When OCD and Substance Use Co-Exist: Understanding the Connection and Finding Help
Living with OCD is exhausting. The intrusive thoughts, the compulsive rituals, the constant fear of something bad happening—it can feel like your brain never shuts off. For many, even the case for you, the need to escape or quiet their mind can lead to turning to substances like alcohol, marijuana, or even prescription medications. And while it may seem like a temporary relief, substance use can quickly become another layer of the struggle.
Why Substance Use Can Feel Like It “Helps” OCD
People with OCD often experience high levels of anxiety, shame, and fear. Substances can appear to take the edge off by:
Reducing anxiety temporarily
Numbing emotional pain or obsessive thoughts
Making it easier to sleep or “zone out” from compulsions
Distracting from rituals or urges
In short, substance use becomes a coping mechanism—one that seems to work in the moment.
But… It Can Make OCD Worse Over Time
Even though substances may bring temporary relief, they actually disrupt the brain’s ability to process and regulate anxiety. Over time, this can:
Increase the frequency and intensity of intrusive thoughts
Make compulsions feel even more urgent and uncontrollable
Interfere with exposure and response prevention (ERP), the gold-standard treatment for OCD
Contribute to avoidance behaviors, which fuel the OCD cycle
Lead to dependence or addiction, creating a new issue to manage alongside OCD
If you’ve noticed that your substance use has crept in as a way to “manage” your OCD, you are not alone. This is a more common experience than many realize.
It’s Not Just About “Willpower”
Stopping substance use while living with OCD is a big ask. It’s not as simple as quitting cold turkey or “just doing ERP or exposure therapy.” Many people with OCD who use substances aren’t trying to party or escape responsibility—they’re trying to survive.
It’s completely normal to feel like giving up substances will make OCD feel more unbearable in the short term. That’s a valid fear. And that’s why support matters.
How a Therapist Can Help
If you’re dealing with both OCD and substance use, you need a therapist who understands the intersection of both. At Better Minds Counseling & Services, our therapists specialize in treating co-occurring disorders (living with multiple diagnoses at once) with compassion and evidence-based care.
Here’s how we can help:
Comprehensive assessment to understand both your OCD symptoms and patterns of substance use
Exposure and Response Prevention (ERP) tailored to your needs, at your pace
Harm reduction strategies if abstinence feels overwhelming at first
Relapse prevention planning that supports your long-term goals
A nonjudgmental space to explore your relationship with substances and what’s behind them
You don’t have to “fix” everything all at once. Healing is a process, and you deserve support every step of the way.
You’re Not Broken—You’re Coping the Best Way You Know How
If you’re using substances to cope with OCD, it doesn’t mean you’ve failed. It means you’ve been in pain and trying to find relief. The good news is: there are healthier, more sustainable ways to feel better—and you don’t have to do it alone.
We’re here to help. Reach out today to learn more about how therapy can support you in addressing OCD and substance use—so you can finally breathe again.
