Recovery Center Blog

Can Untreated OCD Lead to Addiction Relapse?

Written By Recovery Centers - April 18th, 2022
Can Untreated OCD Lead to Addiction Relapse?

Many individuals who struggle with addiction also suffer from a co-occurring mental health condition. According to the Substance Abuse and Mental Health Services Administration, “approximately 9.2 million adults in the United States have a co-occurring disorder.”[1]

One of the most common co-occurring disorders is obsessive-compulsive disorder (OCD). This mental health condition causes recurring and unwanted thoughts or actions. According to a study in 2019, more than a third of the individuals they observed with a substance use disorder also suffered from OCD.[2]

When individuals suffer from OCD and addiction, they must receive professional treatment for both conditions within the same program. This is because the symptoms of untreated OCD put individuals at a high risk of suffering an addiction relapse.

What is Obsessive-Compulsive Disorder (OCD)?

Obsessive-compulsive disorder is a type of anxiety condition that causes individuals to experience a recurring cycle of obsessions and compulsions.

Obsessions are defined as intrusive thoughts, urges, or images that cause the individual distress.

Common types of obsessions individuals suffering from OCD struggle with include:

  • Contamination
  • Fear of losing control
  • Fear of harming others or themselves
  • Perfectionism
  • Unwanted sexual thoughts
  • Religious obsessions
  • Superstitions

Compulsions are characterized by behaviors the individual engages in to eliminate the obsessions and cope with the distress they cause.

Common compulsions associated with OCD include:

  • Washing and cleaning
  • Checking
  • Repeating
  • Rearranging things
  • Telling, asking, or confessing for reassurance
  • Avoiding triggering situations
  • Reviewing events to ensure no harm is done
  • Counting
  • Praying
  • Canceling or undoing (i.e. replacing a “bad” word with a “good” word to cancel out the harm)

According to the U.S. Library of Medicine, young people with untreated OCD are at an increased risk of developing a substance use disorder.[3] Frequently, people with OCD begin abusing substances as a form of self-medication. As a result, the symptoms of their substance abuse begin to exacerbate the symptoms of their OCD, leading to a damaging cycle of obsessions, compulsions, and addiction.

The Relationship Between Untreated OCD and Addiction

Many factors contribute to an individual developing comorbid OCD and addiction.

One of the most common reasons individuals with OCD begin abusing substances is due to self-medication. The stress of dealing with intrusive thoughts often causes individuals to abuse substances in hopes that their symptoms will be soothed. Unfortunately, this only causes their symptoms to worsen and become further debilitating.

Another common cause of co-occurring OCD and substance use disorder is the isolation that individuals with OCD suffer from. Oftentimes, obsessive thoughts and compulsive behaviors make it difficult for individuals to leave their homes or function in their daily lives. As a result, individuals become more vulnerable to drug and alcohol abuse.

What to Expect During Dual Diagnosis Treatment for OCD and Addiction

Individuals suffering from OCD and substance use disorder (SUD) must receive treatment for both conditions at once. If someone only receives treatment for their addiction, the symptoms of their untreated OCD will cause them to experience a relapse.

Dual diagnosis treatment programs specialize in treating co-occurring disorders like OCD and SUD.


The first step in any dual diagnosis treatment program is medical detox. Individuals suffering from addiction will experience symptoms of withdrawal upon the cessation of their substance abuse. Depending on the type of substance they are addicted to, these symptoms may be uncomfortable and even life-threatening without medical intervention.

Thankfully, medical detox programs provide patients with medications to either taper them off of their substance of abuse or soothe the symptoms of withdrawal they are experiencing. Either way, this prevents individuals from experiencing severe symptoms of withdrawal and intense cravings for substances.

Individual Therapy and Group Counseling

For the treatment of OCD, individuals may participate in the following types of therapy:

  • Cognitive-behavioral therapy (CBT)
  • Exposure and response prevention therapy (ERP)
  • Repetitive transcranial magnetic stimulation (rTMS)
  • Holistic therapies like yoga, mindfulness techniques, and exercise
  • Group counseling sessions specific to OCD patients

For the treatment of addiction, individuals may participate in the following types of therapy:

  • Cognitive-behavioral therapy (CBT)
  • Dialectical behavior therapy (DBT)
  • Contingency management (CM)
  • Motivational interviewing (MI)
  • 12-step facilitation therapy
  • Family counseling
  • Group counseling for addiction

The types of therapy individuals will engage in will vary depending on the person’s individual needs. Upon entering a dual diagnosis program, patients will undergo a thorough assessment to determine what their needs and goals are for a complete recovery.

Medication Management

Oftentimes, obsessive-compulsive disorder requires pharmacological treatment. In other words, individuals may take psychiatric medication to soothe their symptoms of OCD that are therapy-resistant.

Most patients who require medication for their OCD are prescribed selective serotonin reuptake inhibitors (SSRIs). Common SSRIs prescribed for OCD during a dual diagnosis treatment program include:

  • Sertraline (Zoloft)
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)

Relapse Prevention Planning

Lastly, before individuals complete their treatment program, they will consult with their therapists to create a relapse prevention plan. For OCD and addiction treatment, a relapse prevention plan will include strategies that prevent relapse in OCD symptoms and substance abuse relapse.

Common aspects of relapse prevention plans include:

  • List of triggers
  • List of positive coping mechanisms to combat triggers
  • Support groups to attend on a regular basis
  • A network of sober and mental health support to call in times of need
  • Continued therapy and group counseling
  • Continued medication management
  • Access to alumni support groups
  • References for sober living programs and halfway homes to attend

Finding Help for OCD and Addiction

If you or a loved one are struggling with addiction, it might be time to consider attending a dual diagnosis treatment program. Finding a reputable program to attend can be difficult, especially if you’ve never attended professional treatment before.

Recovery Centers is here to assist you or your loved one find the help you need. Contact us today for more information on how to find a dual diagnosis treatment center near you.