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Anxiety and Substance Use Disorder: Everything You Need to Know

By Lan Pham, Stefanie Sandler Billette, MS, ACE-CHC
Medically Reviewed by Arpan Parikh, MD, MBA on July 12, 2021
Addiction and anxiety often go hand in hand. So how are the two related?

Anxiety and substance use disorder can have serious impacts on a person's life. Here are the facts about the connections between the two conditions. 

Anxiety Disorders

The National Institute of Mental Health notes that that both hereditary and environmental risk factors may predispose a person to developing an anxiety disorder. There are several clinically-recognized anxiety disorders, and each has its own diagnostic symptoms and recommended treatment plan. But some general symptoms that many anxiety disorders share are:

  • Panic, fear, and uneasiness
  • Sleep problems
  • Cold, sweaty, numb, or tingling hands or feet
  • Heart palpitations
  • Inability to concentrate
  • Intensely or obsessively avoiding feared objects or places

Substance Use Disorder

Substance abuse and substance use disorder are not the same. If your substance abuse can easily be managed or stopped independently, then it has not risen to the level of substance use disorder.

Also known as addiction, substance use disorder occurs when a person cannot control their abuse of a substance, even when that abuse causes significant medical and/or personal harm. 

Mayo Clinic notes that the symptoms of substance use disorder can include:

  • A compulsion to use the substance as often as several times a day
  • Thoughts about the substance that overwhelm all others
  • Developing a tolerance to the substance that creates the urge to take more of it
  • Engaging in risky behaviors such as stealing to obtain the substance
  • The inability to stop using the substance, despite attempts to do so

Is There a Link Between Anxiety and Substance Abuse?

According to the Anxiety and Depression Association of America, an estimated 20% of people who struggle with anxiety or other mood disorders also struggle with substance use disorder. Those with anxiety disorders are two to three times more likely than the average person to have an alcohol or other substance use disorder at some point in their lives.

“Research shows that the onset of an anxiety disorder often occurs before the onset of substance abuse,” Shane G. Owens, PhD, assistant director of campus mental health services at Farmingdale State College in New York, tells WebMD Connect to Care. 

Additionally, “PTSD (post-traumatic stress disorder) or trauma-related disorders have strong associations with alcohol abuse,” Ove Heradstveit, PhD, psychologist and researcher at NORCE Norwegian Research Centre and the Centre for Alcohol and Drug Research in Norway, tells WebMD Connect to Care.

Substance abuse can also have an effect on mental health, particularly for those who already suffer from anxiety or other mood disorders. “Substance use can often make the symptoms of anxiety worse,” Misty Walter, LCSW, clinical social worker and clinical director of Recovery Works South Shore, a residential addiction treatment center in Kentucky, tells WebMD Connect to Care. “In addition, many medications that are used to treat anxiety have the risk of being abused,” Walter notes. 

Treatment for Anxiety and Substance Abuse

Mental health professionals usually recommend a substance abuse treatment plan along with anxiety treatment, according to the Anxiety and Depression Association of America. Fortunately, treatment for one is likely to improve the other, as well. “Studies that examine treatments for anxiety show that the same interventions improve substance abuse along with anxiety,” Owens says.

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