Treating all co-occurring mental health conditions simultaneously in a coordinated way makes addiction treatment most effective. When someone has both obsessive-compulsive disorder (OCD) and addiction, addressing both leads to lasting healing.
A study reported in the Journal of Anxiety Disorders found that 27% of people with OCD had a substance use disorder and could benefit from both OCD and addiction treatment. About 70% of the people with both conditions reported that their OCD came first. As is the case with other mental health conditions, sometimes people turn to drugs or alcohol to manage their condition’s symptoms. Drugs and alcohol can provide temporary relief, but can also cause their own significant problems.
There may be some underlying brain patterns that make both OCD and addiction more likely. The International OCD Foundations notes that in people with OCD, the front part of the brain and the deeper parts sometimes have trouble communicating. Communication relies on the neurotransmitter serotonin, and in some people with OCD, communication improves when serotonin levels become regulated.
Although the primary neurotransmitter associated with addiction seems to be dopamine, the journal Neuropharmacology reports that serotonin may also be involved. Misused drugs target the serotonin system, and serotonin receptors are involved with impulsivity, which can contribute to substance abuse and the need for addiction treatment.
Part of what a human brain needs to do is send signals that say “error” to the part of the brain that says “stop.” A University of Michigan study indicates that in obsessive-compulsive disorder, this process gets off track.
As one researcher notes, “We know that patients often have insight into their behaviors, and can detect that they’re doing something that doesn’t need to be done. But . . . the error signal probably isn’t reaching the brain network that needs to be engaged in order for them to stop doing it.” A similar process may be involved in addiction.
OCD and Addiction
Abusing drugs can make OCD symptoms worse. There’s even a type of OCD called substance/medication-induced obsessive-compulsive disorder caused by drugs. The drugs most often implicated are stimulants, like amphetamine or cocaine.
On the other hand, the drugs most likely to be abused by people with traditional OCD may be ones that depress the system and mitigate anxiety. Benzodiazepine drugs have particularly high abuse potential because they work quickly, but they also wear off quickly, so people find themselves taking them more frequently. The American Psychiatric Association reports that misuse of drugs, defined as using them in a manner different than the prescribed way for mental health treatment, accounts for more than 17% of overall use.
Suppose a person is actively using drugs and alcohol during OCD treatment. In that case, it’s difficult for their practitioner to understand the anxiety source and strength beneath the obsessions and compulsions. It’s also harder for patients to gain the full benefit from certain anxiety-relieving therapies if their anxieties are artificially and temporarily numbed by drugs or alcohol.
If you have both addiction and OCD, it probably feels scary to give up the substances you’ve been using to cope with OCD symptoms, but your therapist can help you through it. Therapies for people with OCD are likely to focus on developing healthy coping skills for managing anxiety and stress—this is especially true for people who also have a substance use disorder.
If you or someone you know is living with OCD and a substance-use disorder, The Right Step Hill Country can help.
Call us at 844.767.9965