The link between anxiety problems and substance abuse is clear. Examining the connection between the two can help to understand an individual’s struggle with anxiety and substance abuse as well as their path to recovery and a better life. 

Mental Illness

Mental illnesses are extremely common in the U.S. In fact, approximately 43.8 million adults experience some form of mental illness in a given year. That’s 18.5 percent or one in every five adults. 

About 9.8 million of those individuals suffer from a mental illness that is more serious, substantially interfering or limiting one or more life activities.

Anxiety Disorders

Anxiety disorders are the most prevalent form of mental illness in the U.S. According to research conducted by the National Comorbidity Study Replication (NCS-R), 19.1 percent of adults in the country suffered from an anxiety disorder in 2001 to 2002; 31.1 percent had experienced an anxiety disorder at some point in their lives. 

Anxiety comes in many forms and can be caused by a number of factors. Some forms of anxiety are rather normal and even helpful.

An individual may experience some anxiety, for example, before starting a new job or when starting a new relationship. A normal amount of anxiety may encourage the individual to prepare better for their first day at the job, or give careful thought to the type of relationship they wish to be in. In these situations, a healthy amount of fear and anxiety helped to make the outcome better.

Anxiety becomes a problem when it begins to have a destructive effect on an individual — when fear or anxious feelings take over and begin to have a negative effect on a person’s life.

To use the same examples as above, the individual might have an anxiety disorder if starting a new job and they had so much fear that they did not sleep, which affects their life and work performance. An anxiety disorder might be present if, at the beginning of a new relationship, they worry about it incessantly and sabotage the relationship with their fear and uncertainty. 

The term anxiety disorders encompass many different conditions of anxiety, including generalized anxiety disorder, panic disorder, phobias, and social anxiety disorder. 

Anxiety and Substance Abuse

Substance abuse comes in many forms and is extremely prevalent in the U.S.

It is impossible to pinpoint whether individuals struggling with both a substance abuse problem and an anxiety disorder began using a substance to help with their anxiety problems or developed anxiety problems as a result of their substance use.

Individuals with an anxiety disorder may struggle with daily life, including relationships, work and family obligations, and reaching personal goals. Held back by fear and anxious tendencies, they may be stuck in a pattern of negative thoughts and bad habits. 

This pattern of fear and bad habits may manifest in numerous ways because there are so many different types of anxiety orders.

People with a generalized anxiety disorder, for example, may struggle to find joy and relaxation in their lives. Instead, they find themselves filled with worry and stress.

Individuals with panic disorder may suffer from uncontrollable panic attacks. Those with phobias may struggle with specific fears that hinder their lives, and people with a social anxiety disorder may be unable to enjoy or express themselves in social settings.

Drugs and substances may appeal to individuals suffering from anxiety disorders for many reasons. Some may use a drug or substance and feel they are finally free from the anxiety that holds them back, suddenly able to express themselves and live like they are meant to live. Others may use a drug or substance to escape and experience calm and relaxation that is normally out of their grasp. 

Many sufferers of anxiety do not realize they have a problem or that it is treatable. They may begin to self-medicate with a drug or substance and quickly become dependent on it, not realizing that there are other options available to help them overcome their anxiety. 

Substance abuse and anxiety can also work the other way. Sometimes, an individual will first develop a substance abuse problem and then an anxiety disorder.

Many substances include anxiety as a side effect, both during use and withdrawal. This increased anxiety, along with the incredibly stressful lifestyle that accompanies drug dependency (including lying, shame, and guilt), can lead to an individual developing a more severe anxiety problem.

Which Drugs Are Most Likely To Be Used by Individuals With Anxiety?

No one plans on becoming addicted to a drug. Those with anxiety disorders can be introduced to substances of abuse in any number of ways.

Some individuals may become addicted to medications prescribed to them for their anxiety problems. Some commonly prescribed anxiety medications, like benzodiazepines, are highly addictive and habit-forming. 

Others may be drawn to the energy and euphoric rushes they might experience while using stimulants like cocaine or methamphetamine. These may especially appeal to those who suffer from social anxiety. They’re suddenly able to communicate with energy and enthusiasm, free of the worries and inhibitions that have held them back in the past. 

The calming and sedative-like effects of many depressants and opioids can also have great appeal to those suffering from anxiety, offering a soothing reprieve from worry and stress. Many of these drugs are extremely addictive and have severe withdrawal symptoms.


  • According to the National Institute on Drug Abuse, people addicted to drugs are twice as likely to suffer from mood and anxiety disorders.
  • A 2015 study from the Substance Abuse and Mental Health Services Administration found that of the 20.2 million adults in the U.S. who struggled with a drug or substance abuse problem, 50.5 percent were also experiencing a mental illness.
  • Generalized anxiety disorder affects approximately 6.8 million adults in the U.S., but only about 42 percent receive treatment.
  • Drugs that can cause mental health problems, such as anxiety, include cocaine, inhalants, ketamine, MDMA, methamphetamine, benzodiazepines, and opioids.

The Addiction and Anxiety Cycle

Whether an individual started with a drug problem that contributed to an anxiety problem, or vice versa, once they are struggling with both, their life can easily spiral into a cycle of addiction and anxiety.

Once dependent on a substance, an individual with an anxiety disorder may feel unable to deal with daily life and stress without the aid of that substance. The symptoms of their anxiety disorder may feel more intense than ever before.

When on the drug, the individual may also experience severe anxiety. In some cases, the drug will be the cause of anxiety. For others, the shame and frustration of dealing with a drug dependency exasperate an existing anxiety condition.

All in all, the user is in a near-constant state of anxiety as they use. They are likely to continuously plan to quit the substance.

Anxiety is also a side effect of withdrawal from most drugs. When attempting to quit, users may feel that their substance of choice offers what seems like their only escape from the worry and anxious thoughts they are experiencing in addition to other uncomfortable withdrawal symptoms. The allure of the high offered by the drug, and the relief they know it will bring, can become overwhelming, especially if the person is attempting withdrawal on their own. 

Even if a user is able to make it through the initial acute withdrawal symptoms successfully, the aftermath of addiction can also be a source of anxiety. Many individuals have to piece their lives together again. The stress can be substantial, especially when combined with the struggle to remain sober. Many are tempted to use again.

Treatment for Addiction and Anxiety

The dangerous cycle of addiction and anxiety is one reason why it is imperative that individuals facing both a substance dependency and anxiety problem have a comprehensive treatment plan in place to set them up for continued, long-term success. 

For many, a residential program is the surest path to recovery. Medical professionals who are experienced in treating co-occurring disorders, like anxiety and addiction, will be able to provide full support throughout the process, starting with withdrawal all the way through to re-entry into society.

Residential programs provide the person the opportunity to focus only on their sobriety and recovery while staying at the treatment center.

Outpatient treatment programs can also be very effective for anxiety and drug abuse recovery, particularly when supervised by a professional experienced in treating both disorders. The person should have a safe and supportive home environment if they are participating in outpatient treatment.

Medications may be used to treat anxiety and substance abuse issues. Non-habit-forming medications, like certain antidepressants and anti-anxiety options, may be used to alleviate ongoing anxiety issues. In more serious cases of withdrawal, medication may be used to make the experience more comfortable and to reduce instances of relapse. 

Therapy should also be a major component of treatment for those dealing with both anxiety and addiction. Ongoing therapy can help an individual realize the underlying trauma or emotional issues that may have drawn them to substance abuse in the first place. It can also provide them with the coping skills they need to make better behavioral choices and navigate through post-recovery life.

Finding Hope

Anxiety and substance abuse are both extremely prevalent in the U.S.

Those who are struggling with a substance abuse problem may also have underlying anxiety issues. They can get caught in a dangerous cycle of anxiety and drug abuse.

To manage both disorders, a comprehensive treatment plan that addresses an individual’s underlying anxiety issues and provides them with improved life and coping skills will be necessary.

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