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Anxiety Disorders and Drug Addiction

About 18% of the U.S. population suffers from some form of anxiety disorder.1 Those who do are about 2 to 3 times as likely to have problems with addiction as those who don’t have anxiety.2 When a person has both a mental health and a substance disorder, this is known as a dual diagnosis. Treatment can address both conditions.

Substance Abuse and Anxiety

Woman laying in bed looking anxiousEveryone experiences stress and anxiety. Yet while most people might experience anxiety every now and then in a fleeting way, for a person with an anxiety disorder, the anxiety can be unrelated to any specific situation. Or it may be seriously out of proportion to the situation at hand. A serious anxiety issue affects your ability to function in your daily life.

Some people with anxiety have a dual diagnosis, which means they have both a mental illness, such as anxiety, as well as a substance abuse disorder. In these cases, it can be hard to tell which came first: the anxiety disorder or the substance abuse disorder. Some people with anxiety may use drugs or alcohol to self-medicate or better manage their symptoms.

Comorbidity is common with anxiety and substance abuse, meaning that the 2 conditions are often found together in people. About 20% of people with anxiety or a mood disorder have an issue with substance abuse, just as about 20% of those with a substance abuse disorder suffer from anxiety or a mood disorder.2

Risk Factors

Even though anxiety and substance abuse are separate disorders, they carry shared risk factors, such as:

Symptoms

There are numerous forms of anxiety disorders, with slightly varying symptoms. The symptoms of generalized anxiety disorder (GAD) include:4

Panic disorder includes symptoms such as:4

People with social anxiety have symptoms such as:4

A number of symptoms are associated with addiction to drugs and alcohol. A person can be diagnosed with a substance abuse disorder if they show at least 2 of these symptoms at any point in the past 12 months:5

Anxiety After Drug Use

At times, a person may experience panic attacks or general anxiety during or after drug use. The Diagnostic and Statistical Manual of Mental Disorders explains that a person can be given a diagnosis of substance-induced anxiety disorder if the anxiety develops during or soon after intoxication and leads to impairment in social or occupational functioning.5

woman holding chest looking hurt, concept of withdrawalDrugs that can cause substance-induced anxiety disorder include alcohol, PCP (phencyclidine), hallucinogens, inhalants, and stimulants.5

Other drugs can cause anxiety when the person stops taking them and experiences withdrawal. This type of anxiety usually occurs with drugs that suppress the central nervous system and reduce anxiety, including benzodiazepines, alcohol, and opioids.

Symptoms of drug-induced anxiety from withdrawal can include:

Marijuana decreases anxiety in some people. However, others may actually experience increased anxiety, especially when they use marijuana in higher doses. Many individual, environmental, and genetic factors can lead to marijuana-induced anxiety. Women, those who seldom use marijuana, and those with preexisting anxiety disorders are more vulnerable to marijuana-induced anxiety than others.7

Treatment

When a person has both a mental illness such as anxiety and a substance use disorder, both conditions need to be treated.14 A person who only completes drug rehab and does not receive treatment for anxiety is more likely to experience medical problems, suicide, or early death.15

In addition to living a healthy lifestyle, which includes a healthy diet, exercise, and good nutrition, medication can be an option to treat both conditions. But the person is likely to have a better outcome if treatment combines the meds with therapy.16

Medications

Anxiety disorders are frequently treated with antidepressant medication. Commonly used antidepressants include both SSRIs (selective serotonin reuptake inhibitors) and SNRIs (selective norepinephrine inhibitors). For short-term anxiety management, some people may be prescribed benzodiazepines, which include such drugs as Xanax and Valium. However, the risk of addiction makes these drugs less than desirable for people with a history of drug abuse.8

Disulfiram (Antabuse) and acamprosate (Campral) can be used to treat alcoholism. These drugs cause an unpleasant reaction when someone drinks and reduce withdrawal symptoms, respectively. Naltrexone, a drug designed to treat opioid addiction, may also work in treating alcohol addiction.9

There are several medication-assisted treatment drugs for people with opioid dependence. As in treatment for alcohol dependence, naltrexone may be used to block some of the rewarding effects of opioids, thereby discouraging continued use. Other drugs, such as methadone and buprenorphine, help to stop the cravings and withdrawal symptoms associated with quitting opioids, making them beneficial during detox as well as maintenance therapy.9

Therapies

Numerous therapies help treat anxiety and addiction. The most common treatments for addiction are:

CBT is the most common treatment for anxiety disorders. For disorders such as social anxiety or panic disorders, most patients receive 12 to 16 sessions over a 3- to 4-month period. However, anxiety disorders tend to be chronic. Recurrence is common, even after treatment. Some people need a longer course of treatment, which can last up to 50 sessions or over a year.8

Recovery Programs

Recovery programs are widely available. Forms of treatment include:

Such programs are sometimes the first stage of treatment. At other times, people will attend IOP or PHP as a step down from a more intense form of treatment, such as inpatient treatment. The intensity of services depends upon individual needs.

Other types of programs, which may be integrated into inpatient or outpatient programs or used as follow-up care to treatment, include:

If you or a loved one is struggling with anxiety and addiction, don’t wait to seek help. Call our helpline today to talk to a treatment referral specialist about the best options for recovery.

Sources

  1. Anxiety and Depression Association of America. (2017). Facts and Statistics.
  2. Anxiety and Depression Association of America. (2016). Substance Use Disorders.
  3. National Institute on Drug Abuse. (2011). Comorbidity: Addiction and Other Mental Disorders.
  4. National Institute of Mental Health. (2016). Anxiety Disorders.
  5. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Arlington, VA: American Psychiatric Association Publishing.
  6. Substance Abuse and Mental Health Services Administration. (2005) Substance Abuse Treatment for Persons with Co-Occurring Disorders.
  7. University of Washington. (2017). Effects of Marijuana on Mental Health: Anxiety Disorders.
  8. University of Maryland Medical Center. (2017). Anxiety Disorders.
  9. National Institute on Drug Abuse. (2016). Treatment Approaches for Drug Addiction.
  10. National Institute on Drug Abuse. (2012). Matrix Model.
  11. Anxiety and Depression Association of America. (2016). Therapy.
  12. University of Michigan. (N.D.) Relaxation Skills for Anxiety.
  13. National Institute on Drug Abuse. (2017). Commonly Abused Drugs Charts.
  14. National Institute on Drug Abuse. (2018). Principles of Effective Treatment.
  15. Substance Abuse and Mental Health Services Administration. (2016). Co-Occurring Disorders.
  16. National Institute on Drug Abuse. (2014). Treatment and Recovery.