Substance abuse problems are a common co-occurrence in individuals with OCD, or obsessive compulsive disorder. While individuals with substance abuse problems experience seemingly uncontrollable compulsions to indulge in drugs or alcohol, it is important to distinguish the compulsions of an addict with the compulsions of an addict with OCD. Due to the perceived psychological need for secrecy in OCD sufferers, it is crucial to diagnose and treat OCD in drug addicts in order for rehabilitation to be effective, rather than potentially harmful, as the following article will discuss.

 OCD vs. Drug Addiction

 The experience of drug addiction has many similarities to the symptoms of OCD. Examining the following points of similarity may help you discern simple addiction from addiction involving OCD.

Intrusive thoughts – People experiencing addiction will often spend an inordinate amount of time thinking about the substance to which they are addicted—when they last had it, when they will next have it, where they will obtain it, how they will obtain it and so on. Even if they wholeheartedly wish to quit, these thoughts appear unbidden and may be virtually impossible to ignore, depending on the severity of the addiction. In people with OCD and drug addiction, similar intrusive thoughts may occur, but intrusive thoughts will likely have been a precursor to as well as a symptom of their addiction.

  • Compulsive Behaviors – Compulsive behaviors in people with substance abuse problems may involve avoiding responsibilities and loved ones and even finding themselves “needing” to lie or steal in order to obtain their “fix.” People with OCD and addiction problems may also feel compelled to do these things, but the compulsions created by their original disorder that may have led to their addiction are usually much more varied, frequently involving the perceived “need” to clean, count or otherwise control their environment. The agitation they feel when unable to engage in these behaviors may look like withdrawal to an outsider, but has a primarily psychological rather than physical cause.
  • Hiding the Problem – Both drug addicts and people who suffer from both OCD and drug addiction are likely to try to hide their problem. However, OCD sufferers may actually be more effective at hiding it, due to a higher level of motivation to do so. Because OCD sufferers often feel strongly that harm will befall themselves or loved ones if they do not engage in their compulsions, the need to continue behaving compulsively and abusing drugs in order to cope with the feelings that arise as a consequence of their OCD behaviors may seem like a necessity that must be protected at all costs.
  • Low self-esteem and Depression – Addicts will often feel deep shame at their perceived inability to function without the use of drugs which can affect their self-esteem and lead to depression. OCD sufferers may feel similar shame due to their own perceived inability to control their own thoughts and compulsions, which also frequently leads to depression.

 Watching for symptoms indicative of OCD such as repetitive and secretive non-drug-related behaviors such as covertly washing hands, arranging objects by size or counting objects around them without the ability to stop will help you to identify the disorder as separate from drug addiction. However, if the only repetitive behaviors you experience are drug related, OCD is probably not related to the compulsions you experience due to your addiction.

 Rehab Challenges and the Importance of Diagnosing OCD

 The secrecy that OCD often entails due to OCD sufferers’ perceived need to enable themselves to engage in compulsive behavior, and to ease the psychological pain that can arise from the symptoms of OCD through substance abuse, poses a serious challenge to sufferers from OCD who are also involved in drug rehabilitation programs.

 The importance of diagnosing OCD as a condition separate from substance addiction cannot be overestimated. If the fears that lead to compulsive behaviors, psychological suffering and drug use as self-medication are not addressed, the individual will feel as though they must continue to use in order to survive in a world where they must also suffer from uncontrollable fears and anxieties. You can read more about fears and anxieties on the author’s website

A person with OCD who is untreated for their disorder and forced to engage in drug rehabilitation has a very low chance of success. In addition, rehab may even worsen the condition of a person with untreated OCD co-occurring with substance abuse problems, in that the perceived necessity of being even more secretive than ever and the likelihood of failure may worsen pre-existing feelings of depression linked to both their OCD and their drug addiction.

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