Substance Use Disorder (SUD) and OCD

By Dr. Patrick McGrath

It is not uncommon for someone with Obsessive-Compulsive Disorder(OCD) to learn through experimentation that certain substances can help to calm the OCD mind. Over time, it is not uncommon to become addicted to these substances due to the fact that they have been used so often to help to mitigate the OCD. Therefore, over time, the substance use becomes a problem in its own right, and its help in alleviating OCD diminishes over time as well.

It can be difficult for individuals with co-occurring OCD and SUD to find treatment. Many therapists avoid working with individuals who suffer from both OCD and SUD due to not specializing in one, the other, or both. A therapist who does specialize in one disorder often to do not have the clinical expertise to treat the co-occurring disorder. This obstacle can lead to the co-occurring disorder going undiagnosed and untreated causing significant interference in therapy.

State-Dependent Learning is a psychological phenomenon that can contribute to an individual with OCD not improving despite the fact that they are in specialized care. This phenomenon occurs if prior to going to see their therapist they take a substance to calm their anxiety and then engage in ERP. When the individual only engages in ERP while on a substance, it can lead to the belief that treatment is only effective while under the influence of the substance.

In a similar aspect, when an individual with SUD does not effectively treat their OCD while receiving treatment for substance use then OCD can remain hidden and be an ongoing stressor in the person’s life.

It takes a great deal of bravery and commitment to overcome one of these disorders singularly, but it can be much more difficult to address them both. Therefore, if you are struggling with OCD and SUD you need to be sure to inform your therapist of both issues. If you work with a provider who specializes in one but not the other, it is recommended to find a specialist for the other as well. Do not suffer in silence and feel that your case is hopeless. Many individuals with co-occurring disorders have been treated successfully and are functioning in a higher quality lifestyle not consumed by OCD and SUD

Please reach out for help and let someone give you the assistance that you need in order to start on your journey of recovery.

Videos: Substance Use Disorder (SUD)

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