Drug Addiction and Anxiety

Dr. Purushothaman
September 1, 2013

Drug addiction and anxiety are closely associated with one another (Hazelden Facts About Addiction and Anxiety Disorders) in that anxiety issues can cause drug use, and drug use can cause or exacerbate anxiety issues - a true double-edged sword. For people who believe in the disease model of addiction, anxiety must be treated concurrently with addiction or alcoholism. Industry experts who do not believe in the disease model instead sometimes state that anxiety is most likely a cause of addiction and therefore treatment of anxiety as a primary clinical condition will serve to eradicate the problems caused by addiction. However, a more realistic view of anxiety and addiction is that each is completely independent of the other - many people suffer from addiction but not anxiety and vice versa. As a result the only effective way to understand and treat these conditions is independently; despite the fact that they often co-occur in addicts and alcoholics.

According to Hazelden, a mental health services education and treatment organization;

"Anxiety disorders are one of the most common mental disorders in America today. An estimated 13% of adults ages 18 to 54 in a given year (more than 19 million people) are affected by anxiety disorders." (Hazelden Facts About Addiction and Anxiety Disorders)

These are astonishing figures considering the high number of addicted and alcoholic individuals in the US and the fact that treatment for one condition or another largely depends on where the patient initially entered the treatment system. (National Institute on Drug Abuse Treatment Patterns Vary Among People With Co-Occurring Disorders Based on Type of Treatment System Entered) And based upon the fact that some addiction treatment centers practice addiction model treatment and some do not, the type of treatment that someone suffering from anxiety and addiction will receive is somewhat unpredictable. Therefore, success rates for treatment of these individuals are also unpredictable comparatively across different treatment methods.

There are many different kinds of anxiety-related disorders, including OCD or Obsessive Compulsive Disorder, Chronic Panic Disorder and other conditions. In general these conditions would be treated with various forms of psychotherapy and proper medication where warranted. (Mayo Clinic Generalized Anxiety Disorder - Treatments and Drugs) However, medications for anxiety issues can be extremely addictive considering that the prescribed drugs of choice by some psychiatrists are benzodiazepines like Valium and Ativan. This means that when anxiety co-occurs with substance abuse or alcoholism, treatment can become complicated.
Addition is usually treated with an inpatient treatment program or an outpatient treatment plan that focuses on the addiction as a primary condition. The reasoning behind this is actually quite simple: while a person can be treated for anxiety with medication and therapy, the clinical and neurological processes in the brain and nervous system that are responsible for addictive behaviors will remain. In fact, a person can have numerous other conditions where addiction exists independently. In fact, many proponents of the disease model of addiction argue that even if anxiety issues caused the addictive behavior, once addiction has set in it must be treated as an independent disease.

The fact that addiction and alcoholism often co-occur with anxiety related illnesses is no surprise; often people suffering from these conditions will self-medicate to the point of physical dependence. And because substance abuse often exacerbates pre-existing anxiety conditions, it can appear that the two are inseparable and that one is the cause of the other. However, clinical science would indicate otherwise: anxiety can occur without addiction and addiction can occur without anxiety. But when the two are present in the same person, each must be treated in order to affect a lasting recovery process.

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