How Do OCD and Addiction Go Hand in Hand?

Addiction often does not occur on its own. Many addicts also suffer from co-occurring mental disorders such as depression, anxiety, PTSD, OCD, etc. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 17.5 million Americans, 18 or older, have had a severe mental health disorder in the past year. Four million of those individuals had a co-occurring substance abuse disorder. This is a common phenomenon, unfortunately, but this means that more treatment options are available. For those suffering from both obsessive-compulsive disorder and a substance abuse disorder, life can be challenging. However, understanding how these two go hand-in-hand can create better treatment options and lower the stigma surrounding them. 

What is Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder (OCD) is a mental disorder in which individuals struggle with intrusive thoughts, urges, or images that trigger specific compulsions or obsessions. 

An obsession is defined as unwanted thoughts, urges, and images that are continually flooding a person’s mind. These intrusive thoughts often cause extreme discomfort and anxiety. Most individuals with OCD are aware that their obsessions are irrational. Still, they cannot stop due to severe anxiety if things are not done precisely right. 

On the other hand, compulsions are the actual behaviors, thoughts, or actions that are repeated because of obsessions. They happen to make the obsessions go away or, at the very least, neutralize them. They are coping mechanisms that give the person with OCD temporary relief until the next trigger. Compulsions can take a toll on a person’s life, interpersonal relationships, and responsibilities. 

Common Obsessions

While every individual with OCD has their own specific obsessions and compulsions, some are very common. The most common obsessions are losing control, unwanted sexual thoughts, contamination, perfectionism, religious fixations, and a fear of bad luck or contracting diseases.

Common Compulsions

There are numerous compulsions that individuals with OCD may engage in to try to neutralize or get away from their obsessions. Common compulsions include washing and cleaning, checking, repeating, and mental compulsions. Others focus on avoiding triggers or doing things until they feel “just right.” These compulsions are often exhausting, and most individuals with OCD would rather not engage in them. They do so, however, because they are afraid of the consequences of not doing them. 

OCD and Addiction

According to the International OCD Foundation, 25% of people with OCD also have a substance abuse disorder. This is mainly because many with OCD use drugs or alcohol to escape obsessions and compulsions. The physical effects of drugs or alcohol often help them cope with their anxiety, but it can be dangerous. Using drugs or alcohol to escape the symptoms of OCD will usually make the symptoms worse over time. The longer a person engages in substance abuse, the more likely they are to develop an addiction and have their OCD symptoms become more severe. The person may begin using more to cope with the more severe symptoms, thus continuing the vicious cycle. 

Dual Diagnosis Treatment

Because OCD is classified as an anxiety disorder, treatment involves treating anxiety and addiction concurrently. This is called dual diagnosis treatment. A dual diagnosis is when a person suffering from a mental illness is also struggling with a substance abuse disorder. Dual treatment is crucial in helping the patient succeed in recovery. 

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is often used to treat anxiety disorders such as OCD. CBT helps individuals recognize their negative thoughts and behaviors and learn how to change them into healthier ones. When utilizing CBT, a therapist will often have their client with OCD face their fears by exposing them to a triggering situation. During these CBT sessions, they learn healthier coping skills that will help reduce their need to perform compulsions and the intensity of their obsessions. Hopefully, this will teach the person that there is no reason to be afraid, thus reducing their anxiety. It can also help those in addiction treatment by helping them identify their negative behaviors when coping with stress and learning to utilize healthier ones.


Medications such as antidepressants are often used to reduce the symptoms of OCD. Many individuals who begin taking medications for their disorder find that they can function better and have less anxiety than before. The most common drugs used are serotonin reuptake inhibitors (SSRIs). 

Medication can also be used to help in addiction treatment. The medications a doctor will prescribe often depend on the kind of addiction the person is struggling with. Most are prescribed to reduce withdrawal symptoms, which makes the client more comfortable during detox. Other medications can be used throughout a person’s recovery, at the discretion of the consulting therapist or physician. 


OCD, when coupled with a substance abuse disorder, can be devastating for an addict. Not knowing how to cope with either of their disorders can leave them feeling lost and hopeless.. At Choice House, we understand the importance of dual diagnosis treatment. We give our clients the best chance at recovery with a reduced risk of relapse after treatment. By educating ourselves on various mental disorders that coincide with substance abuse disorders, we learn how to target both simultaneously and offer the best treatment possible. Dual diagnoses can often result in cycles of worsening symptoms and increased drug or alcohol intake. We help our clients stop the cycle and find joy in a sober life by treating both of their disorders. For more information about our program, call us at (720) 577-4422. Don’t let substance abuse and mental health control your life. 

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