How to Treat Co-Occurring OCD and Substance Use Disorder in a PA Rehab Facility

From time to time, most people will experience obsessive thoughts. Unfortunately, individuals with OCD may have trouble controlling the urges connected to these thoughts. Obsessive-compulsive disorder makes individuals feel like they must repeat specific routines. This repetition can disrupt their everyday life forcing them to deal with obsessive thoughts and compulsive behavior. At Little Creek Recovery, we have experience treating substance use disorder, and our patients sometimes describe their behavior as compulsive. Some studies point to an increased risk of addiction for those with OCD. Join us, as we determine if there is truth to those claims and examine the link between OCD and addiction. We will also explain our approach and how to treat co-occurring OCD and substance use disorder in a PA rehab facility.

What is OCD

Obsessive-compulsive disorder (OCD) is considered to be both a mental and a behavioral disorder. It is a relatively common, yet chronic disorder where individuals have obsessive uncontrollable thoughts or act out in repetitive compulsive behaviors. There is often an inability to escape from such thoughts or an urge to repeat these behaviors. These unwanted thoughts and urges usually lead to feelings of disgust or anxiety.

There is currently no known cause of OCD; however, there are recognized risk factors. One of the leading contributing factors to the development of OCD seems to be a genetic predisposition. The risk is highest for first-degree relatives with a family member who developed OCD as a child. However, there are also environmental and societal factors, the leading ones being a history of child abuse or childhood trauma. Some patients have exhibited signs of OCD after experiencing a streptococcal infection.

Upon examination of brain imaging studies, patients with OCD have differences in their frontal cortex and subcortical structures. Unfortunately, there is a lack of evidence leading to the connection between specific areas of the brain and OCD. Some OCD patients have a reduced amount of serotonin in their system, which is also common for drug users. A low level of serotonin can cause anxiety, affect mood and emotions, lead to memory issues and disrupt sleep patterns.

Light switch.
OCD can force individuals to repeat actions such as turning the lights on and off.

The Link Between OCD and Substance Use Disorder

Diagnosing OCD relies on recognizing presented symptoms and behaviors, which requires an experienced physician. Some presented symptoms may resemble those seen among drug users, so accurate observation and diagnosis are necessary. Psychologists, psychiatrists, or clinical health workers can perform a formal diagnosis.

Most patients with OCD realize their compulsive thoughts and behavior don’t necessarily make sense. However, they feel compelled to act out to relieve their anxiety and the stress caused by their obsessions. Occasionally, those individuals seek relief through substance use. Some people suffering from OCD-induced anxiety abuse drugs or alcohol as a coping mechanism. Sadly, due to its addictive nature, drug use may become a compulsive behavior.

Individuals with OCD typically have trouble controlling their urges, putting them at a higher risk of developing substance use disorder. Without treatment OCD and substance use disorder will get progressively worse. Due to compulsive behavior and lack of control, addiction can quickly progress in patients with OCD. For this reason, getting professional treatment in the early stages of your addiction is critical.

There have even been instances where drug use can mask the obsessive behaviors of OCD. If incorrectly diagnosed, the exhibited compulsive behavior may be attributed to addiction instead of OCD. Patients with substance use disorder have difficulty controlling their cravings, so without an accurate diagnosis, your OCD might go unnoticed.

How Common are Co-Occurring OCD and Substance Use Disorder

Substance use disorder is a chronic mental illness that can affect the mental well-being of individuals. It’s not uncommon for patients suffering from addiction to exhibit other co-occurring disorders. Frequently, those co-occurring disorders have common risk factors. A study showed that 27% of observed individuals with OCD also suffered from some form of substance abuse. For a large majority of them (over 70%), their OCD preceded substance use by at least a year.

Substance use disorder affects more than a quarter of all patients who seek treatment for their OCD. Addiction is also more common in patients who had an early onset of OCD, especially alcohol addiction. Therefore, adolescents and young adults need to be particularly careful regarding alcohol addiction. If you or a loved one are struggling with alcohol abuse, we can offer alcohol rehab at our Pennsylvania facility.

When occurring together, OCD and substance use can cause individuals to present more severe symptoms of OCD. Additionally, those individuals are less likely to seek treatment. Even when they do get treatment, if they only enter rehab for substance use, they will have poor success rates. For the best outcomes, it’s crucial to simultaneously treat co-occurring OCD and substance use disorder.

Patients with untreated addiction and OCD have higher rates of suicidal ideation and are more likely to report suicide attempts. Due to the chronic and progressive nature of these disorders, it’s imperative that you enter addiction therapy immediately. At the Little Creek facility, we can offer mental health counseling and teach you how to manage your mental state. Reach out to us before it is too late.

Depressed man sitting in the darkness.
OCD can lead to depression, anxiety and social isolation.

The Warning Signs of OCD and Substance Use Disorder

Both OCD and substance use disorder can present a wide variety of symptoms. If you are struggling with addiction and believe you may have undiagnosed OCD, we suggest contacting a healthcare provider. It’s never a good idea to self-diagnose, especially when it comes to mental and personality disorders. A licensed physician can give you an accurate diagnosis and direct you to a treatment facility suited to your needs.

In previous articles, we have discussed the signs of addiction that can tell you it’s time to seek treatment. Therefore, we would like to focus on the warning signs of OCD. Keep in mind that some symptoms occur together in so-called clusters. If you believe that you or a loved one has OCD, here is what you can look for:


Obsessions are uncontrolled and stress-inducing thoughts that trouble affected individuals despite their attempts to ignore them. Common symptoms of obsessive thoughts include worrying about:

  • Germs, contamination, and dirt. Thoughts of uncleanliness are common, leading individuals with OCD to repeatedly clean and wash.
  • Unwanted sexual obsessions. Due to these thoughts’ unwanted and intrusive nature, individuals can attach an unnatural significance to them. This can lead to feelings of guilt, shame, and the questioning of their sexual identity.
  • Aggressive or harmful thoughts. These thoughts are usually directed at oneself and usually revolve around obsessing over self-harm.
  • Fear of harm. Individuals may develop an irrational fear that someone or something will harm them or their loved ones.
  • Symmetry. This type of obsession includes having things perfectly ordered; however, counting and repetitive compulsions are also common.


Individuals with OCD may perform repetitive activities in the form of compulsive rituals. While some believe they must perform these activities, others do so to relieve the anxiety of their obsessive thoughts. Even when individuals realize their compulsions are irrational, they still feel compelled to perform them. There is sometimes even a memory distrust of one’s actions or perception, leading to additional repetitive actions. Although most people occasionally second-guess if they performed menial tasks, individuals with OCD lose upwards of one hour a day. These behaviors cannot be controlled, and unless they are performed, individuals may experience intense panic and dread. Here are some common compulsions found in individuals with OCD:

  • Hand washing and cleaning, either of oneself or specific items that need to be cleaned in a particular way.
  • Repetitive checking, especially locks, ovens, or switches. Memory distrust can exacerbate the checking.
  • Constant ordering and rearranging of items. This type of sorting is often done in a very precise way to achieve symmetry.

Can Substance Use Cause OCD?

For many people suffering from co-occurring OCD and substance use disorder, their use of drugs or alcohol came after the onset of OCD symptoms. Although there are many symptoms of OCD, early signs can be seen in childhood or adolescence. Growing up, those individuals with obsessive thoughts were more likely to abuse drugs or alcohol and develop an addiction. Additionally, the anxiety, depression, and social isolation accompanying OCD can often push adolescents into substance abuse. Unfortunately, dependence on drugs or alcohol can increase their depression and isolation, and in some cases, even worsen their OCD. This behavior can create a vicious pattern where both disorders are likely to escalate and progress. The only way to break free is by entering a specialized rehabilitation facility for treating substance use and co-occurring disorders. Without adequate treatment, self-destructive behavior will only escalate.

According to the Diagnostic and statistical manual of mental disorders, some drugs can induce OCD. Although the cause of OCD is unknown, people without previous symptoms can develop OCD through drug use. The development of OCD is mostly tied to atypical antipsychotics including olanzapine and clozapine. Especially vulnerable are individuals diagnosed with schizophrenia.

Unfortunately, even recreational drug use, particularly when hard drugs are involved, can cause brain changes and induce OCD. The drugs most associated with the onset of obsessive thoughts and compulsive behavior are methamphetamine and cocaine. These drugs act quickly by stimulating the central nervous system, and dependence can occur even after a single use. Due to the intense withdrawal effects, the only way to rid yourself of cocaine addiction is by entering cocaine addiction rehab. With our help, you can learn to manage your addiction and your OCD.

Man in individual therapy for OCD and substance use disorder.
Behavioral therapy is commonly used to treat OCD and substance use disorder.

How to Treat Co-Occurring OCD and Substance Use Disorder

Patients who wish to receive treatment at Little Creek Recovery must undergo our admissions process. We can conduct an initial assessment when you contact us and suggest a form of treatment. However, when you reach our facility, our clinicians will give you a thorough examination. Based on your current state and type of addiction, we can devise the best form of treatment for your needs.

Patients arriving at our Pennsylvania facility with substance use disorder and a co-occurring mental disorder are given a dual diagnosis. These patients ought to visit dual diagnosis treatment centers in Pennsylvania where their disorders are treated concurrently. This approach has given us the best outcomes when treating co-occurring OCD and substance use disorder.

Since both substance abuse and OCD are chronic mental disorders, you should realize that there is no cure. However, with adequate treatment, you can learn to manage your condition. We can help you lead a drug-free life and teach you how to balance your mental state. When it comes to treating OCD, there are several levels of treatment available.

Behavioral Therapy

Behavioral therapy is often considered the first-line treatment for OCD because of its non-invasive nature. CBT treatment plan for substance abuse, and in particular exposure and response prevention (ERP) is commonly used to treat OCD. Under the supervision of a licensed clinician, patients are given repeated exposure to their obsessive triggers. By building up a gradual tolerance, they can learn to prevent themselves from carrying out compulsive actions.

Another form of behavioral therapy used to treat personality disorders is dialectical behavioral therapy. In DBT patients can develop cognitive and emotional control, allowing them to break the cycles of self-harm. DBT for substance abuse can teach patients to process their negative thoughts and emotions. Instead of giving in to negative thoughts, individuals can learn more productive coping skills when facing stressful or triggering situations.

Music Therapy, Adventure Therapy

Besides relying on behavioral therapy to teach patients productive coping skills, we also provide a variety of evidence-based treatment programs. Some patients with OCD have trouble focusing and adhering to a structured living regimen. For this reason, we like to include fun activities in our recovery programs.

Patients can explore their creativity and engage in personal development through music therapy. Little Creek Lodge has a fully equipped music studio where our patients can practice and have recording sessions. Playing with others in a band is an excellent way to feel less alone and work towards a common goal. Music also requires strict timing and reacting to other people’s queues, making it an excellent form of therapy. Patients with OCD are encouraged to engage in behaviors contrary to their regular rituals and alter their obsessive thought patterns. In CBT patients are taught that ritual behavior can strengthen their OCD. On the other hand, not performing those behaviors will weaken OCD. Music can help provide patients with a structured activity where they can get away from their compulsive behavior.

As part of our therapy, we also encourage patients to be physically active. After all, a full recovery must include the body and mind. Where many other rehab centers fail, is that they believe treating the body ends after detoxification. However, we provide our patients with a challenging and exciting experience in our Pennsylvania outdoor adventure program. Patients can reconnect with their bodies and find their sense of adventure while also engaging their imagination. Those participating in our adventure program develop self-esteem and resilience as part of their journey to recovery. Sobriety can be fun, and an endless adventure is waiting to be discovered.

Man in outdoor adventure therapy.
Re-discover your sense of adventure at Little Creek Recovery.


Physicians often rely on medication to treat OCD, frequently administering antidepressants and serotonin reuptake inhibitors. Patients coming into Little Creek for treatment should know that we can administer their prescription medication. However, patients are required to have a prescription from their primary physician. Therefore, incoming patients must have a prescription detailing the dosage for any approved medication.

If you plan to attend our Lake Ariel facility, you should contact us and pre-approve any necessary medication. Feel free to contact our admissions coordinators and they can explain what is allowed and what to pack. Remember that you are also responsible for providing any medication you are required to take.

Last Resort Treatment

There are certain treatments for OCD that we don’t provide in Little Creek. For example, electroconvulsive therapy has only been successful in rare and severe cases. We also do not provide psychosurgery for OCD or any other invasive form of treatment. These types of last-resort treatments are only applied when all other options have been exhausted. It is always preferable for patients to attempt treatment with a licensed cognitive-behavioral therapist before pursuing extreme measures.

Man packing his luggage to enter rehab.
We can help you prepare to enter our rehab facility.

Entering Rehab for OCD and Substance Use Disorder

We believe that every patient’s story is unique, and we offer all of our clients a personalized treatment plan. If you want to hear how we can help you, don’t hesitate to contact us or fill out an admission form. However, if you have trouble verifying your insurance, we suggest contacting your provider.

On the other hand, we can also check your insurance and explain what coverage you are eligible for. We can also answer all of your questions regarding rehab and the Little Creek approach to recovery. In case your insurance doesn’t cover the full cost of your treatment, we can discuss payment options. Patients always have the option to cover part or all of their treatment out of pocket. We will work with you to find the best payment plan suitable to your needs and financial situation.

Incoming patients should also be aware of the necessary criteria for admission. To enter rehab at our Pennsylvania facility, you must meet medical clearance. We will be forced to decline treatment if you suffer from conditions or handicaps that make you unable to participate in our programs. Inpatient care requires overnight stay in our residential facility. All incoming residents should also be motivated and willing to accept a structured living setting for 30 to 90 days.

There is also the possibility of receiving care in our outpatient programs that don’t require an overnight stay. In the Little Creek outpatient rehab programs, patients have the option to spend nights and evenings at home. However, patients are still required to attend regular therapy sessions in our Pennsylvania facility.

The Bottom Line

Now that we’ve explained our approach to how to treat co-occurring OCD and substance use disorder in a PA rehab facility, we hope you realize that your condition can be treated. Treatment is available as long as you want to get better and are willing to put in an effort. We can help you recover from your substance abuse and teach you how to manage your mental health disorders. All you have to do is contact us, and we will set you on the path to recovery.

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“Adventure trek is always popular”

Little creek lodge is such an amazing place for people who want to make a serious change in their life. I’ve watched my loved one grow immensely through his recovery with the help of the caring staff and engaging programs. Adventure trek is always popular on the agenda!

Annabelle Stiso |

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