OCD and Addiction

When many people think of OCD, they immediately picture someone preoccupied with arranging items, colour coordination, or even hoarding. While these behaviours may indicate OCD, the disorder encompasses much more. The complexity increases further when addiction is also a factor. This page is dedicated to offering an in-depth exploration of OCD, addiction and the dual diagnosis of both conditions.

What is OCD?

Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviours (compulsions) that they feel the urge to repeat over and over. People with OCD may have symptoms of obsessions, compulsions or both. These symptoms can interfere with all aspects of life, such as work or school, as well as personal relationships.


Obsessions are repeated thoughts, urges or mental images that cause anxiety. Common symptoms include:

  • Fear of germs or contamination
  • Unwanted, forbidden or taboo thoughts involving sex, religion or harm
  • Aggressive thoughts towards others or self
  • Having things symmetrical or in a perfect order


Compulsions are repetitive behaviours that a person with OCD feels the urge to do in response to an obsessive thought. Common compulsions include:

  • Excessive cleaning and/or handwashing
  • Ordering and arranging things in a particular, precise way
  • Compulsive counting
  • Checking and rechecking actions (e.g., whether the door is locked or the oven is off)

People with OCD may not want to perform these tasks but feel compelled to do so to relieve their anxiety or prevent something bad from happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary relief from anxiety.

Are there different types of OCD?

OCD can manifest in various forms, each characterised by specific types of obsessions and compulsions. While the core features of OCD involve obsessions and compulsions aimed at reducing the anxiety caused by these thoughts, the specific themes can vary widely. Here are some common types of OCD:

Type Description
Contamination / Washing Fear of contamination by germs, dirt or other perceived harmful substances leading to compulsive washing or cleaning.
Symmetry / Ordering A need for things to be symmetrical or in a perfect order, leading to compulsions to arrange objects in a particular way.
Harm / Checking Fear of causing harm to oneself or others, leading to compulsive checking behaviours, such as making sure doors are locked or appliances are turned off.
Hoarding Difficulty discarding items regardless of their actual value, leading to an accumulation of items that can clutter and disrupt living spaces.
Intrusive thoughts / mental rituals Experiencing unwanted, often disturbing thoughts, about violence, sexual acts or blasphemy and engaging in mental rituals to counteract or neutralise these thoughts.
Ruminations / existential OCD Obsessive thinking about philosophical or existential questions that may have no clear answer or resolution.
Health anxiety/hypochondriasis Obsessive concern about having a serious illness despite medical reassurance, leading to compulsive health-related behaviours or research.
Relationship OCD (ROCD) Obsessive doubts and questions about one’s relationships, leading to constant reassurances or comparisons.

Is there a link between OCD and addiction?

Research indicates a possible association between obsessive-compulsive disorder (OCD) and substance abuse, though this connection is intricate and not entirely clear. A comparative study between individuals with and without OCD revealed that those suffering from OCD are significantly more likely to engage in drug and alcohol misuse.

The findings include:

  • A 4.5 times greater risk of suffering from alcohol-related disorders.
  • A 6.7 times higher likelihood of experiencing any drug-related disorder.
  • A 1.2 times increased chance of receiving a substance use–related criminal conviction.
  • A 5.2 times higher risk of dying from substance-related causes.
  • A notably increased risk for disorders related to the misuse of sedatives and other drugs, with a 10.5-fold rise.

Furthermore, the data below shows that by age 32, the cumulative incidence of alcohol- and drug-related disorders among those with OCD is 23%, compared to a 5% incidence rate in the broader population.

Source: NCBI- Association of Obsessive-Compulsive Disorder and Obsessive-Compulsive Symptoms With Substance Misuse in 2 Longitudinal Cohorts in Sweden

It’s important to note that not everyone with OCD develops an addiction and vice versa. Additionally, the nature of the relationship between addiction and OCD can vary among individuals.

Why does OCD commonly co-occur with addiction?

The co-occurrence of OCD and addiction is a scenario often referred to as ‘dual-diagnosis’ and means the person has been diagnosed with both OCD and addiction at the same time. Here are some reasons why the two can commonly co-occur with each other.

Neurobiological and psychological factors

Both OCD and addiction share disruptions in similar brain circuits, particularly those linked to reward and compulsion. Serotonin plays a vital role in OCD, affecting mood, anxiety and compulsive behaviours. Likewise, dopamine, essential for the brain’s reward mechanism, is deeply involved in addiction.

These common neurobiological pathways could make individuals with OCD more prone to substance use disorders as they may use substances trying to self-medicate or relieve their OCD symptoms, leading to addiction. Unfortunately, this coping strategy can lead to a vicious cycle where substance use exacerbates OCD symptoms over time, creating a reinforcing loop that can spiral into addiction.

Environmental and stress-related influences

Environmental stressors and traumatic events can worsen both OCD and addiction. People with OCD may face increased stress levels, amplifying their symptoms. To cope with this stress and the overpowering nature of OCD symptoms, some might turn to substance use.

The temporary relief substances can be deceptive, leading to a dependency that morphs into addiction. Moreover, the social isolation often felt by those with OCD can heighten the risk of substance abuse as a way to seek social interaction or ease loneliness.

Can addiction cause OCD?

Direct causation from addiction to OCD is not supported by current research; however, the interaction between pre-existing, undiagnosed or latent OCD symptoms and substance use disorders (addictions) can indeed be significant.

Worsening of symptoms

While addiction does not cause OCD, it can exacerbate symptoms in people with pre-existing, undiagnosed or latent OCD. For instance, substance use can increase anxiety levels, which may, in turn, intensify the frequency or severity of obsessive thoughts and compulsive behaviours.

Interference with treatment

Addiction can complicate the treatment of OCD. Substance use can interfere with the effectiveness of medications prescribed for OCD by altering brain chemistry or reducing adherence to medication regimens.

Addiction can also make it more challenging for individuals to engage in and benefit from psychotherapeutic interventions like Cognitive Behavioural Therapy (CBT) that have already been catered to the person’s OCD issues. This underscores the importance of a dual diagnosis, allowing CBT to be used for both OCD and addiction as one.

Stress and OCD symptoms

The stress associated with managing an addiction, along with the potential for disrupted social, occupational and health statuses, can serve as a significant trigger for OCD symptoms.

This is particularly relevant for people with pre-existing but perhaps milder or less noticeable OCD symptoms; the added stress of addiction can exacerbate these symptoms, making them more pronounced and disruptive.

Treatment for OCD and addiction

Navigating the path to addiction recovery can be challenging, yet having access to a diverse set of tools and approaches is crucial for a positive outcome. Addressing OCD and addiction simultaneously through a dual-diagnosis approach can enhance overall recovery success.

Although Sanctuary Lodge does not offer a dedicated rehab program specifically for OCD, several of our treatment modalities for addiction can concurrently aid in managing OCD symptoms.

Here’s what we offer:

Detoxing services: If you have an addiction, however, Sanctuary Lodge provides detoxing services depending on what type of substance you are addicted to. Round-the-clock treatment is provided for you, with professional medical staff on board to help deal with any uncomfortableness during this stage.

Therapy: We tailor individual and group therapy sessions to delve into the underlying causes of both addiction and OCD. This personalised approach allows individuals to express their feelings and confront their issues. Through the application of Dialectical Behaviour Therapy (DBT), we equip our clients with the necessary skills for emotional regulation, which are vital for treating both OCD and addiction.

Our treatment programmes also incorporate holistic therapies such as yoga and meditation, aiming to improve overall health and wellness. These practices foster self-awareness, alleviate stress and build emotional resilience, thereby supporting the treatment of OCD in conjunction with addiction recovery.

Aftercare: The significance of aftercare cannot be overstated, as it provides continued support. Group therapy offers a platform for sharing experiences and reinforcing coping mechanisms, which is instrumental in managing OCD while maintaining recovery momentum.

By integrating these therapeutic strategies, we address substance addiction and lay a comprehensive groundwork for effectively tackling and managing OCD.

What are the next steps?

If you’re struggling with the challenges of both OCD and addiction, remember that you’re not in this fight by yourself. At Sanctuary Lodge, we know the significant toll these issues can take on your well-being. We invite you to reach out to us for empathetic support and effective treatment options for both OCD and addiction. Our dedicated team is committed to guiding you on the path to recovery, providing a nurturing space where you can rediscover hope and begin to reconstruct your life.

(Click here to see works cited)

  • Singh A, Anjankar VP, Sapkale B. Obsessive-Compulsive Disorder (OCD): A Comprehensive Review of Diagnosis, Comorbidities and Treatment Approaches. Cureus. 2023;15(11):e48960. Published 2023 Nov 17. doi:10.7759/cureus.48960
  • Virtanen S, Kuja-Halkola R, Sidorchuk A, et al. Association of Obsessive-Compulsive Disorder and Obsessive-Compulsive Symptoms With Substance Misuse in 2 Longitudinal Cohorts in Sweden. JAMA Netw Open. 2022;5(6):e2214779. Published 2022 Jun 1. doi:10.1001/jamanetworkopen.2022.14779
  • Mancebo MC, Grant JE, Pinto A, Eisen JL, Rasmussen SA. Substance use disorders in an obsessive compulsive disorder clinical sample. J Anxiety Disord. 2009;23(4):429-435. doi:10.1016/j.janxdis.2008.08.008
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