Coping with anxiety, stress, and unresolved mental health issues is one of the most commonly reported reasons for drug and alcohol abuse. Approximately 20% of individuals who struggle with anxiety develop a co-occurring substance use disorder [1].
Drugs and alcohol can temporarily relieve stress, slow racing thoughts, improve self-esteem, and reduce tension. But overtime creates a dangerous, addictive feedback loop and can worsen symptoms of already existing anxiety.
What Is Anxiety?
Anxiety is a natural response to perceived threats, involving feelings of fear, worry, and tension. It triggers the body’s fight or flight response, causing physical symptoms like increased heart rate, rapid breathing, sweating, and muscle tension.
When anxiety becomes excessive, persistent, and interferes with daily life, it may be diagnosed as an anxiety disorder, such as generalized anxiety (GAD). Individuals with GAD worry excessively about everyday things such as relationships, work, finances, and health, even if there is little reason to do so [2].
Does Anxiety Increase The Risk of Drug Use?
Anxiety heightens the risk of substance use and disrupts the balance of the mind and body, creating a sense of unease and disconnection. Anxiety can make people feel restless, with many reporting turning to drugs or alcohol for relief as an attempt to soothe internal turmoil.
Anxiety can cause impulsive or avoidance behaviors, increasing the risk of developing a substance use disorder. For example, isolation, low self-esteem, and the desire to escape overwhelming feelings can cause individuals to turn to drugs and alcohol as a form of emotional numbing [3].
Does Drug and Alcohol Abuse Cause Anxiety?
Substance use can directly induce or worsen anxiety symptoms. Drugs and alcohol disrupt the neurochemical balance that regulates mood, emotional regulation, and stress response. Drugs, whether uppers (cocaine, meth) or downers (alcohol, benzos), both affect the nervous system.
Long-term use of drugs and alcohol often heightens the stress hormone, cortisol, and dependency triggers withdrawal-related anxiety. This creates a paradox where the attempt to self-medicate deepens the cycle of anxiety, making it harder to quit use without professional intervention.
Different substances can increase anxiety in a variety of ways, some of which include [4][5][6]:
- Alcohol and benzodiazepines cause anxiety by disrupting the neurotransmitter balance of GABA and triggering withdrawal-related stress responses.
- Cocaine, methamphetamine, and other stimulants induce anxiety by overstimulating dopamine pathways, leading to heightened arousal and panic symptoms.
- Marijuana can provoke anxiety or paranoia in some users by altering cannabinoid receptor activity and brain function.
- Opioid withdrawal produces intense anxiety via dysregulation of the brain’s reward and stress systems.
- Synthetic drugs like MDMA or bath salts can cause acute anxiety due to unpredictable effects on neurotransmitter release.
- Nicotine increases anxiety through stimulation of the stress hormone cortisol and withdrawal-induced irritability.
What is Dual Diagnosis for Substance Use Disorder and Co-Occurring Anxiety?
Dual diagnosis refers to the presence of both a substance use disorder and an anxiety disorder, where each condition can intensify the other. Common treatment modalities often include medication-assisted treatment (MAT), which uses FDA-approved medications to ease withdrawal symptoms, reduce cravings, and stabilize mood while supporting recovery.
Alongside medication, evidence-based psychotherapies are fundamental. Cognitive Behavioral Therapy (CBT) helps patients identify and change harmful thought patterns and behaviors, while Dialectical Behavioral Therapy (DBT) teaches mindfulness, emotional regulation, and distress tolerance skills.
Trauma-focused therapy is also often incorporated, recognizing that unresolved trauma often underlies both anxiety and substance use disorders. Peer support groups, such as 12-step programs or other community-based groups, provide social connection and accountability.
Integrative Addiction Treatment in Kansas for Co-Occurring Disorders
Treating co-occurring disorders requires an integrated, holistic approach that addresses the roots of addiction, anxiety, and emotional challenges. At Avalon Wellness & Recovery, we provide whole-person care through intentional movement, restorative therapies, nervous system support, and daily practices that help clients feel safe and grounded in their bodies.
Blending evidence-based substance abuse and anxiety treatment with wellness practices such as infrared sauna, steam therapy, and cold plunge therapy, this supports the nervous system, reduces cravings, and encourages deep somatic healing.
Contact our admissions team today to learn about how Avalon’s integrative wellness offerings can help you or a loved one achieve recovery.
Sources
[1] National Institute of Drug Abuse. 2024.Co-Occurring Disorders and Health Conditions.
[2] National Institute of Mental Health. Generalized Anxiety Disorder.
[3] Smith, J. P., & Book, S. W. (2008). Anxiety and Substance Use Disorders: A Review. The Psychiatric Times, 25(10), 19–23.
[4] Prevot, T. D. (2023). GABAergic signaling in alcohol use disorder and withdrawal: pathological involvement and therapeutic potential. Frontiers in neural circuits, 17, 1218737.
[5] Hesham, M. 2025. Stimulants, ecstasy, and other ‘party drugs. Ecstasy (MDMA) (3,4-methylenedioxy methamphetamine). Research Gate.
[6] Leventhal, A. M. (2014). Cortisol levels decrease after acute tobacco abstinence in regular smokers. Human psychopharmacology, 29(2), 152–162.