Anxiety and AddictionOkay, let’s talk anxiety.

Keeping it super simple, anxiety is a generalized, non-specific “bad” feeling. This feeling can range from anything to unease, to nervousness, to worry, to feelings of imminent death. An important thing to note is that anxiety is not the same as fear.

Fear is a specific reaction that occurs when we’re confronted with something that we perceive as risky or even dangerous. That being said, anxiety is a huge component of addiction. As manager of our inpatient detox facility, I’ve seen countless patients completely gripped with anxiety.

Anxiety about taking the first steps, anxiety as they’re being discharged, anxiety centered around money, loved ones, living situations… you name it. A retrospective chart review showed that 54 of the 61 patients we’ve seen since we opened last summer, reported having unmanaged anxiety. That’s 89%! This is a serious disorder that deserves a little clarification and discussion.

Why does using drugs or alcohol seem to help anxiety?

People like drugs and alcohol because they feel awesome… up until they create a physical dependency that forces you to keep using to not feel sick and/or ruin your personal, professional, and emotional world.

Drugs create a reward system in our brain: they target the brain’s pleasure center and increase dopamine release, which gives us a feeling of euphoria. These intense feelings of well-being and elation are, temporarily, very successful at counter-attacking common feelings associated with anxiety such as dread and worry.

Why do people sometimes experience more anxiety when they stop using?

As use increases over time, our brains have an amazing capability to increase enzyme production which metabolize drugs. Additionally, we desensitize and deplete neurotransmitters in our brain.

A specific example of this is commonly seen with ethanol (alcohol) ingestion, which targets gamma-aminobutyric acid receptors. As these receptors are down-regulated, other cells begin to compensate. This is the very basis for withdrawal symptoms that are experienced during cessation of drugs and alcohol. This is commonly known as tolerance or more specifically, pharmacokinetic tolerance.

Tolerance literally results in permanent physical changes in our reward system (which we discussed earlier) and can heighten feelings of irrationality, denial, and obsessive thinking. In a nutshell, addiction perpetuates anxiety. When we cease drinking or drugging, our body is left with an insane tolerance and mental/physical dependency upon these substances to “feel normal”.

How long can it take for anxiety to go away after I stop using?

Sometimes, never. Many addicts are prone to idiopathic feelings of anxiety before they ever begin drinking or drugging. This is a very common trigger for beginning addictive patterns in the first place: we want to make these uneasy feelings go away. The underlying predisposition to anxiety does not go away, even if sobriety is maintained for many years.

The great news is, there are many medications, referred to as anxiolytics, which help alleviate feelings of anxiety. Some of these medications, such as benzodiazepines, have addictive properties. As an addict you’ll want to steer clear of any drugs that could potentially be habit-forming.

Reducing Stress

There are countless other ways to reduce anxiety in your life: healthy diet and exercise, calming music, taking time to stop and focus on your breathing, meditation, volunteer service, light therapy, massage, journaling, hot baths, and stretching can all help in the path toward enjoying a more relaxing life.

If you know somebody struggling with addiction and you want to help them quit, download our intervention checklist. It will help you encourage them to take that first step to overcoming their addiction.


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~Turning Point Recovery Center