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Substance-Induced Anxiety Disorder

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By: Renaissance Recovery

Medically Reviewed by: Diana Vo, LMFT

Last Updated: 7/1/2021

An image of a woman with Substance-induced anxiety disorder

Authored By: Joe Gilmore

Table of Contents

Substance-induced anxiety disorder, also known as medication-induced anxiety disorder, is the diagnostic term for anxiety or panic attacks triggered by alcohol, illicit drugs, or prescription medications.

Drug-induced anxiety disorder is more than fleeting feelings of anxiety in stressful situations, and it is also more than the transient feelings of panic or anxiety that sometimes accompany intoxication or withdrawal from drink or drugs. Substance-induced anxiety disorder is a condition causing impaired functioning and clinically significant distress.

Regrettably, the same drugs some people use in an attempt to relax, lower their inhibitions, and boost their confidence are also the drugs most likely to cause panic attacks or substance-induced anxiety.

When anxiety and substance abuse co-occur, not everyone realizes that the alcohol, drugs, or medication they are taking is causing the anxiety. This is especially apparent in those who associate substance abuse with feeling good rather than anxious or panicky.

What is Substance-Induced Anxiety Disorder?

Substance-induced anxiety disorder is characterized by restlessness, nervousness, panic, or anxiety after taking a drug or while taking a drug. The drug can be a legal substance like alcohol or prescription medication, or it could be an illicit substance like heroin or cocaine.

Anxiety and substance use must co-occur for a diagnosis of substance-induced anxiety disorder. If you were experiencing anxiety before using the substance, this is not considered substance-induced anxiety, even if the substance inflames your symptoms.

The majority of the diagnostic criteria for the mental health disorders outlined in DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders) require that the symptoms presenting are not due to the use of a substance or medication.

With substance-induced anxiety disorder, the reverse applies. Per DSM-5, the symptoms of anxiety or panic must coincide with the use of a substance – either during or directly after use – to differentiate this disorder from other states of anxiety.

The following criteria must be satisfied for a diagnosis of substance-induced anxiety disorder:

  1. Anxiety or panic attacks are predominant.
  2. There is evidence that the symptoms above developed during or shortly after intoxication, exposure to, or withdrawal from a medication. As well, the substance must be capable of producing the above symptoms.
  3. This condition is not better explained by another non-substance-induced anxiety disorder.
  4. Anxiety or panic does not exclusively occur during a delirium.
  5. The condition causes clinically significant distress or general impairment to functioning.

The criteria set out in DSM-5 for substance-induced anxiety disorder or the same as those of the other anxiety disorders.

In this updated edition of APA’s diagnostic tool, obsessive-compulsive disorders are categorized separately from anxiety disorders. This was not the case in the previous fourth edition of DSM. As such, obsessions and compulsions should not be present for a diagnosis of medication-induced anxiety disorder.

Symptoms must present either during intoxication or within a month of use.

The substance in question must be known to cause anxiety and the symptoms must not be ascribable to other anxiety disorders.

An image of a person with substance-induced anxiety disorder

Can Drugs Give You Anxiety?

Many drugs can trigger anxiety. These include legal substances and illicit drugs, such as:

  • Alcohol
  • Marijuana
  • Cocaine
  • Amphetamine
  • Meth
  • Intoxicants
  • Hallucinogens
  • PCP (phencyclidine)

Withdrawal from the following substances can also trigger manifestations of anxiety:

  • Alcohol
  • Opiates
  • Cocaine
  • Nicotine
  • Caffeine

All of the following OTC and prescription medications can also bring on anxiety and panic:

  • Corticosteroids
  • Analgesics
  • Anesthetics
  • Anticholinergics
  • Mood stabilizers
  • Antidepressants
  • Antipsychotics
  • Sympathomimetics
  • Anticonvulsants
  • Thyroid medications
  • Antihistamines
  • Antiparkinsonians

Substance-Induced Anxiety Disorder Symptoms

Medication-induced anxiety is characterized by anxiety or fear. These feelings are sometimes accompanied by physical symptoms, including:

  • Shakiness
  • Breathlessness
  • Racing heart

In addition to feelings of worry and nervousness, symptoms of substance-induced anxiety disorder can also include:

  • Difficulty falling asleep
  • Waking up frequently during the night
  • Problems with concentration and memory
  • Feelings that bad things will happen
  • Weight loss
  • Fearing you are losing control
  • Chills and hot flashes
  • Breathing problems
  • Trouble swallowing
  • Chest pain

These symptoms can occur during intoxication or withdrawal.

Panic attacks, generalized anxiety, and manifestations of phobia can all be triggered by substance use and withdrawal from substances.

Does Substance-Induced Anxiety Disorder Go Away?

In most cases, anxiety symptoms induced by alcohol, drugs, or medications will subside when the substance is eliminated. This means the duration of symptoms hinges on the half-life of the substance.

Anxiety symptoms triggered by alcohol or drug withdrawal will first manifest within four weeks of discontinuing the use of the substance.

Some prolonged symptoms of panic and anxiety may manifest for up to six months.

How to Treat Drug-Induced Anxiety Disorder

The most effective treatment involves discontinuing the responsible medication or drug and then continuing to abstain from this substance.

You should then seek a diagnostic evaluation from a mental healthcare provider once the cause has been eliminated.

In some cases, the onset of substance-induced anxiety is a strong indicator that outpatient substance use disorder treatment might be beneficial.

An image of a beach next to a treatment center for substance-induced anxiety disorder

​​Substance-Induced Anxiety Disorder Treatment at Renaissance Recovery

If you are concerned about anxiety and addiction, or you are experiencing waves of anxiety after drugs, we can help here at Renaissance Recovery Center.

To get the right treatment for your needs, it’s vital to start with an accurate diagnosis. Once it is determined that substances are precipitating your panic or anxiety, discontinuing the use of the substance should cause the symptoms to dissipate.

If you are unable to stop using drink, drugs, or prescription medications, we offer a variety of outpatient treatment programs to help you achieve this, including:

Medication-assisted treatment (MAT) can help streamline withdrawal and recovery. You will have access to MAT here at Renaissance, along with psychotherapy and counseling to help you address the psychological aspect of addiction.

By the time you complete your treatment program, you should be substance-free and unencumbered by the symptoms of anxiety or panic. Put substance abuse and anxiety behind you and make this a reality by reaching out to Renaissance at 866.330.9449.

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Diana Vo, LMFT

Diana is an addiction expert and licensed marriage and family therapist who has been in the field of mental health for over 10 years.

Joseph Gilmore

Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country