Trust SoCal Treatment Center

OCD & Addiction

Integrated, evidence-based treatment for ocd & addiction and co-occurring substance use disorders

Obsessive-compulsive disorder (OCD) is a chronic mental health condition characterized by intrusive, unwanted thoughts (obsessions) that produce intense anxiety, and repetitive behaviors or mental acts (compulsions) performed to reduce that anxiety. OCD goes far beyond the popular misconception of "liking things neat" -- it is a deeply distressing condition that can consume hours of a person's day and severely impair functioning in work, relationships, and daily life.

Approximately 25% to 30% of individuals with OCD develop a substance use disorder during their lifetime (Journal of Anxiety Disorders).
Alcohol is the most commonly misused substance among people with OCD, with rates of alcohol use disorder approximately 2 to 3 times higher than in the general population (Comprehensive Psychiatry).
Individuals with both OCD and substance use disorders have significantly higher rates of depression, suicidal ideation, and functional impairment than those with either condition alone (NIMH).

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Understanding Obsessive-Compulsive Disorder & Addiction

The co-occurrence of OCD and substance use disorders is more common than many realize. Individuals with OCD frequently turn to substances as a way to temporarily silence obsessive thoughts, reduce the overwhelming anxiety that drives compulsive rituals, or escape the shame and frustration that accompanies living with the condition. Alcohol is the most commonly misused substance among individuals with OCD, as it provides rapid anxiolytic effects that temporarily dampen the urgency of obsessions. Benzodiazepines, marijuana, and opioids are also frequently used for their calming properties.

The challenge with self-medicating OCD is that substances interfere with the brain's serotonin system, which is centrally involved in OCD pathology. Alcohol and other substances disrupt serotonergic function, ultimately intensifying obsessive thoughts and compulsive urges over time. Additionally, substance use impairs the cognitive flexibility and inhibitory control needed to resist compulsions, creating a worsening cycle. At Trust SoCal, our dual diagnosis program employs specialized treatment for OCD alongside addiction treatment, combining Exposure and Response Prevention (ERP) with relapse prevention strategies to address both conditions effectively.

Signs of Co-Occurring Obsessive-Compulsive Disorder & Addiction

Recognizing the signs of co-occurring obsessive-compulsive disorder and substance use disorder is the first step toward getting the right help. Common indicators include:

Using substances to quiet intrusive, repetitive thoughts or reduce the anxiety produced by obsessions
Increasing substance use before or after engaging in compulsive rituals
Experiencing intensified obsessive thoughts during periods of withdrawal or sobriety
Rigidity in thinking patterns combined with loss of control over substance use
Significant time consumed by both compulsive rituals and substance-seeking behaviors, impairing daily functioning

How Obsessive-Compulsive Disorder Relates to Addiction

OCD and substance use disorders share dysfunction in the brain's serotonergic and dopaminergic systems. The compulsive nature of OCD -- the inability to stop a behavior despite recognizing it as excessive -- mirrors the compulsive drug-seeking behavior that defines addiction. Research from the Journal of Anxiety Disorders indicates that approximately 25% to 30% of individuals with OCD will develop a substance use disorder at some point in their lives. Conversely, OCD is found at elevated rates among individuals in substance abuse treatment. The two conditions reinforce each other: OCD creates distress that drives substance use, and substance use disrupts the neurochemistry needed to manage OCD, creating an escalating cycle of worsening symptoms in both disorders.

Treatment at Trust SoCal

Treatment for co-occurring OCD and addiction at Trust SoCal integrates Exposure and Response Prevention (ERP), the gold-standard therapy for OCD, with comprehensive addiction treatment. ERP helps clients gradually confront feared situations and resist the urge to perform compulsive rituals, building tolerance for anxiety without resorting to substances. Serotonergic medications such as SSRIs (fluvoxamine, sertraline, fluoxetine) are used to address the neurochemical basis of OCD and are safe for use during addiction recovery. Cognitive therapy addresses the dysfunctional beliefs that maintain obsessive fears. Mindfulness-based interventions teach clients to observe intrusive thoughts without reacting to them. Relapse prevention planning integrates strategies for managing OCD triggers alongside substance use triggers, recognizing that an increase in obsessive symptoms can be a warning sign of impending relapse.

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Key Statistics

Approximately 25% to 30% of individuals with OCD develop a substance use disorder during their lifetime (Journal of Anxiety Disorders).

Alcohol is the most commonly misused substance among people with OCD, with rates of alcohol use disorder approximately 2 to 3 times higher than in the general population (Comprehensive Psychiatry).

Individuals with both OCD and substance use disorders have significantly higher rates of depression, suicidal ideation, and functional impairment than those with either condition alone (NIMH).

Related Co-Occurring Conditions

Anxiety & Addiction

Anxiety Disorders

Anxiety disorders are among the most common mental health conditions in the United States, affecting approximately 40 million adults each year. When anxiety disorders co-occur with substance use disorders, the relationship between the two conditions creates a self-reinforcing cycle that can be extremely difficult to break without professional treatment. Individuals with generalized anxiety disorder, social anxiety disorder, panic disorder, or specific phobias frequently turn to alcohol, benzodiazepines, marijuana, or opioids in an attempt to self-medicate the persistent feelings of worry, dread, and physical tension that characterize anxiety.

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Depression & Addiction

Major Depressive Disorder

Major depressive disorder (MDD) is a debilitating mental health condition characterized by persistent feelings of sadness, hopelessness, and a loss of interest in activities that were once enjoyable. When depression co-occurs with substance use disorder, the two conditions create a devastating feedback loop: depression drives individuals to seek relief through substances, and substance use deepens depressive symptoms through neurochemical disruption, social isolation, and the accumulation of negative consequences.

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Borderline Personality Disorder & Addiction

Borderline Personality Disorder

Borderline personality disorder (BPD) is a complex mental health condition characterized by pervasive instability in interpersonal relationships, self-image, emotions, and behavior. Individuals with BPD experience intense and rapidly shifting emotions, chronic feelings of emptiness, a deep fear of abandonment, and frequent interpersonal conflicts. Impulsivity is a core feature of the disorder, manifesting as reckless spending, unsafe sexual behavior, self-harm, and -- critically -- substance abuse.

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Frequently Asked Questions

Can OCD lead to addiction?

Yes. The intense anxiety and distress caused by OCD can drive individuals to use substances as a coping mechanism. Over time, this self-medication pattern can develop into physical dependence and addiction. Additionally, the compulsive nature of OCD may contribute to the compulsive patterns of substance use characteristic of addiction.

What is Exposure and Response Prevention and how does it work with addiction treatment?

Exposure and Response Prevention (ERP) is the most effective therapy for OCD. It involves gradually exposing individuals to their feared obsessions while preventing the compulsive response they typically use to reduce anxiety. In dual diagnosis treatment, ERP is combined with addiction therapy so that clients learn to tolerate anxiety without turning to either compulsive rituals or substances.

Will my OCD get worse during substance withdrawal?

It is common for OCD symptoms to temporarily intensify during early recovery and withdrawal as the brain adjusts to the absence of substances that were dampening anxiety. This is a critical period where specialized dual diagnosis support is essential. With proper psychiatric care and ERP therapy, OCD symptoms typically stabilize and begin to improve.

Are there medications that treat both OCD and addiction?

SSRIs such as sertraline and fluoxetine effectively treat OCD and are safe for individuals in addiction recovery. While no single medication treats both conditions directly, an integrated medication plan managed by a psychiatrist experienced in dual diagnosis can address both OCD and addiction-related symptoms effectively.

Medically reviewed by Rachel Handa, Clinical Director on 2026-02-01

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Understanding Obsessive-Compulsive Disorder & Addiction

Frequently Asked Questions

Can OCD lead to addiction?

What is Exposure and Response Prevention and how does it work with addiction treatment?

Will my OCD get worse during substance withdrawal?

Are there medications that treat both OCD and addiction?