The Drug Class Blog

Aug 02

Anxiety and Substance Use

I have been saying for a long time that frequent substance use seems to increase a person's anxiety.  This as particularly an issue for adolescents as there are in a critical period of learning how to deal with stress.  Substance use can short circuit that very important learning process.  Here is a great article.

Self-Medicating Anxiety Raises Risk Of Social Phobia And Substance Abuse Disorders

Individuals with anxiety-related symptoms who self-medicate with drugs or alcohol have a higher risk of having a substance abuse problem and social phobia, researchers from the University of Manitoba, Winnipeg, Canada, revealed in Archives of General Psychiatry.

The authors wrote: "Self-medication of anxiety symptoms with alcohol, other drugs or both has been a plausible mechanism for the co-occurrence of anxiety disorders and substance use disorders.

Given the significant consequences of mental illness comorbidity and its high prevalence in the general population, clarifying the underlying mechanisms through which comorbidity [mental health issue coupled with substance use disorder] develops will have considerable implications for prevention and treatment."

Jennifer Robinson, M.A., and team gathered data in two waves from the National Institute on Alcohol Abuse and Alcoholism survey to find out what the substance abuse rate might be in people with anxiety disorders.

They also wanted to find out what the incidence might be in new-onset anxiety disorders in individuals with a substance disorder. One wave was carried out in 2001-2002 while the second in 2004-2005. 34,653 individuals completed both waves.

The participants were separated into three categories:

  • Self medication with alcohol only
  •  Self medication with drugs (perhaps with or without alcohol as well) 
  • No self-medication 


The researchers found that among those who reported substance abuse during the previous twelve months, 12.5% said they self-medicated with alcohol, while 24.4% did so with other drugs. Of those with substance use disorders at baselines, 23.3% used alcohol for self-medication and 32.7% did so with drugs.

Of those who had a diagnosed anxiety disorder and self-medicated with alcohol, 12.6% developed an alcohol-use disorder. Of those who did not self medicate, 4.7% developed an alcohol-use disorder.

Examples of anxiety disorders include panic, generalized anxiety disorder, specific phobias and social phobia. Among those with a baseline alcohol use disorder, between 5.7% (panic) and 9.9% (specific disorder) had an anxiety disorder if they self-medicated with alcohol. Among those who self-medicated with drugs, 8% has a panic disorder while 13.5% had a specific disorder. 6.9% of new-onset social phobia was found to be caused to self-medication with alcohol, and 20.4% among those who self-medicated with drugs.

The researchers also found that among those who already had anxiety and alcohol use or drug use disorders, reported self-medication was linked to the persistence of alcohol and/or drug use disorders, but not anxiety.

The researchers concluded: "Given the high percentage of incident substance use disorders and social phobia that can be attributed to self-medication, the reduction of self-medicating behavior may lead to a significant decrease in incident comorbidity in the general population. These results not only clarify several pathways that may lead to the development of comorbidity but also indicate at-risk populations and suggest potential points of intervention in the treatment of comorbidity."

Written by Christian Nordqvist Copyright: Medical News Today Not to be reproduced without permission of Medical News Today Article Reference: Arch Gen Psychiatry. 2011;68[8]:800-807.

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