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OCD and Addiction: Signs, Symptoms, and Treatment Centers in Maryland
Obsessive-compulsive disorder (OCD) and substance use disorder are two challenging mental health conditions to overcome. When they occur together, which is known as dual diagnosis, it can complicate both diagnosis and treatment.
Treating OCD and addiction requires a comprehensive approach that addresses both conditions simultaneously. The Freedom Center approaches dual diagnosis with OCD and substance use disorder with an evidence-based approach that supports wellness and positive treatment outcomes.
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Key Points
- OCD and substance use disorder frequently co-occur, creating a dual diagnosis that requires integrated treatment.
- Substance use may be used to self-medicate OCD symptoms, but it often worsens the condition and leads to substance use disorder.
- Effective treatment of OCD and addiction includes a combination of therapy, support, and medication for both disorders.
What Is OCD?
Obsessive-compulsive disorder (OCD) is a chronic anxiety disorder that’s characterized by uncontrollable, recurring thoughts (obsessions) and behaviors (compulsions) that an individual feels compelled to perform. OCD affects an estimated 1.2% of U.S. adults, typically more females than males.[1]
Some common obsessions include:[2]
- Fear of contamination or germs
- Intrusive thoughts
- Need for symmetry or exactness
- Excessive concern with morality or making a mistake
Some common compulsions include:
- Excessive cleaning or hand washing
- Repeated checking of locks, appliances, or other items
- Counting or repeating actions
- Performing mental rituals like prayers or phrases
OCD can be highly distressing and time-consuming. It often interferes with relationships, daily routines, work, and well-being.
Addiction and OCD
OCD and addiction may seem unrelated, but overlapping traits exist between the two. OCD is driven by anxiety, and addiction is driven by reward-seeking behavior, but compulsion is common to both conditions.
There are additional factors that link these co-occurring disorders. Both conditions have been linked to genetics. Studies indicate that having a first-degree relative with OCD or a substance use disorder increases the risk of developing either condition.[3]
Impulsivity is another shared trait. Though compulsions mark OCD, studies show that people with OCD report higher levels of impulsivity.[4] Impulsivity is both a risk factor for developing an addiction and a consequence of chronic substance use, which affects the brain’s regions responsible for impulse control and decision-making.[5]
Some studies suggest that trauma can influence both OCD and addiction. Experiencing trauma can increase the likelihood of developing an addiction and may affect the onset of OCD.[6,7]
According to the Journal of Anxiety Disorders, of 323 adults with OCD, 27% met the criteria for substance use disorder.[8] Of the disorders that co-occur with OCD, alcohol use disorder is most common, followed by co-occurring OCD and drug abuse.
People with OCD may use substances to self-medicate their symptoms, quiet obsessive thoughts, or numb anxiety, leading to temporary relief.
Unfortunately, substance use often worsens OCD symptoms over time. What starts as a coping mechanism can quickly devolve into a dangerous cycle of addiction and poor mental health.
Challenges of Treating OCD and Substance Use Disorder
Treating co-occurring OCD and substance use disorder requires a comprehensive approach. Each condition can mask or worsen the symptoms of the other, making an accurate diagnosis difficult.
For example, it’s common for compulsive behaviors to be misinterpreted as addiction-related or vice versa. We often see people who are addicted to drugs show various signs of compulsion, especially drug-seeking behaviors. The anxiety associated with OCD can also trigger cravings for substances, while withdrawal can intensify obsessive thoughts and compulsions.
Given these challenges, an integrated dual diagnosis OCD treatment center is an integral part of long-term recovery.
Signs and Symptoms of OCD and Substance Use Disorder
One of the first steps toward recovery is recognizing the signs of dual diagnosis. The symptoms can vary based on the substance involved and the severity of OCD, but may include:[9]
- Repeated rituals
- Isolation and avoidance of responsibility
- Escalating use of substances to manage symptoms
- Conflicts at home or work because of mental health and substance use issues
- Increased anxiety, guilt, or fear of harm
- Intense cravings and obsessive thoughts about substance use
- Mood swings, depression, or emotional numbness
- Cognitive confusion or memory issues caused by either disorder
What Is Substance-Induced OCD?
Substance-induced obsessive-compulsive disorder (OCD) is a type of OCD that is developed as a direct result of drug or alcohol use, the withdrawal process, or exposure to medication.[10] This type of OCD is present without any other attributable cause for the condition, such as preexisting OCD, and it wasn’t present before drug or alcohol use began.
The presence of substance-induced OCD can make it challenging to diagnose co-occurring OCD and addiction because many of the symptoms can overlap. Identifying the onset of symptoms and determining whether the compulsive behaviors existed before substance use, emerged during substance use, or resulted from substance withdrawal is crucial to distinguishing between OCD and substance-induced OCD.
Dual Diagnosis Treatment for OCD and Substance Use Disorder
OCD and substance use disorder treatment can present unique challenges, but recovery is possible. Dual diagnosis treatment programs offer support and structure to address both OCD and addiction simultaneously. Clients may begin in medical detox to manage the symptoms of withdrawal and any worsening mental symptoms that arise during withdrawal. Once stabilized, clients may enter an inpatient or residential treatment program, a partial hospitalization program (PHP), an intensive outpatient program (IOP), or an outpatient treatment program, depending on the level of care and support they require.
Regardless of treatment level, dual diagnosis treatment for OCD and addiction is individualized at the recovery center and may include:
- Individual therapy: This provides personalized, one-on-one counseling to address mental health challenges, distressing thoughts or behaviors, or other difficulties.
- Group therapy: This promotes a sense of community among people in recovery through shared experiences, advice, and support strategies.
- Family therapy: This brings the family and their loved one together to learn healthy communication, uncover and resolve past pain or conflict, and create a positive environment for recovery.
- Cognitive behavioral therapy (CBT): This type of therapy focuses on identifying and changing unhelpful thought patterns and behaviors.
- Dialectical behavior therapy (DBT) is a type of behavioral therapy that helps individuals learn to regulate their emotional responses and break unhealthy patterns of behavior.
Related Treatments
We Accept With Most Major Insurance
If you or a loved one is ready to get help but finances are holding you back, give us a call. We can work with your health insurance provider.
Related Treatments
We Accept With Most Major Insurance
If you or a loved one is ready to get help but finances are holding you back, give us a call. We can work with your health insurance provider.
Seeking Help and Freedom
People with OCD and addiction can get treatment at any time. Generally speaking, the earlier the better because this helps reduce the risk of severe symptoms or complications. The Freedom Center in Gaithersburg, MD, is prepared to help you with experienced therapists, mental health professionals, and addiction specialists.
Our dual diagnosis program can provide the kind of treatment team you need to overcome this assault on your physical and mental health. Our mental health professionals are experienced in several types of behavioral therapy, family therapy, and of course, individual talk therapy.
In addition, Freedom Center has four levels of care, from residential to a standard outpatient program. You can enter at the level appropriate for your needs and step down or up as your needs require. Free yourself from the hold of OCD. Contact us today.
Editorial Guidelines at The Freedom Center
All content produced by The Freedom Center undergoes a detailed evaluation process to ensure accuracy and quality. We only work with medical professionals and individuals with extensive experience in the field, and all content produced undergoes a review process to ensure accuracy. Our goal is to be a reliable resource the recovery community can turn to for information they can trust.
Frequently Asked Questions About OCD and Addiction
Powder cocaine is a hydrochloride salt that’s usually snorted or dissolved and injected.
Crack cocaine is a crystalized form that’s smoked. Crack produces a faster, more intense high, but also wears off quickly, leading to more frequent use. [11]
Both forms are highly addictive, but crack is often associated with a quicker path to dependence due to how rapidly it enters the bloodstream and affects the brain.
Finishing rehab doesn’t mean the journey ends.
At The Freedom Center, the team will help each person develop a personalized recovery plan that lasts. That might include alumni support, sober living connections, and continued therapy.
The goal is that everyone leaves with a roadmap—and a support system—to stay sober and thrive in real life after their time at The Freedom Center.
While OCD itself doesn’t cause addiction, individuals with OCD may use drugs or alcohol as a way to cope with obsessive thoughts or anxiety. Over time, using substances to self-medicate can lead to dependence, meaning the body adapts to the substance and begins to require it to function normally. The symptoms of OCD may worsen over time, leading to more frequent substance use.
Sources
https://www.psychdb.com/ocd/z-substance-medication[1] U.S. Department of Health and Human Services. (n.d.). Obsessive-compulsive disorder (OCD). National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd on 2025, April 21.
[2] What is are obsessive-compulsive and related disorders?. Psychiatry.org – What Is are Obsessive-Compulsive and Related Disorders? (n.d.). Retrieved from https://www.psychiatry.org/patients-families/obsessive-compulsive-disorder/what-is-obsessive-compulsive-disorder on 2025, April 21.
[3] Virtanen, S., Kuja-Halkola, R., Sidorchuk, A., Fernández de la Cruz, L., Rück, C., Lundström, S., Suvisaari, J., Larsson, H., Lichtenstein, P., Mataix-Cols, D., & Latvala, A. (2022, June 1). Association of obsessive-compulsive disorder and obsessive-compulsive symptoms with substance misuse in 2 longitudinal cohorts in Sweden. JAMA network open. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC9171556/ on 2025, April 21.
[4] Frydman, I. (2019, December 16). Self-reported and neurocognitive impulsivity in obsessive-compulsive disorder. Comprehensive Psychiatry. Retrieved from https://www.sciencedirect.com/science/article/pii/S0010440X19300781#:~:text=Despite%20not%20differing%20from%20healthy%20controls%20in%20any%20neurocognitive%20impulsivity%20domain%2C%20OCD%20patients%20demonstrated%20increased%20impulsivity%20in%20a%20self%2Dreport%20measure%20(particularly%20attentional%20impulsivity) on 2025, April 21.
[5] Kozak, K., Lucatch, A. M., Lowe, D. J. E., Balodis, I. M., MacKillop, J., & George, T. P. (2019, September). The Neurobiology of Impulsivity and Substance Use Disorders: Implications for treatment. Annals of the New York Academy of Sciences. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6450787/ on 2025, April 21.
[6] Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010, December). Substance use, childhood traumatic experience, and posttraumatic stress disorder in an urban civilian population. Depression and anxiety. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC3051362/ on 2025, April 21.
[7] Murayama, K., Nakao, T., Ohno, A., Tsuruta, S., Tomiyama, H., Hasuzawa, S., Mizobe, T., Kato, K., & Kanba, S. (2025, May 23). Impacts of stressful life events and traumatic experiences on onset of obsessive-compulsive disorder. Frontiers. Retrieved from https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2020.561266/full on 2025, April 21.
[8] Mancebo, M. C., Grant, J. E., Pinto, A., Eisen, J. L., & Rasmussen, S. A. (2009, May). Substance use disorders in an obsessive compulsive disorder clinical sample. Journal of anxiety disorders. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC2705178/ on 2025, April 21.
[9] Co-occurring OCD and substance use disorder: What the research tells Us. International OCD Foundation. (2017, December 7). Retrieved from https://iocdf.org/expert-opinions/co-occurring-ocd-and-substance-use-disorder-what-the-research-tells-us/ on 2025, April 21.
[10] PsychDB. (2022, February 3). Substance/medication-induced obsessive-compulsive and related disorder. Retrieved from https://www.psychdb.com/ocd/z-substance-medication on 2025, April 21.
