How Anxiety, Fear and Stress Impact Substance Use Disorders

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Contributor: Staff at Sierra Tucson

The presence of mental health concerns like anxiety, fear and stress can put someone at an increased risk for developing a substance use disorder and make maintaining recovery more challenging. We all experience these feelings from time to time, but for those who are in recovery from addiction, anxiety, fear and stress can be especially difficult to manage.

The Link Between Anxiety Disorders and Substance Use Disorders

Many individuals who develop substance use disorders also meet the criteria for mental health concerns, specifically anxiety disorders such as generalized anxiety disorder, panic disorder and posttraumatic stress disorder (PTSD) [1]. However, this doesn’t necessarily mean that one disorder causes the other. It may be more likely that someone who is struggling with a substance use disorder and a co-occurring anxiety disorder has the risk factors for both.

Substance use disorders and mental health disorders share some genetic and environmental risk factors, such as early exposure to trauma. For example, those who have suffered from physical or emotional abuse are more likely to develop a substance use disorder [2]. Those who have PTSD from past trauma may be more likely to turn to drugs or alcohol in an attempt to cope with the anxiety and fear they’re feeling.

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How Anxiety Disorders Can Lead to Self-Medicating

Self-medicating involves turning to substances like drugs or alcohol to cope with certain negative feelings. There are many reasons why someone may begin self-medicating, whether it’s to relax during times of stress, aid with sleep or ease social anxiety. Others may turn to substances to cope with unpleasant memories or unresolved trauma. Whatever the reason, using drugs or alcohol to self-medicate can do more harm than good.

The use of drugs or alcohol to cope with feelings like anxiety or fear could cause mental health conditions to go undiagnosed and untreated. While self-medicating might provide short-term relief for some, it can lead to bigger issues over time and increase the risk of developing a substance use disorder. It’s important to receive professional help for symptoms of anxiety to properly identify a mental health disorder and help prevent a substance use disorder from developing.

How Stress Can Complicate Recovery

Like anxiety and fear, stress can be a trigger for substance use disorders and can complicate recovery. Many specialists believe that stress is the No. 1 cause of relapse to drug use [3].

Lady sitting alone dealing with anxiety New research on both humans and animals shows that stress leads to an increase in brain levels of a peptide known as corticotropin-releasing factor (CRF) [3]. This increase in CRF can trigger several biological responses that may contribute to substance use.

Further research found that people who experience chronic stress, such as those suffering from PTSD, have hormonal responses that are not properly regulated and do not return to normal once the stress has passed [3]. This could help explain why certain individuals are more prone to stress-related illness and substance use disorders.

Managing Anxiety, Fear and Stress When in Recovery

Negative feelings like anxiety, fear and stress can complicate someone’s recovery from a substance use disorder. It’s important to find healthy ways to cope with these feelings to avoid turning to substances.

Here are some tips for managing anxiety, fear and stress while in recovery:

  • Practice meditation by focusing on your breath when anxious and letting go of judgment
  • Talk to a trusted member of your support group, like a friend or family member, instead of keeping thoughts to yourself
  • Use grounding techniques to focus on the present moment
  • Incorporate regular exercise into your routine to improve mood and decrease stress and anxiety
  • Eat a healthy diet and cut down on sugar and junk food to improve mood and boost energy
  • Practice journaling to work through anxious thoughts

If you’re struggling with anxiety, fear or stress while in recovery from a substance use disorder, help is available. With the right treatment, you can achieve lasting recovery.


[1] NIDA. (2021, April 13). Part 1: The connection between substance use disorders and mental illness. National Institute on Drug Abuse.

[2] NIDA. (2021, April 13). Why is there comorbidity between substance use disorders and mental illnesses? National Institute on Drug Abuse.

[3] NIDA. (2001, November 1). Stress and substance abuse: A special report after the 9/11 terrorist attacks. National Institute on Drug Abuse.

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Sierra Tucson BannerLocated in Tucson, Arizona, Sierra Tucson is the nation’s leading residential and outpatient treatment center for substance use disorders, trauma-related conditions, chronic pain, mood and anxiety disorders, and co-occurring concerns. We provide integrated, holistic care for adults age 18 and older of all genders, including specialized programs for military members, first responders, and healthcare workers. Sierra Tucson was ranked No. 1 in Newsweek’s list of Best Addiction Treatment Centers in Arizona for 2020.

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on July 7, 2021
Reviewed by Jacquelyn Ekern, MS, LPC on July 7, 2021
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About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.