Obsessive-Compulsive Disorder (OCD) and Addiction

OCD and addiction

Many people who suffer from addiction have certain rituals they follow when they abuse drugs or alcohol. An example of a ritual could be the way a person prepares a drug for injection or the way they prepare their home for a night-in of drinking. They also experience obsessive thoughts and cravings for substances. However, some people who struggle with addiction have another co-occurring disorder that causes unwanted compulsions and obsessions: obsessive-compulsive disorder (OCD).

When OCD and addiction co-occur, individuals may suffer immensely from depression, anxiety, and social isolation. While there is no cure for either condition, both can be treated simultaneously with a dual diagnosis rehab program.

What is Obsessive-Compulsive Disorder (OCD)?

Obsessive-compulsive disorder, better known as OCD, is a mental health condition that is characterized by unwanted and recurring thoughts (obsessions) and/or the urge to do something over and over again (compulsions), usually to deal with or obtain relief from the obsession.

While it is normal to have certain thoughts or habits that people repeat, people with OCD suffer from actions and/or thoughts that:[1]

  • Consume at least one hour of their time each day
  • Seem to beyond their control
  • Are not enjoyable and may be distressing
  • Significantly interfere with one’s work, school, or social life

Some people may have symptoms that come and go, worsen over time, or get better over time. Unfortunately, people with OCD may attempt to stop their unwanted thoughts by abusing drugs and alcohol. While most realize that self-medication is ineffective, some people with OCD may be more susceptible to addiction.

OCD Obsessions

Obsessions refer to the repeated thoughts or urges that provoke anxiety in people with OCD. Some of the most common obsessions include:

  • Fear of germs, bacteria, viruses, getting sick, or contamination
  • Unwanted or intrusive thoughts regarding harm, sex, or religion
  • Having aggressive thoughts towards others or oneself
  • Feeling the need to have items in a certain order, whether it be symmetry, color, number, or alphabetical

The distress caused by these obsessions can lead to severe anxiety, disrupted relationships, depression, or even self-medication with drugs or alcohol.

OCD Compulsions

Compulsions refer to the repetitive behaviors people with OCD act out on in order to respond to an obsessive thought. In other words, compulsions are how people with OCD try to cope with their obsessions.[1]

Common examples of compulsions include:

  • Excessive or repeated handwashing and/or cleaning
  • Organizing and arranging things in a particular and precise way
  • Obsessively checking on certain things, such as the lock on a door or a light switch
  • Compulsive counting
  • Hoarding of useless items or trash
  • Repeatedly checking in on a loved one’s safety

While these compulsions may not seem that harmful, they can seriously disturb a person’s day-to-day life. A person with OCD could spend hours a day acting out on their compulsions, causing them to be late to work, suffer from anxiety, and have difficulty completing tasks.

The Relationship Between Obsessive-Compulsive Disorder (OCD) and Substance Abuse

Like many other mental health conditions, OCD often co-occurs with drug or alcohol addiction. This is because the psychological pain and discomfort caused by OCD can lead people with this diagnosis to abuse drugs or alcohol.

Studies have found that approximately 24% of people with OCD meet the criteria for an alcohol use disorder and 18% meet the criteria for a drug use disorder. Similarly, between 6-12% of people receiving treatment for addiction are thought to struggle with OCD.[2]

Even though the media often depicts people with OCD as organized, clean, and functional people, OCD can be terribly exhausting and debilitating. When obsessive thoughts arise, a person may feel anxious, depressed, and lonely. They may choose to cope by self-medicating with alcohol or taking drugs.

Furthermore, OCD is typically diagnosed in the late teens to early twenties – the very same time young people are experimenting with drugs and alcohol the most. For instance, a 21-year-old with undiagnosed OCD may see no problem with drinking several glasses of wine every night to calm their thoughts and fall asleep until they wake up one day with the shakes.

In some cases, OCD can develop in the younger teen years. Sadly, research suggests that people with juvenile-onset of OCD are more vulnerable to developing a substance use disorder.[2]

OCD, like drug and alcohol addiction, can cause people to become depressed and isolated from their loved ones. People with OCD may feel shame or embarrassment regarding their compulsions, causing them to isolate themselves. Isolation is another risk factor for substance abuse.

Treating OCD and Addiction

Since OCD and substance abuse have overlapping symptoms (obsessive thoughts, rituals, depression, anxiety, isolation), they must be treated at the same time. Treatment for OCD and substance use disorder involves integrated therapy that can be found at a dual diagnosis rehab.

A combination of pharmacotherapy involving antidepressants and cognitive behavioral therapy (CBT) is the standard treatment for these two conditions.[1] CBT helps patients with OCD learn how to cope with the unwanted thoughts they have which lead to drug or alcohol use. In addition, antidepressant medications can help reduce many OCD symptoms.

Inpatient or outpatient treatment programs can provide detox and dual diagnosis services to help people with OCD manage their symptoms and avoid relapse.

Find Help Today

Obsessive-compulsive disorder is a serious mental health issue that requires professional treatment – not self-medication with drugs and alcohol. Here at PAX Memphis, our clinical team and mental health track are here to help people with OCD and addiction get started on their recovery journey.

Medically Reviewed: September 25, 2019

Dr Ashley

Medical Reviewer

Chief Editor


All of the information on this page has been reviewed and verified by a certified addiction professional.

Dr Ashley Murray obtained her MBBCh Cum Laude in 2016. She currently practices in the public domain in South Africa. She has an interest in medical writing and has a keen interest in evidence-based medicine.

All of the information on this page has been reviewed and verified by a certified addiction professional.