Anxiety disorders affect 40 million American adults and if you have an anxiety disorder, you are 2-3 times more likely to have a co-occurring substance use disorder.  Anxiety disorders encompass a broad range of disorders including generalized anxiety, panic disorder, obsessive-compulsive disorder, social anxiety, and phobias.  Approximately one-third of individuals with an anxiety disorder will not seek help but may instead choose to self-medicate with alcohol or drugs.

Approximately 20% of individuals with an anxiety disorder have a co-occurring substance use disorder; however, 50% is more likely with specific anxiety problems.  Those individuals who experienced a traumatic event may have even high rates.

Many ask the question, which addiction came first.  One researcher reviews three ways in which the co-occurring disorders develop.  First, one can develop an anxiety and then start to self-medicate to reduce the symptoms of anxiety.  Another scenario is that the two disorders just happen in the same individual.  Last, an individual with a substance-use disorder might develop a co-occurring anxiety disorder because of using drugs or alcohol.  Alcoholics can experience anxiety, which is secondary to their addiction to alcohol.

Treating one disorder without effectively treating the other does not work.  Individuals may receive conflicting information on which disorder needs to be treated first; therefore, neither disorder gets addressed.  Treating both disorders at the same time is the preferred method.

One issue that arises with treating co-occurring substance use and anxiety disorders is that many medical professionals will treat the anxiety with medications such as benzodiazepines, which are highly addictive.  Due to the addictive nature of these medications, many professionals are now prescribing antidepressants, as they are not addictive and can treat anxiety as well as any underlying depression.

Treating anxiety and substance abuse now goes beyond medication.  An individual with a co-occurring substance use and anxiety disorder need professional help from individuals who are qualified to treat both issues.  Effective treatment will address the type of addiction (opioids, alcohol, cocaine) while simultaneously working on reducing the symptoms of anxiety.  Addressing both disorders with psychotherapy, 12-step groups, and educational, relapse prevention skills can work well.