Treatment for Co-Occurring Disorders: OCD and Substance Abuse

Those who are living with more than one mental health disorder or substance abuse disorder suffer from co-occurring disorders. Another term for this is dual diagnosis. A co-occurring disorder is present in an individual when they become dependent on a substance but also suffer from a mental health disorder. 

Dual diagnoses can occur in many different combinations; OCD and substance abuse is very common among the possibilities. Those who suffer from addiction and obsessive-compulsive disorder will benefit from treatment for both these disorders.

Dual Diagnosis Treatment OptionsWhat is Obsessive-Compulsive Disorder (OCD)?

Obsessive-compulsive disorder (OCD) involves unwanted thoughts and actions. Many think those with OCD are physically and mentally healthy, but experience tendencies to be extremely organized, ritualistic, or nervous. While those who suffer from obsessive-compulsive disorder are certainly able to carry out “normal” lives, they tend to face disruptive home, work, and family lives as the mental illness can be exhausting. As an equally common disease in men and women, OCD has affected approximately 2.2 million people in the U.S. according to the Anxiety & Depression Association of America.

Signs & Symptoms of OCD

Classified by having obsessions and compulsions, OCD gets its name from the constant actions carried out by those who suffer from this disorder. Obsessive-compulsive disorder is associated with the pattern of unwelcome thoughts or fears that lead to repetitive behavior. The obsessions and compulsions experienced by those with OCD are time-consuming; they can disrupt a person’s life and can take up more than an hour of their day.

Furthermore, trying to ignore the thoughts and behaviors associated with OCD can lead an individual to become stressed and ridden with anxiety. Without following through with a certain thought or behavior, the urge to complete it will continue to come back. This behavior leads to a vicious cycle that causes the individual to become ritualistic.

Most of the time, obsessive-compulsive disorder revolves around certain themes that are related to the victim. For example, if an individual is afraid of germs, they may become more ritualistic in their handwashing routine. The effects of OCD can be unpredictable, whereas the obsessive traits and compulsions may be anticipated and fall similarly in line with other victims.


When one has an obsession, it means a frequent urge or thought to complete something. If that event is not completed, it can cause great distress to the suffering individual. Since these thoughts are so frequent, those who suffer may try to ignore them or get rid of the thought with another image or action. This then leads to compulsion, the other part of OCD. 

Some examples of obsessive actions may include:

  • Acting doubtful
  • Unwanted sexual thoughts
  • Having things neat, orderly, and symmetrical 
  • Creating obsessions over “good” or “bad” numbers, odd or even
  • Having intrusive thoughts of self-harm, harm towards others, or bad events
  • Creating images of harming others, such as driving a car into a crowd of people
  • Thoughts about acting inappropriately or shouting obscenities
  • Fear of losing family or friends to an injury or illness
  • Uncontrollable fear of germs, viruses, and bacteria


Compulsions are actions that an individual tries to complete in order to deflect the unwanted urge or thought (obsession) to do something. Although the compulsive reaction has no relation to the original obsession, those with OCD feel compelled to complete the deed. Regardless of the logic behind these compulsions or obsessions, they are part of having OCD.

Some examples of compulsive actions or routines may include:

  • Counting in patterns
  • Following a strict routine
  • Counting steps as you take them
  • Silently repeating a certain word or phrase
  • Washing your hands until the skin becomes raw
  • Arranging your pantry so all the labels face a specific way
  • Checking things repeatedly to make sure they are as you left them
  • Keeping certain items even if they have no use

On average, individuals who suffer from OCD will experience symptoms when they are around 19 years old. However, some individuals may experience these unwanted obsessions or compulsions as early as 14 years old or sooner.

Furthermore, obsessions and compulsions are directly related to OCD but a person may not experience them simultaneously. Experiencing symptoms such as the ones mentioned above can become a concerning sign in the development of obsessive-compulsive disorder.

Since the onset of OCD can begin at such a young age, many teens are not aware of the harm they can cause to themselves. If left untreated, OCD can cause early symptoms of anxiety, depression, and even suicidal thoughts. 

Even more so, many young teens begin experimenting with drugs and alcohol which can escalate the potential for co-occurring disorders, such as OCD and substance abuse.

Understanding OCD and Addiction as a Dual Diagnosis

OCD is categorized as a type of anxiety disorder. With the rise in diagnosis, approximately 20 percent of people who experience anxiety and OCD develop a substance abuse disorder. Those who suffer from OCD and fall victim to substance abuse will find that alcohol or illicit drugs make the symptoms worse. Ultimately, it increases the need in the individual to give in to obsessions and compulsions. 

Dual DiagnosisAddiction

In the development of a substance abuse disorder, the individual will have uncontrollable desires for alcoholic or drug-related substances. The desire will continue to develop. Even as the person experiences more harmful consequences from the mind-altering substances, they will find this addiction as part of their routine. 

The continuous use of substances like alcohol, tobacco, and drugs can impair the individual and leave them unable to function on a day-to-day basis. Similar to OCD, addiction becomes a vicious pattern that leaves individuals trapped in a repetitive cycle. 

Developing Addiction Related to OCD

Like many anxiety disorders and depression, alcohol and drug addiction often co-occur with OCD. The mental and emotional turmoil related to addiction can leave one with the feeling of shame and loneliness, also often associated with OCD. Furthermore, the physical and social isolation individuals with OCD experience can easily lead to self-medicating with drugs and alcohol. 

Those who self-medicate with drugs find it will only provide a short relief from their scheduled routine. For more relief periods and longer intervals, the individual will continually use that drug or alcohol to get the desired effect. 

This creates a pattern that the individual finds releases them from their unwanted thoughts or urges, but only for a short period of time. With enough repetition and abuse, a drug or alcohol addiction can form.

Those suffering from OCD may recognize that others do not understand their obsessions and compulsions. This often leads individuals to feel insecure and shameful for the way they act. The development of substance abuse affects more than a quarter of the population that seeks treatment for OCD. If you are part of this number, you can seek help today through the dual diagnosis program at Harmony Place.

Dual Diagnosis Treatment Options

The importance of seeking medical attention for a co-occurring disorder can be momentous in the development of a person’s future. The key to effectively beating a co-occurring disorder, such as OCD and substance abuse, is to treat those disorders at the same time. Dual diagnosis is ideal for those who suffer from these types of disorders because it works to treat them simultaneously. 

There are few options people can consider when choosing to enter treatment. Some of those options include CBT, inpatient or outpatient rehab, medical detox, and medications.

Cognitive-behavioral therapy (CBT) aims to improve mental health by challenging the cognitive and emotional processes of the brain. It is based on the idea that negative thoughts and feelings can trap an individual in a vicious cycle. CBT helps those with obsessive-compulsive disorder and substance abuse to cope with unwanted thoughts and feelings. 

Residential or outpatient rehab is similar to each other in that they both focus on drug abuse and mental health education. In an inpatient center, the individual will check themselves into a controlled environment and stay for at least 24-hours where they have assisted medical and emotional support. In an outpatient center, the individual will take part in a less-restrictive program that meets 10-12 hours per week. Outpatient centers are ideal for those with mild addictions but still need support as they strive to live without substance abuse.  

A medically-assisted detox is a process of ridding the brain and body from any past substances and toxins. This process is designed to help people safely work through withdrawal symptoms while in a controlled environment with medical supervision. At times, medical professionals may administer medication to relieve severe withdrawal symptoms. 

While there are many therapy-related options for treating OCD and addiction, medication-assisted treatment is another alternative. Since addiction is a chronic illness, it’s important to remember that medication can assist in treating mental health symptoms but overcoming addiction will require a more constant approach. 

Common antidepressant medications for treating OCD symptoms may include Fluoxetine (Prozac), Fluvoxamine (Luvox CR), Sertraline (Zoloft), Paroxetine (Paxil, Pexeva), and Escitalopram (Lexapro).

Contact Us to Begin Your Journey to Recovery

Living with OCD and addiction can put many individuals in a helpless and lonely place. If you or someone close to you is experiencing a co-occurring disorder, medical professionals at Harmony Place can lead you in the right direction.

For help in treating OCD and substance abuse, Harmony Place offers multiple programs, including a dual diagnosis program. Our Los Angeles dual diagnosis treatment center strives to assist those struggling with addiction and mental health disorders. Reach out to us today for help in your journey to recovery.