The Link Between OCD and Addiction

What Is Obsessive-Compulsive Disorder (OCD)?

OCD is a mental health condition that involves obsessions—repetitive unwanted thoughts—and compulsions, which are irrational, uncontrollable urges to fulfill these unwanted obsessions.¹ 

Examples of obsessions may include upsetting thoughts or images like imagining committing violent acts, having unwanted sexual thoughts, or constantly doubting whether they’ve done something right (e.g., wondering whether they left the stove on).¹

Compulsions are repeated actions or mental acts that the person feels they must do, either to suppress obsessions or in an attempt to adhere to a rigid rule. The person engages in these compulsions to reduce anxiety or to prevent some dreaded situation; however, the actions they take are either excessive or not linked in any way to what they are trying to prevent. Examples of compulsions include repetitive behaviors (such as excessive hand-washing or checking) and repeated mental acts (like praying or counting).¹

Obsessions and compulsions are very time-consuming, taking up more than 1 hour per day, and they typically cause significant distress to the person experiencing them.¹ 

Obsessions and compulsions vary by person.¹ Some common signs and symptoms of obsessive-compulsive disorder include:²

• Fear of contamination or germs.
• Fear of forgetting or losing something.
• Strong desire to have things symmetrical or in a certain order.
• Repeated thoughts of aggression toward oneself or others.
• Excessive cleaning or handwashing.
• Excessive checking to make sure, for example, that the door is locked or the alarm is set.
• Compulsive counting.
• Repetitive praying or repeating words silently to themselves.

What Is Addiction?

Addiction—also known as substance use disorder (SUD)—is the continued use of a substance, despite it causing significant problems in a person’s life.¹ Signs and symptoms of addiction include:¹

1. Taking the substance for longer periods of time or in larger amounts than intended.
2. Strong desire to stop using the substance or repeated unsuccessful efforts to stop.
3. Spending a lot of time obtaining, using, and recovering from the effects of the substance.
4. Experiencing cravings.
5. Inability to fulfill responsibilities due to substance use.
6. Continued use of the substance despite it causing problems in the person’s interpersonal or social relationships.
7. Giving up social, recreational, or occupational activities due to substance use.
8. Using the substance in dangerous situations.
9. Continuing substance use despite knowing they have a physical or mental problem that is caused or worsened by substance use.
10. Building a tolerance to the substance, meaning they need to use more of the substance to achieve previous effects or using the previous amount does not yield the same effects.
11. Experiencing withdrawal when they discontinue or significantly reduce substance use or continuing to use the substance to avoid withdrawal.

2 or more of the above exhibited in a 12-month period may result in a positive diagnosis for SUD from a medical professional.¹   

The Link Between OCD and Addiction

It is very common for people with addictions to have co-occurring disorders.³ OCD is one such co-occurring condition; however, research findings vary widely on the percentage of people with OCD that also have a substance use disorder.⁴

Fortunately, simultaneous treatment of both conditions can be effective in helping patients with OCD and addiction recover and improve their overall wellness.⁴

Factors Linking OCD and Addiction

Various explanations exist for the co-occurrence of OCD and SUD. These may include:

• Genetics. Genetic makeup is a common link between the 2 disorders, with OCD and SUDs sharing some traits that a person experiencing both may have inherited. For instance, reports from people who have first-degree relatives (parent, siblings, children) with alcohol dependence have shown an increased risk of having OCD.⁵ Many genes may play a role in the risk for both addiction and mental disorders.⁶
• Trauma. A past study found that 60% of participants experienced a traumatic or stressful life event before their OCD symptoms began.⁷ Trauma—especially when experienced during childhood—is also linked to addiction.⁸
• Impulsivity. A 2015 study found that those with OCD were more impulsive than those without OCD.⁹ Impulsivity is a strong predictor of problematic substance use.¹⁰

Sometimes, OCD may influence someone’s substance use directly. Researchers have hypothesized that some people with obsessive-compulsive disorder may use substances as a way to cope with OCD symptoms like anxiety and, in turn, develop a SUD over time.⁴ For example, a past study found that those with OCD had a high risk of misusing sedatives, which are drugs that slow down brain activity and increase calmness.^5,11

Treatment for OCD and Addiction

For someone who has both an obsessive-compulsive disorder and a substance use disorder, simultaneous treatment of both conditions often results in improved outcomes.¹² Treatment is also best if tailored to the person’s specific symptoms and situation, and this may include both behavioral therapy and medication.^4,12

Cognitive-behavioral therapy (CBT) is an evidence-based treatment that has proven effective in addressing various conditions, including OCD and SUD. CBT is based on the idea that thoughts, emotions, and behaviors are interrelated and that unhelpful thought patterns lead to distress and problematic behaviors.¹³ A key tenet of CBT is that changing unhelpful thought patterns to more helpful types can aid in reducing distress and increase engagement in healthy coping strategies.¹³

In addition to comprehensive treatment, peer support through a 12-Step group can bolster treatment, giving you the encouragement of others who are also dealing with addiction. Participation in a 12-Step group alongside treatment increases chances of long-term abstinence.¹⁴

If you or someone you love needs help with OCD and addiction, call to speak with an AAC admissions navigator who can answer your questions about treatment and help you find a rehab center near you.

It’s never too late to seek help. Please call or text us. We are here 24/7 and happy to help.

Frequently Asked Questions