Treatment of Co-occurring Anxiety Disorders and Substance Use Disorders

Abstract

Anxiety disorders co-occur with substance use disorders at a high rate in both the general population and in treatment-seeking samples. The co-occurrence of these disorders is associated with greater symptom severity, higher levels of disability, and poorer course of illness relative to either disorder alone. However, relatively little research focus has been afforded to the treatment of co-occurring anxiety and substance use disorders. This notable gap in the research literature may not only leave anxiety untreated or under-treated, but may also increase the risk for relapse and poor substance use outcomes. The aim of this manuscript is to provide a review of the current state of the literature on the treatment of co-occurring anxiety and substance use disorders. This review includes brief overview of the epidemiology of this co-occurrence, challenges in assessing anxiety in the context of a substance use disorder, evidence for treatment approaches, and new advancements and future directions in this understudied area. The importance of future research to identify optimal behavioral and pharmacologic treatments for co-occurring anxiety and substance use disorders is highlighted.

Therapist and computer‐based brief interventions for drug use within a randomized controlled trial: effects on parallel trajectories of alcohol use, cannabis use and anxiety symptoms

“…First, we found that TBI was an effective intervention for reducing harmful drug and alcohol use, as well as co‐occurring anxiety symptoms, among ED patients. These results indicate that successfully intervening on drug use can positively impact comorbid alcohol use and anxiety symptoms, suggesting that concurrent or integrated treatments for anxiety‐related problems may not be necessary for some individuals . Although CBI reduced cannabis use days when examined as a sole outcome , CBI relative to EUC did not result in significant reductions in severity of alcohol use, cannabis use and anxiety when examined as simultaneous outcomes.…”

Randomized controlled trial of telephone monitoring with psychiatry inpatients with co-occurring substance use and mental health disorders

“…Having a peer on the treatment team of patients with co-occurring disorders was associated with better fidelity to treatment plans, more engagement in care (e.g., outpatient care after hospital discharge), and better outcomes (e.g., reduced substance use and mental health symptoms) (Harrison et al, 2017; O’Connell et al, 2017). Further, to enhance use of outpatient treatments after hospital discharge, new integrated treatments should continue to be developed and tested, such as cognitive behavioral therapies for co-occurring substance use and anxiety disorders (McHugh, 2015; McHugh et al, 2017), and combined behavioral and pharmacotherapies for alcohol use disorders and depression (Samakhvalov et al, 2017). …”

Smoking Status and Substance Use Treatment Outcomes Among Spanish Speakers Enrolled in Substance Abuse Treatment

“…Our findings are of clinical relevance and indicate that being a smoker during the first month of substance use treatment is associated with a significant increase in the odds of substance use relapse at follow‐up. Our analytic approach accounted for a number of demographic and psychosocial factors that are known to be associated with substance use treatment outcomes (Carpenter, Schreiber, Church, & McDowell, ; Hser, Huang, Teruya, & Douglas Anglin, ; Ilgen, Tiet, & Moos, ; Kelly, Finney, & Moos, ; Lydecker et al., ; McHugh, ). Findings demonstrate that smoking status maintains its effect above and beyond the control variables in our logistic model, which underscores the robust nature of the relationship.…”