Anxiety Disorders & Substance Use Disorder | Symptoms, Risks, & Treatment

Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS

on July 27, 2023

Numerous people live with anxiety disorders, such as generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder. Some try to self-medicate their symptoms with drugs. This behavior often leads to substance use disorder (drug addiction), which can be treated with a dual diagnosis treatment program.

Anxiety disorders are the most common mental health disorders, affecting almost 30% of adults. 

These conditions cause a significant amount of anxiety that disrupts daily life. When left untreated, they often lead to substance abuse and substance use disorder (SUD/drug addiction). 

People with co-occurring anxiety and addiction can recover at dual diagnosis treatment programs

Co-Occurring Anxiety Disorders & Substance Use Disorder

Substance use disorder may co-occur with many different types of anxiety disorders. The most common types include:

  • generalized anxiety disorder (GAD), which causes excessive anxiety about everyday situations
  • panic disorder, which causes frequent panic attacks (episodes of intense fear and distressing physical sensations) 
  • social anxiety disorder (also called social phobia), which causes excessive anxiety about social situations
  • selective mutism, which prevents a person from speaking in certain situations
  • separation anxiety disorder, which causes excessive anxiety when a person is away from their loved ones
  • phobias, such as agoraphobia (fear of public spaces), claustrophobia (fear of confined spaces), and acrophobia (fear of flying)
  • obsessive-compulsive disorder (OCD), which causes unwanted, distressing thoughts (obsessions) that lead to unwanted, repetitive actions (compulsions)
  • post-traumatic stress disorder (PTSD), which causes stressful symptoms (such as anxiety, nightmares, and flashbacks) after a traumatic experience 

To self-medicate these disorders, some people misuse drugs. That means they use drugs in a way that harms their health. 

For example, they might drink too much alcohol, use illegal drugs, or use prescription medications in a manner not prescribed. The most commonly misused drugs among people with anxiety disorders include:

  • alcohol
  • marijuana
  • benzodiazepines, such as alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan)
  • prescription opioids, such as oxycodone (OxyContin), hydrocodone (Vicodin), and codeine
  • prescription stimulants, such as amphetamine (Adderall), dextroamphetamine (Dexedrine), and methylphenidate (Ritalin)
  • heroin
  • cocaine
  • methamphetamine

Misusing any of these drugs can lead to substance use disorder. This disease makes you feel unable to stop using drugs. When left untreated, it poses serious health risks, including fatal overdose.

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Symptoms Of Co-occurring Anxiety & Substance Use Disorders

The most common symptoms of anxiety disorders include:

  • fear and panic
  • ruminating (constantly thinking about something that makes you anxious and feeling unable to stop)
  • trouble concentrating 
  • trouble sleeping
  • nausea
  • dizziness
  • muscle tension
  • faster breathing or shortness of breath
  • increased heart rate
  • sweating
  • shaking

The most common symptoms of substance use disorder include:

  • frequent drug cravings
  • tolerance (needing increasingly larger or more frequent amounts of a drug to feel the desired effects)
  • physical dependence (experiencing unpleasant withdrawal symptoms when you don’t use drugs)
  • loss of interest in activities once enjoyed
  • loss of motivation
  • avoidance of family members and friends
  • decline in personal hygiene
  • mood swings
  • trouble concentrating 

Risk Factors For Co-Occurring Anxiety & Substance Use Disorders

Certain risk factors make you more likely to develop a co-occurring anxiety disorder and substance use disorder. These factors include:


Some people are genetically predisposed to anxiety disorders and substance use disorder. If you have a family history of these conditions, you face a higher risk of developing them yourself. 


After you experience a traumatic event (such as war, assault, or a natural disaster), you may develop an anxiety disorder. You might also misuse drugs to self-medicate your anxiety surrounding the trauma, which can lead to addiction.

Early Drug Use

Using drugs at an early age can disrupt brain development, increasing the risk of both anxiety disorders and addiction. 

Peer Pressure

If you have an anxiety disorder, someone in your life might pressure you to try easing your symptoms with drugs. This type of peer pressure often leads to addiction.

Anxiety & Addiction Dual Diagnosis Treatment Options 

If you or someone you love shows signs of a co-occurring anxiety disorder and substance use disorder, seek help at a dual diagnosis treatment program. These programs offer evidence-based treatments for addiction and co-occurring disorders. 

Some dual diagnosis treatment programs are inpatient, meaning you live at the treatment center. Others are outpatient, meaning you live at home and regularly visit the treatment center. 

In general, inpatient care is recommended for people with moderate-to-severe disorders, while outpatient care may work for people with milder disorders and strong support systems at home.

Whether you choose inpatient or outpatient care, you will receive a personalized treatment plan. Depending on your needs, this plan may include services such as:

Medical Detox

During medical detox, doctors monitor your mental and physical health as they help you get drugs out of your system. They may also prescribe medications to ease certain withdrawal symptoms.


In therapy, a mental health professional can teach you healthy ways to cope with your anxiety, such as journaling, exercising, and meditating. Your therapist can also help you manage drug cravings and other psychological symptoms of addiction. 

Some of the most effective types of therapy for anxiety and addiction include:

  • cognitive behavioral therapy (CBT), which can help you change unhelpful beliefs and behaviors
  • exposure therapy, which can help you slowly and safely face your fears so you become less sensitive to them
  • family therapy, which can help you and your loved ones resolve conflicts and support your long-term recovery


Some people with anxiety disorders benefit from medications, especially antidepressants (such as selective serotonin reuptake inhibitors, or SSRIs) and anti-anxiety medications. 

Also, if you have an addiction to alcohol or opioids, your treatment team can prescribe medications to ease your cravings and withdrawal symptoms.

Support Groups

In a support group, you get the chance to share your experiences with other people recovering from anxiety disorders and addiction. Your fellow group members can give you important coping tips and help you feel less alone. 

Aftercare Planning

Before you leave your treatment program, your doctors can help you create a personalized aftercare plan. This plan will include strategies to reduce your risk of relapse, such as:

  • ongoing therapy
  • regular exercise
  • assistance with education, employment, or housing

To learn more about treatment for anxiety disorders and addiction, please reach out to Ohio Recovery Center. Our board-certified healthcare providers offer comprehensive, inpatient care to help you or your loved one build a fulfilling life.

  1. American Psychiatric Association — What are Anxiety Disorders?
  2. Harvard Review of Psychiatry — Treatment of Co-occurring Anxiety Disorders and Substance Use Disorders
  3. National Institute of Mental Health — Anxiety Disorders
  4. Social Work in Public Health — Substance Use Disorders and Anxiety: A Treatment Challenge for Social Workers

Written by Ohio Recovery Center Editorial Team

© 2024 Ohio Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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