ABSTRACT

The relationship between anxiety, anxiety disorders, and substance use disorders is complex. A number of studies suggest that anxiety disorders, symptoms of anxiety, and substance use disorders commonly co-occur. In the Epidemiologic Catchment Area Study (ECA) (1), approximately 24% of individuals with anxiety disorders had substance abuse or dependence at some time in their lives. In the National Comorbidity Study (NCS) (2) it was reported that individuals with anxiety disorders were 2.5 times more likely to have a lifetime substance use disorder when compared to the general population. The interaction between these disorders and symptom clusters, however, is not likely to be unidirectional, but rather multifaceted and variable. Anxiety disorders may be a risk factor for the development of substance abuse and dependence. They can modify the presentation and outcome of treatment for substance use disorders, just as substance abuse and dependence can modify the presentation and outcome of treatment for anxiety disorders. Anxiety symptoms are also likely to emerge during the course of chronic intoxication and withdrawal. The interplay of these variables differs in individual clinical cases and between different anxiety disorders.