Co-Occurring Anxiety and Substance Use

Whether prescribed or taken outside of the bounds of a doctor’s recommendation, benzodiazepines are often used to treat symptoms of anxiety. These medications can be prescribed and used safely, but when taken long-term they can become extremely addictive. Unfortunately, the longer a person uses these medications, the less effective they become unless the dosage is increased. That increase, however, can pose a negative and deadly threat, especially when combined with other substances. Studies have shown that approximately 30% of the opioid overdose cases in the U.S. also showed traces of extremely high, illicit benzodiazepine use. 

When abused, benzodiazepines can actually increase anxiety within the individual or cause anxiety in a person who did not previously suffer from the disorder. Adolescents and young adults often take benzos like Xanax at parties or recreationally with friends, but addiction and anxiety can set in very quickly when these drugs are abused. Other associated symptoms include doctor shopping, blackouts, poor decision-making, mood changes, and risk-taking behaviors. Withdrawal from benzodiazepines is extremely dangerous, often leading to relapses because of increased anxiety and uncomfortable physical symptoms.

In general, when alcohol is used alongside anxiety it is to decrease the uncomfortable side effects associated with that anxiety. Alcohol use is linked to decreased inhibition, increased talkativeness, an overall sense of euphoria, feelings of relaxation, and impulsive behaviors. If an individual suffers from anxiety, particularly in social settings, he or she may then drink in excess to combat those feelings. When a person continues using alcohol as an anti-anxiety, the body and brain crave the substance and increase symptoms of anxiety in order to prompt the individual to continue drinking. 

Studies have also shown that the initial use of alcohol can promote the development of an anxiety disorder by inducing anxiety when alcohol is not present within the individual’s system. The main reason for this is that alcohol use and abuse increase GABA activity in the brain. As continued use of alcohol stimulates those receptors, the brain begins to establish a new normal level. If alcohol is not present, the brain will experience a deficit in GABA activity, thus inducing symptoms of anxiety in order to initiate the drinking process to receive stimulation.