Co-Occurring OCD & Substance Use Disorder

People who struggle with addiction, medically known as a substance use disorder (SUD), may also have obsessive-compulsive disorder (OCD). According to one study, SUDs affect more than 25% of people who seek treatment for OCD.¹

If you or someone you care about is facing OCD and a co-occurring addiction, integrated treatment to treat both disorders can help you or your loved one recover. This article will help you understand OCD, the symptoms of OCD, the relationship between OCD and substance misuse, risk factors for both disorders, and how to seek help to start the path to recovery.

What Is OCD?

OCD is a common and chronic mental illness that involves uncontrollable, repetitive thoughts and/or behaviors.² Although it was previously considered to be an anxiety disorder, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) now places OCD in the class of obsessive-compulsive and related disorders.³

What Are the Symptoms of OCD?

OCD typically involves a combination of unwanted, intrusive thoughts and compulsive behaviors, but people can sometimes have just one or the other.²

The DSM provides diagnostic criteria for OCD, which include:⁴

• The presence of obsessions, compulsions, or both.
  –Obsessions means recurrent or persistent unwanted thoughts, urges, or images that cause distress and anxiety. You may try to ignore or suppress obsessions.
  –Compulsions means repetitive behaviors (such as handwashing) or mental acts (such as checking or counting) that you feel driven to complete in response to an obsessive thought or to specific and rigid rules. Compulsions are intended to reduce anxiety or distress or an imagined, dreaded consequence, but they are either not connected in a realistic way with what they are intended to neutralize or are clearly excessive.
• Obsessions or compulsions must be time-consuming or cause clinically significant distress in important areas of functioning (such as work or family life).
• These symptoms cannot be attributable to the physiological effects of a substance or another medical condition.
• Other mental/psychiatric conditions that could explain the behaviors have been ruled out.

While there’s not enough evidence to clearly answer the question, “Does OCD cause addiction?”, research indicates that there are common brain changes and other potential links between the two disorders that may play a role.⁵

The Relationship Between OCD and Addiction

A dual diagnosis (another term used to refer to co-occurring disorders) of OCD and SUD appears to involve similar and perhaps overlapping brain changes as well as other potential links.⁵

While there is a clear difference between OCD and addiction in terms of symptoms and diagnostic criteria, both involve high levels of compulsive behavior.⁶

Although there’s not yet conclusive evidence, researchers have speculated that both OCD and SUD involve similar changes in brain circuitry and neurochemistry, even though many of the available studies were performed in animal models.⁵

Some evidence also indicates that there may be a relationship between having a family history of impulsive and compulsive symptoms/disorders and the subsequent development of OCD and SUD.⁵

Additionally, it seems that OCD may develop first for many people; one report indicates that 60% of people who had SUDs and OCD indicated that that OCD preceded the SUD, although, for 40% of people, the SUD developed first.¹

This could support the self-medication hypothesis, which means that people with OCD may self-medicate their symptoms in an effort to alleviate tension and distress, but more studies are needed.¹

How Alcohol Affects People With OCD

The co-occurrence of OCD and alcohol use is relatively common, with one study of Veterans with OCD reporting that alcohol was the most commonly used substance, and another study of university students with OCD showing similar results.⁸

People with OCD may drink alcohol as a form of self-medication to alleviate or reduce their symptoms.⁹ Alcohol is a depressant, so it may cause temporary feelings of calmness.⁹ However, ongoing alcohol misuse can actually make you feel worse, lead to further health problems, and potentially worsen OCD symptoms.⁸

How Drug Misuse Affects People With OCD

As with alcohol use, people with OCD may use drugs to self-medicate their symptoms. One study of Veterans with OCD and SUD indicated that cocaine, cannabis, opioids, and amphetamine were among the more commonly used drugs, while another study of university students with OCD and SUD reported that opioids, cannabis, sedatives, stimulants, cocaine, and hallucinogens were commonly used.⁹

Co-occurring drug use disorders and OCD can lead to increased impairment and decreased functioning, and studies have shown that people with OCD and SUDs can experience more severe OCD symptomatology.⁹

Does OCD Increase the Chances of Becoming Addicted to Drugs or Alcohol?

Having OCD may increase the risk of having an SUD, but that doesn’t mean one disorder caused the other. As mentioned earlier, many people experience OCD before the SUD, but some also develop the SUD before the OCD.⁷

Certain shared risk factors can influence the development of addiction and co-occurring mental health disorders, but it involves a complex interplay of factors; there is not necessarily a direct cause and effect relationship.¹⁰

Risk Factors for Co-Occurring OCD and Substance Use Disorder

Researchers believe that co-occurring disorders may develop for different reasons, such as:¹⁰

• Common risk factors, such as genetics, stress, or adverse childhood experiences.
• Mental illness can contribute to SUDs.
• Substance use disorders can contribute to mental illness.

Treatment for Co-Occurring OCD and Addiction

If you or a loved one are struggling with OCD and addiction, co-occurring disorder treatments can help. It’s generally advised that both disorders are treated together, as each can worsen the other.⁷ Sunrise House offers specialized, evidence-based co-occurring disorder treatment that may involve different levels of addiction treatment.

Our New Jersey metro area inpatient rehab facility provides a comprehensive continuum of care that includes medical detox, residential rehab, and aftercare.

During OCD and addiction treatment, you may receive medication for OCD or SUD, depending on the substance you use.⁷ You may also participate in different types of therapy, such as: ⁷

• Trauma-based therapies.
• Family therapy.
• Cognitive behavioral therapy (CBT).
• Individual therapy.
• 12-Step support groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).

Sunrise House Treatment Center also facilitates specialized addiction treatment programs, like LGBTQ+ addiction treatment or Veterans rehab. These programs are customized to address specific patient needs.

You can start the admissions process today by calling an admissions navigator at . Or, learn more about ways to pay for rehab or insurance coverage for rehab. You can also instantly and easily verify your insurance coverage with us online.