Obsessive Compulsive Disorder and Substance Abuse

Many people in America suffer from mental illness and a drug or alcohol addiction that co-occur. These types of disorders often mask one another and can be hard to diagnose and treat.


Obsessive Compulsive Disorder (OCD) is an anxiety disorder that affects 3.3 million Americans. (1) The disorder causes the sufferer to feel an overwhelming lack of control in their life. They have obsessive thoughts of things like contamination, self harm, or aggression. These thoughts and worries cause the person to perform rituals, or compulsions, such as excessive hand washing, counting, repeating, checking, arranging, and hoarding. Our society has made light of this condition in recent years with tv shows or jokes, but to someone who really suffers from OCD, the disease makes their life like a prison.

Self-Medicating with Drugs or Alcohol

As if having an anxiety disorder like OCD is not enough, many of these people also have a problem with substance abuse. Sometimes they take drugs or drink alcohol to self-medicate and escape their obsessing for a while. Because a person with OCD has compulsive tendencies naturally, this often easily carries over into drug and alcohol abuse, which leads to addiction very quickly. One study reported that 12% of people in a clinical population with OCD had a lifetime history of alcoholism. In a test where 50 patients with a diagnosis of alcohol dependence or abuse were screened it was found that 6% had OCD — 3 times the lifetime prevalence of OCD in the general population. (2) However, many people with OCD recognize that they have a problem, and are ashamed of it and the fact that they are using substances to feel better, therefore they are very good at keeping both the disorder and addiction a secret from others.

Treating Dual Diagnosis

When a person is diagnosed with both a mental health disorder and a substance abuse disorder it is called dual diagnosis. In order to treat someone with a dual diagnosis, it is important to first of all identify all that is going on with the patient, and then treat both disorders at the same time. There are still relatively few treatment centers that treat dual diagnosis effectively, but it is slowly becoming more understood. It used to be that patients would have to jump from the drug rehab center to the mental health clinic, without any coordination of services occurring between doctors. Today, the best place for someone with a dual diagnosis is a facility that is equipped to treat both disorders. Detox is necessary for the substance abuse, and therapy and sometimes medication is needed for both of the disorders.

The road to recovery for a patient with dual diagnosis may be long and difficult, but getting help early is effective, and getting help at a qualified facility is the best way to recover.

Unsure where to start? Take Our Substance Abuse Self-Assessment

Take our free, 5-minute substance abuse self-assessment below if you think you or someone you love might be struggling with substance abuse. This evaluation consists of 11 yes or no questions that are designed to be used as an informational tool to assess the severity and probability of a substance use disorder. The test is free, confidential, and no personal information is needed to receive the result. Please be aware that this evaluation is not a substitute for advice from a medical doctor.