with obsessive-compulsive disorder (OCD) can be exhausting. Individuals with this type of mental illness may try to self-medicate with drugs or alcohol. OCD patients may also try to use substances to feel normal. However, this will only provide temporary relief. Though it may only be a quick fix, at times, individuals may crave that constant high to avoid feeling symptoms of OCD. Craving a constant high may lead to repeated abuse, and over time, a drug or alcohol addiction can form.

Drug Abuse as a Hindrance to OCD Treatment

Social isolation is a common result of OCD, and many individuals become homebound as a result of their overly consuming fears. The isolation they place themselves in due to the disorder can increase the risk of depression, making the individual more vulnerable to drugs or alcohol abuse. However, OCD is not the only topic here that increases desire for isolation; chemical dependency does as well.

The outcome of this combination is that a person may avoid treatment or drop out of treatment to avoid other people. Continued drug or alcohol use could change the individual’s outlook or willingness to continue treatment, even if they are not isolating themselves. If left untreated, both OCD and addiction are likely to progress, potentially leading to an escalation of self-destructive behavior.

Effects of Substance Abuse on OCD Symptoms

Individuals may abuse substances to ease the internal tension of OCD, yet alcohol and drugs can make the symptoms of the disorder worse. Both OCD and substance use disorder include unwanted repetitive behaviors, often with negative costs to social and professional lives.

While seeking relief from the symptoms of OCD, the individual may consume drugs or alcohol, and then again when they begin to pursue sobriety. By trying to avoid these symptoms through substance abuse, the individual is creating worse symptoms. This behavior makes the disorder harder to treat and live with.

Substance abuse can increase anxiety, depression, desire to be alone, physical health problems and changes in brain chemistry.

OCD and Alcohol

At the end of a stressful day, it may be tempting to have a glass of wine or beer to calm the nerves. However, drinking alcohol, especially in large quantities and over a long period of time, can increase an individual’s anxiety. Drinking alcohol can backfire on someone who is using it to treat OCD because alcohol can cause anxiety.

An occasion drink to unwind isn’t necessarily dangerous, though once you start the occasional drinking, you can build a tolerance to the relaxing effects of alcohol. Tolerance may make the individual desire to drink heavier to feel the effects again. With higher doses of alcohol, the stress becomes harder to cope with. According to the Substance Abuse and Mental Health Services Administration, prolonged drinking may cause anxiety in some instances, making OCD symptoms more severe.

OCD and Marijuana

The use of marijuana strongly associates with many anxiety disorders, including OCD. As the individual is commonly anxious or worried about circumstances in their life, such as relationships, they may look to marijuana for the same reasons they use alcohol, to help them calm their mind.

Marijuana may allow the individual to temporarily relax after a stressful day or during a nervous situation. However, because this is only a temporary feeling when the high is gone, the OCD symptoms return. Because marijuana may make a person feel normal, they may begin to use marijuana more often until it becomes a daily routine. The lack of peace when sober can cause people to use at times that may affect their school or risk their job and relationships. This effect could also lead to using more addictive substances to feel calm for longer periods of time.

OCD and Stimulants

Anxiety is a well-known side effect of stimulant medications. Since OCD is considered a subtype of anxiety, this choice of self-medication can also add to the negative symptoms of the individual’s disorder. It is common for children who have been taking prescribed stimulants to control their ADHD to develop an anxiety disorder. Stimulants are chemicals that excite the central nervous system to release more chemicals to send faster messages through your nerves and body.

Stimulants are not usually prescribed to treat anxiety. College students with high anxiety may ingest stimulants to help them stay awake to study. This use may become addicting and lead to a dependence on the drug to function normally and avoid withdrawal. This habit may create more stress by stimulating OCD symptoms, creating a devastating cycle of stress.

Statistics on OCD and Drug Abuse

Unfortunately, OCD and substance use often co-occur. It is likely that this happens because individuals with symptoms of OCD use drugs or alcohol to cope and to try to suppress negative, obsessive thoughts.

• The occurrence of OCD in American adults is between 6 and 2.3 percent. It has been estimated between 25 and 40 percent of these individuals with OCD also abuse substances. The frequency of OCD among individuals in treatment for substance use disorders is between 6 and 12 percent, about two to six times as high as in the general population.
• Fewer than half of people with OCD and a substance use disorder ever get treatment for OCD.

Drug Abuse as a Cause of OCD

There is no evidence that substance abuse can directly cause OCD to develop. However, substance use may reduce an individual’s ability to cope with feelings of anxiety, which eventually can cause more severe symptoms of OCD. Current research suggests that individuals with OCD are likely to use and abuse harmful substances. The early usage of alcohol and drugs that is common among OCD patients could affect the brain chemistry of young adults, causing the disorder to develop. We do know that, whether or not drug abuse is a cause, it does greatly elevate the negative symptoms and make treatments more challenging.

Treatment for OCD with Co-Occurring Substance Use Disorder

Individuals who have a co-occurring condition of OCD and substance abuse may have a difficult time in treatment. Both disorders must be treated simultaneously for true healing to happen. When one of the conditions goes untreated, the treated condition often resurfaces repeatedly until they can properly treat both disorders.

Individuals who have OCD face a high risk of developing a substance use disorder. These individuals should look for certain qualities in a dual diagnosis rehab that will treat both the OCD and substance addiction together. The best inpatient dual diagnosis facilities will provide services such as intake evaluation, detox, medical maintenance, therapy, group counseling, 12-step programs and holistic wellness programs.

If you or a loved one needs treatment for a drug or alcohol addiction, The Recovery Village can help. People who have substance use disorders with co-occurring OCD symptoms can receive help from one of the facilities located throughout the country. To learn more, call The Recovery Village to speak with a representative.

Editor – Camille Renzoni

Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more

Medically Reviewed By – Krisi Herron, LCDC

Krisi Herron is an Adjunct Psychology Professor, a Licensed Chemical Dependency Counselor and a freelance writer who contributes to several mental health blogs. Read more