Understanding OCD and Addiction: Signs, Risks, and Recovery Options

Obsessive compulsive disorder (OCD) and addiction are brain disorders that can co-occur and result in negative consequences for you and your family. Approximately 1% to 3% of Americans have OCD, while 48.4 million struggle with substance use disorders. Fortunately, effective help exists for OCD and addiction.

Dual diagnosis treatment in specialized centers can address the root causes of both conditions and help you regain control of your life.

Download our OCD & Addiction Quiz if you or someone you love is struggling with obsessive symptoms and/or a substance use disorder.

What Is OCD (Obsessive Compulsive Disorder)?

OCD is a mental health condition characterized by two classes of symptoms:

• Obsessions are recurrent intrusive thoughts, impulses or urges of a disturbing nature that are difficult to ignore and can cause mental distress. 
• Compulsions are physical or mental repetitive behaviors that are used to lessen feelings of anxiety caused by obsessions.

Examples of OCD Obsessions and Compulsions

While each person’s OCD symptoms are different, how the symptoms present often fall into recognizable patterns.

Below are some common examples of obsessions and compulsions associated with OCD:

Contamination

• Obsession: Fear of germs.
• Compulsion: Excessive hand washing.

Forbidden Thoughts

• Obsession: Thoughts or urges of a sexually disturbing nature.
• Compulsion: Persistent silent or mental praying.

Responsibility for Harm

• Obsession: Constant preoccupation with injury due to an exaggerated sense of responsibility for events occurring.
• Compulsion: Frequently check locks and appliances. 

Symmetry

• Obsession: Feels a need to arrange things in specific ways 
• Compulsion: Rigid organizational habits to achieve subjective ‘’just right’’ ways of doing things.

Addiction vs Compulsion

OCD is commonly fueled by intense urges and anxieties caused by obsessions. Addiction is also characterized by a compulsive use of substances in ways that resemble OCD.

You may feel powerless against an intense desire to use drugs, similar to how people with OCD feel about their rituals. Anxiety disorders and addiction can also co-occur.

How OCD and Addiction Are Linked

OCD and drug addiction are linked through the compulsive nature of the disorders. Intense urges to do drugs or alleviate an obsession override typically healthy behaviors. This results in negative consequences to your physical and mental well-being.

The association between mental health disorders and alcohol misuse is profound. You may self medicate to relieve the distress produced by obsessions. This can result in developing substance use disorders. 

Repetitive behaviors, whether they are prolonged substance use or compulsions to counteract OCD obsessions, can produce brain changes. These may predispose you to using drugs or engaging in rituals that become habits.

Substance misuse can precipitate symptoms of OCD, while OCD may predispose you to be more vulnerable to misusing drugs or alcohol. 

This feedback loop requires careful professional assessment and targeted interventions to address both conditions simultaneously. Recovery from OCD while misusing substances is rarely successful when symptoms are treated independently.

See if your behavior fits OCD and addiction with this quiz. 

OCD and Substance Misuse Statistics

Obsessive compulsive disorder (OCD) and substance use disorders often happen at the same time, creating unique challenges in diagnosis and treatment.

Understanding the statistics behind this connection highlights this common overlap and why integrated care is so important.

• 1% to 3% of Americans are affected by OCD.
• OCD is the fourth most common mental disorder worldwide.
• In 70% of dual diagnoses of OCD and addiction, OCD symptoms appeared first. 
• Only 19.8% of individuals with OCD received treatment.
• 90% of individuals diagnosed with OCD meet the criteria for at least one other mental health disorder.
• 20.4 million Americans over 18 have a co-occurring mental health and substance use disorder.
• 13.3% of young adults (18-25) in the United States struggle with addiction and mental health disorders.
• Americans over 18 with elevated anxiety symptoms are more likely (48.9% vs. 22%) to use illicit drugs compared to those without or with minimal anxiety.
• 25.6% of adolescents (12-17) in the US with high anxiety levels use illicit drugs, compared to 10.1% with lower anxiety levels.

How many people with OCD have an addiction?

Approximately 38.6% of people in the US with an OCD diagnosis also have an addictive disorder.

• OCD and alcohol addiction co-occur in 36.7% of individuals.
• Cannabis addiction and OCD co-occur in 20% of patients.

Types of OCD and Addictions to Watch For

OCD can appear in different forms, and when combined with addiction, the patterns may intensify compulsive behaviors or fuel substance use. Recognizing the types of OCD linked to addiction can help you better understand what to look for in yourself or a loved one.

OCD and Alcohol Misuse

Individuals with OCD have an increased risk of developing an alcohol addiction. Distress caused by OCD’s symptoms may lead some individuals to try to numb or alleviate negative emotions and obsessions with alcoholic beverages.

OCD and Marijuana

Roughly 42.8% of people diagnosed with OCD have consumed cannabis, also known as marijuana or weed, in their lives seeking calm states, yet 23.3% report that weed made their anxiety symptoms worse. 

OCD and Stimulants

Some individuals use stimulants for more energy to engage in time-consuming compulsive rituals. Stimulants that might be used include prescription Ritalin or Adderall or illegal methamphetamines.

Beyond the risk of developing an addiction to them, stimulants also make symptoms worse and are associated with more severe OCD cases.

OCD and Prescription Drug Misuse

Misusing prescription drugs occurs in 13.8 million Americans. Individuals with OCD may misuse medications as part of the rituals that help them achieve a desired mental state.

Signs You or Someone You Know Struggles with OCD and Addiction

OCD and addiction can share overlapping behaviors that are difficult to recognize at first. Learning the common signs can help you identify when professional support may be needed for yourself or someone close to you.

Behavioral Signs 

OCD

• Difficult to control repetitive behaviors
• Continued compulsive behaviors despite knowing they are excessive
• Tics or other repetitive movements

Addiction

• Unable to reduce use of the substance
• More of the drug is required to feel similar effects
• Use causes a wide range of personal, social and physical problems, such as:
  • Neglected hygiene
  • Disrupted daily schedules
  • Relationship problems
  • Declining responsibilities
  • Emotional and behavioral changes
  • Legal and financial issues
  • Health and safety neglect

Emotional Signs

OCD

• Obsessions trigger distress
• Compulsions provide only temporary relief from anxieties 

Addiction

• Cravings and urges for the substance cause negative mental and emotional states
• Withdrawal symptoms such as depression, anxiety, irritability and anger 

Functional Symptoms

OCD

• Compulsions taking more than 15 to 30 minutes daily
• Rituals affect responsibilities and cause personal issues, such as poor time management, self care neglect, occupational or academic challenges and more

Addiction

• Substance use affects social obligations, work and school 
• Increasing amounts of time seeking, using or recovering from drugs
• Abandoning long life interests

If you are struggling with OCD and addiction, you may be reluctant to disclose your symptoms to others, a healthcare provider or a mental health professional. Call 800-996-6135(Sponsored) today to speak with someone who can help.

Short-Term and Long-Term Effects of OCD and Addiction

Potential consequences of OCD and substance misuse include:

Short Term Effects of OCD and Addiction

• Relationship problems
• Poor work and school performance
• Erratic behavior 
• Negative emotional state
• Poor self-care
• Avoid social situations

Long Term Effects of OCD and Addiction

• Risk of depression and other mental health disorders
• Poor social functioning
• Divorce
• Unemployment
• Financial hardships
• Isolation
• Hospitalization 
• Overdose 
• Elevated suicide risk

Causes and Risk Factors

Mental health disorders are often triggered by the interplay of genetic tendencies, environmental conditions and personal experiences. 

Risk factors can include:

• Genetics 
  • Twin studies reveal a nearly 4 times elevated risk of developing a substance use disorder in people diagnosed with OCD that may be related to genetic predispositions.
• Brain Chemistry 
  • Serotonin level abnormalities have been found in people with OCD and addictive disorders that could fuel compulsive habits.
  • Seeking refuge in substances can lead to brain changes that promote compulsive behavior.
• Trauma
  • The trauma and OCD addiction link is being actively investigated. Brain regions that regulate behavior may be altered, resulting in intrusive thoughts and urges, which are common in PTSD, OCD and addiction.
  • More studies are needed to establish a causal relationship.
• Impulsivity 
  • OCD and addiction can trigger impulsivity that may lead to compulsive behaviors. Difficulties sustaining attention and managing self-control may indicate neurological tendencies toward impulsivity that increase the risk of developing OCD and addiction.
• Stress Biology
  • Stress can trigger intrusive thoughts leading to relapse or engagement in ritualistic behaviors to relieve uncomfortable emotions. 

Treatment for OCD and Addiction

Treatment for co-occurring OCD and addiction is more effective when both disorders are addressed simultaneously as part of a comprehensive program.

Step 1: Detox Treatment

Detox for addiction when you also have OCD is commonly the first stage of recovery. Substances like benzos, opioids and alcohol can produce physical and psychological dependence.

When you stop taking them, medical monitoring as part of a comprehensive Medication Assisted Treatment (MAT) provides evidence-based withdrawal support to manage symptoms (such as cravings) while keeping you safe and comfortable.

Dual diagnosis detox can be fundamental for setting the next stage of treatment. Safely quitting may be a major key to addressing OCD symptoms, which are often made worse by substance misuse. Continuous use of substances can prove dangerous when treating OCD with common antidepressants. 

Step 2: Inpatient Treatment

Dual diagnosis inpatient programs may follow crisis stabilization in detox.

Residential OCD treatment centers offer co-occurring disorder treatment can help you rebuild your life by:

• Providing a distraction-free and quiet environment where healing is the only goal
• Delivering a tailored pharmacological program
• Avoiding OCD and addiction symptom triggers 
• Accessing evidence-based therapies
• Engaging with peers battling the same fight

Step 3: Outpatient Treatment

Dual diagnosis outpatient rehab offers flexible recovery options that may meet your needs without hospitalization.

These programs include:

• Medication management
• Peer support groups
• Individual and family therapy
• OCD and addiction management skills building workshops 

OCD outpatient treatment is fundamental when you transition from residential treatment. Stress and personal challenges can trigger compulsions or may lead to relapse, so long-term support and accountability offer you the best chance of sustainable recovery.

Step 4: Medication Therapies

OCD and addiction are conditions that influence how your brain works. Medications can help address neurological and brain chemistry changes and may reduce obsessions, compulsions, cravings and withdrawal symptoms.

The best medications for OCD and substance misuse will depend on your symptoms, underlying conditions and type of substance use.

Anafranil (Clomipramine) is a tricyclic antidepressant approved for managing OCD symptoms. Selective serotonin reuptake inhibitors (SSRIs) are effective for managing dual diagnosis with fewer side effects, but are ineffective for alcohol abuse as they increase the risk of increased alcohol consumption. 

There are approved medications for managing addictive disorders that may be prescribed, including:

• Naltrexone: Managing opioid and alcohol use disorders
• Methadone: Managing opioid addiction
• Suboxone: Reduce withdrawal symptoms and cravings for opioid use disorders
• Campral: Reduce alcohol cravings and restore brain chemical balance 

Step 5: Behavioral Therapies

Behavioral therapies are critical components of successful dual diagnosis treatment as they can address the underlying reasons for compulsive and addictive disorders.

OCD and addiction therapy options include:

• Cognitive Behavioral Therapy (CBT): CBT is a highly effective intervention helping reframe obsessive thoughts that may fuel compulsions and addictive behaviors.
• Exposure and Response Prevention (ERP): Exposure therapy is a form of CBT that helps you gradually confront fears that trigger compulsive behaviors.
• Dialectical Behavior Therapy (DBT): A structured form of CBT teaching skills for emotional regulation, distress tolerance, mindfulness and improving relationships.
• Acceptance and Commitment Therapy (ACT): Teaches psychological flexibility to deal with thoughts, emotions and circumstances contributing to OCD and substance abuse.
• Mindfulness: Practices that increase your awareness of internal and external environments to improve healthy responses.

At Home & Self Help Strategies

OCD and addiction challenges are best addressed with professional help. However, some at-home practices can complement professional treatment, including: 

• Journaling is a safe way to reflect, track progress and understand triggers
• Mindfulness helps you deal better with stress
• Reduce alcohol and caffeine as they aggravate OCD symptoms
• Join support groups to access relapse prevention support

Dual Diagnosis Treatment Centers

Dual diagnosis treatment centers for OCD provide specialized treatment to manage co-occurring substance use disorders and mental health conditions like obsessive compulsive disorder. Integrated care is crucial to achieving recovery.

A dual treatment program can address common challenges such as:

• Stigma: OCD and addiction are often misunderstood as quirks (OCD) or immorality (addiction). Facilities offer unwavering support.
• Shame: People may hide their symptoms from close ones or even general practitioners. Specialized programs provide empathetic help.
• Underdiagnosis: Symptoms from one diagnosis may overshadow the other. This can lead to not addressing root causes. 
• Misdiagnosis: Insufficient experience in both disorders may result in an incorrect diagnosis and poor treatment. 

Look for centers with specialists in dual disorders. Ask about: 

1. Their expertise in managing OCD and substance misuse
2. Types of behavioral therapies they use
3. Medication management capabilities

When to Seek Help for OCD and Addiction

If your intrusive thoughts, rituals or substance use are affecting your capacity to be productive, straining your relationships or eliciting negative emotions, these can be warning signs suggesting it’s time to seek help.

Take the OCD & Addiction Quiz and get instant results so you can act today.

FAQs About OCD and Addiction

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