Key Takeaways
- Individuals with OCD are approximately twice as likely to develop a substance use disorder compared to the general population.
- Approximately 25-30% of people seeking treatment for OCD also have a co-occurring substance use disorder.
- People with OCD commonly use alcohol, benzodiazepines, and marijuana to manage anxiety, intrusive thoughts, and compulsive urges.
- Substance use temporarily reduces OCD anxiety but ultimately worsens the condition by preventing the brain from developing natural coping mechanisms.
- Effective treatment addresses both conditions simultaneously using ERP (Exposure and Response Prevention) for OCD alongside addiction treatment.
- SSRIs are the first-line medication for OCD and are safe to use during addiction recovery.
The OCD-Addiction Connection
OCD (Obsessive-Compulsive Disorder) is characterized by intrusive, unwanted thoughts (obsessions) and repetitive behaviors performed to reduce anxiety (compulsions). The relentless anxiety and distress of OCD makes substance use a tempting escape.
Why People with OCD Self-Medicate
- Intrusive thoughts are exhausting and terrifying — substances provide temporary mental quiet
- Compulsive behaviors take hours each day — alcohol or drugs offer an alternative relief from anxiety
- Social anxiety often accompanies OCD — alcohol reduces social discomfort
- Sleep disruption from OCD — sedatives and alcohol help initiate sleep
- Shame and isolation — substances numb the embarrassment many people with OCD feel about their symptoms
Common Substances Used by People with OCD
- Alcohol: Most commonly used for general anxiety relief
- Benzodiazepines: Provide rapid anxiety reduction but carry high addiction potential
- Marijuana: Used for relaxation and thought distraction
- Opioids: Provide a sense of calm and emotional numbing
Treatment for Co-Occurring OCD and Addiction
For OCD:
- ERP (Exposure and Response Prevention) — the gold standard OCD therapy
- SSRIs (often at higher doses than for depression)
- Mindfulness-based approaches
For Addiction:
- Comprehensive outpatient treatment (PHP/IOP)
- Group and individual therapy
- MAT if opioid or alcohol use disorder is present
- Relapse prevention
Integrated approach:
- One treatment team addressing both conditions
- Understanding that OCD symptoms may temporarily worsen as substances are removed
- Teaching alternative anxiety management before removing substance-based coping
If you or a loved one is facing these challenges, learn more about OCD treatment within an addiction recovery framework available at Trailhead Treatment Center in Salem, NH.
Trailhead Treatment Center provides specialized care for OCD and substance use disorders to support lasting recovery and wellness.
Conclusion
OCD and substance abuse are more connected than most people realize. Effective treatment requires addressing both the obsessive-compulsive symptoms and the substance use simultaneously. Trailhead Treatment Center provides dual diagnosis treatment for OCD and addiction.