OCD and Substance Use Disorders

Because substances like alcohol and drugs are often used to try to suppress thoughts and feelings, people affected by强迫症（OCD）对开发物质使用障碍的风险更大。虽然酒精和吸毒可能最初是掩盖OCD症状, in the long run using substances can make symptoms worse, interfere with treatment and disrupt supportive relationships.

What Is a Substance Use Disorder?

在检查OCD和物质使用障碍之间的关系之前，我们首先要概述物质使用障碍的内容。有两种主要的物质使用障碍：substance dependence和物质滥用。

物质依赖

被诊断出来substance dependence, you must have three or more of the following symptoms at any time within the same year:

• Greatly increased tolerance, meaning that you need more and more of the substance to get the desired effect.
• Psychological (e.g., anxiety, depression) and/or physical withdrawal symptoms (e.g., shakes, nausea) when you stop using the substance.
• 使用比预期的更长的物质更少量的物质，而不是计划的内容。
• A strong desire, but lack of ability, to quit the substance or many unsuccessful efforts to stop using the substance.
• 获得物质的大量时间，使用物质或从其效果中恢复。
• Giving up important social, occupational or recreational activities to use the substance.
• 尽管它造成的心理或生理问题，但仍继续使用该物质。

物质滥用

被诊断出来药物滥用，you must demonstrate one or more of the following symptoms within the same year:

• Recurrent substance use that leads to failure to fulfill obligations at work, school or at home.
• Repeatedly using a substance in situations in potentially dangerous situations, such as driving a car or operating a machine.
• 因物质使用而与法律的疑问。
• 尽管物质引起的人际关系，但仍继续使用该物质。

OCD and Substance Use Disorders

It has been estimated that nearly 30% of people with OCD have had a substance use disorder at some point in their lives. This is nearly double the rate of the general population. Although the rate of substance use disorders is high among people with OCD, it is lower than those of many other forms of mental illness includingbipolar disorder要么精神分裂症。

Even though the OCD symptoms of people who develop substance use disorders are similar to those with OCD who do not, research has demonstrated that those who develop substance use disorders are often less educated, often have other forms of mental illness in addition to OCD, and had OCD symptoms that始于一个早期。Indeed, most people report that their OCD symptoms started well before they developed a substance use disorder.

It's important to note that people with OCD who develop substance use disorders are at a greater risk for suicide and住院治疗。

Substance Use Disorders and the Treatment of OCD Symptoms

许多人都开始使用物质作为自我药物的形式，即直接降低他们的严重程度obsessions要么强迫要么to decrease the distress associated with the consequences ofliving with OCDrela等问题tionships or difficulties at work.

In effect, substance use can be thought of as acoping strategy。然而，如果它允许您避免处理您遇险的实​​际来源，物质使用是一种特别差的应对策略。因此，在使用物质可能让您暂时感觉更好时，您的OCD症状将继续变得更糟，并且您的关系将继续恶化。反过来，这可能会导致更多物质使用，这只有助于您避免更多的问题。此外，通过掩盖焦虑，物质可以干扰对许多人至关重要的曝光练习psychological treatments对于OCD。

如果您有物质使用障碍，您的治疗需要专注于用更自适应的应对策略取代物质使用。这些包括帮助您直接享受症状及其相关困难更加舒适的策略。虽然这最初可以产生更高水平的焦虑，但长期的收益正在开发更好的工具，以处理OCD症状。