Do A Lot of People Have Anxiety and Addiction at the Same Time?

Summary: Yes, a lot of people have anxiety and addiction at the same time, which experts call co-occurring anxiety and addiction.

Key Points:

• Anxiety and alcohol use disorder (AUD) and anxiety and substance use disorder (SUD) often co-occur.
• Successful prevention and treatment of co-occurring anxiety and addiction requires addressing both disorders simultaneously.
• Depending on severity, treatment for one may need to start before the other.
• However, for a person to recover from both, each disorder requires professional treatment and support.
• Treating one without treating the other can reduce likelihood of long-term, sustainable recovery from both.

Anxiety and Addiction at the Same Time: Evidence-Based Treatment is Effective

Many anxiety disorders first appear in youth, pre-adolescence, or early adolescence, before exposure to alcohol or drugs that lead to addiction. Not all anxiety disorders appear before addiction disorders, though. Specific subsets of anxiety disorders, such as generalized anxiety disorder or panic disorder (GAD or PD) often emerge after an individual develops an AUD or SUD. Recent studies into the relationship between anxiety and addiction show how each disorder can intensify the other. These studies also recommend ways providers might fine-tune intervention, screening, and treatment strategies to serve people diagnosed with anxiety and addiction at the same time, i.e. co-occurring anxiety and addiction disorders.

Rates of Co-Occurrence of Anxiety and Addiction

When anxiety and addiction co-occur, one common outcome is that the negative, life-interrupting aspects of the disorders reinforce one another. In other words, each disorder can make the other worse, and vice versa. In many cases, the symptoms of an anxiety disorder can lead to self-medication with alcohol or drugs in order temporarily relieve uncomfortable, painful emotions. Over time, tolerance to alcohol and substances may turn into physical dependence. Once that happens, the likelihood of misuse, disordered use, and addiction becomes more likely.

But how often does that happen?

Here are the latest statistics on AUD, SUD, and anxiety disorders among adults in the U.S., published in the most recent National Survey on Drug Use and Health (2025 NSDUH), published by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institutes of Health (NH).

First, we’ll share the latest rates of alcohol and drug addiction (AUD/SUD), as well as the most recent rates of mild, moderate, and severe anxiety.

AUD, SUD, and Anxiety in 2025

Alcohol use disorder (AUD):

• Total: 25.7 million (8.9%)
  • 12-17: 710,000 (2.8%)
  • 18-25: 4.7 million (13.1%)
  • 26-49: 12.6 million (12.0%)
  • 50+: 7.6 million (6.2%)

Substance use disorder (SUD):

• Total: 15.3%
  • 18+: 24.2 million (9.1%)
  • 18-25: 4.5 million (12.6%)
  • 26-49: 10.9 million (10.4%)
  • 50+: 8.7 million (7.1%)

Anxiety Disorder (AD), Mild, Moderate, Severe:

• Mild: 37.4 million total (14.3%)
  • 18-25: 7.7 million (21.1%)
  • 26-49: 18.7 million (17.7%)
  • 50+: 11.6 million (9.4%)
• Moderate: 11.2 million total (4.2%)
  • 18-25: 2.8 million (7.8%)
  • 26-49: 5.3 million (5.1%)
  • 50+: 3.0 million (2.4%)
• Severe: 6.3 million total (2.4%)
  • 18-25: 1.6 million (4.3%)
  • 26-49: 3.1 million (3.0%)
  • 50+: 1.6 million (1.3%)

As the numbers show, millions of people in the U.S. have addiction disorders, and millions of people have anxiety disorders. Next, let’s look at how many people with moderate to severe anxiety reported using alcohol and/or drugs.

Substance Use Among People With Moderate or Severe Anxiety, Adults 18+:

• Alcohol, past month: 50.3%
  • Binge alcohol use: 25.5%
  • Heavy alcohol use: 8.8%
• Any illicit drug, past year: 47.8%
• Marijuana, past year: 42.1%
• Marijuana use, past month: 31.6%
  • Marijuana vaping: 15.2%

Next, since we don’t have data on people with both a clinical diagnosis of AD and AUD or AD and SUD, we’ll share the data we do have. This bullet list includes the rates of people with substance use disorder and any mental illness, as well as rates of people who received treatment for both.

Co-Occurring SUD and AMI

• 18+: 18.4 million (7.0%)
  • Received treatment for both: 12.7.%
• 18-25: 4.0 million (11.1%)
  • Received treatment for both: 9.9%
• 26-49: 10.5 million (10.0%)
  • Received treatment for both: 13.2%
• 50+: 3.9 million (3.2%)
  • Received treatment for both: 14.2%

This next bullet list includes the rates of people with substance use disorder and serious mental illness, as well as rates of people who received treatment for both.

Co-Occurring SUD and SMI

• 18+: 7.8 million (2.9%)
  • Received treatment for both: 16.4%
• 18-25: 1.9 million (5.4%)
  • Received treatment for both: 12.3%
• 26-49: 4.6 million (4.4%)
  • Received treatment for both: 17.3%
• 50+: 1.2 million (1.0%)
  • Received treatment for both: (data unavailable)

As we can see, rates of treatment among people who have anxiety and addiction at the same time are far too low:

87.3 percent of adults 18+ with any mental illness and anxiety didn’t get the treatment they need, and 83.6 percent of adults 18+ with any serious illness and anxiety didn’t get the treatment they need.

Given the significant prevalence of co-occurring AUD/SUD and anxiety – and the significant lack of treatment received – it’s important to understand how addiction and anxiety are related.

We’ll start with a general discussion of anxiety and anxiety disorders.

Anxiety Disorders: Where Do They Come From?

A diagnosis of an AD very generally means that an individual is experiencing excessive fear and/or anxiety in relation to daily life. Both anxiety and fear are useful emotions that regulate successful interactions with the world by indicating danger and potential harm. Fear tends to be about a present, specific object or event, while anxiety is triggered by a future event that may or may not be specific.

For example, seeing a snake on a path in the woods may evoke an instant reaction: fear. In response, an individual takes action to avoid the snake. That’s the simple function of fear, in most cases. It enhances safety, and therefore, survival.

On the other hand, anxiety in advance of an important meeting with a boss for a work performance review might also evoke an instant, fear-type reaction that most of us would identify as anxiety. In this case, the anxiety/fear may cause an individual to tighten up their work habits, increase performance, and prepare thoroughly for the review.

In both cases, anxiety and fear are productive.

That’s helpful – but it doesn’t give use additional information on how anxiety and addiction are related.

Which Typically Happens First? Anxiety or Addiction?

The subtypes of ADs that researchers have been able to identify as developing before or after the onset of addiction are social phobia, generalized anxiety disorder, panic disorder, and agoraphobia.

Here’s when they most commonly develop, in relation to addiction:

• Social phobia is most likely to develop before the onset of AUD/SUD
• Generalized anxiety disorder is more clearly likely to develop after the onset of ADU/SUD.
• Panic disorder and agoraphobia most often develop before the onset of AUD/SUD, but in some cases develop after AUD/SUD

The earlier onset of social phobia, now known as social anxiety disorder, may be explained by the fact that it typically emerges in childhood and early adolescence, before most people experiment with alcohol or drugs. Here are the symptoms of social phobia/social anxiety disorder:

• Excessive fear of interacting or talking with strangers
• Excessive fear that others are negatively evaluating your actions
• Excessive worry over embarrassing or humiliating yourself in social/public situations
• Excessive fear that others will notice your anxiety and its physical symptoms (sweating, shaky voice, trembling, etc.)

The symptoms of generalized anxiety disorder include physical symptoms that overlap with the symptoms of withdrawal, which explains why this diagnosis is often made after an individual develops AUD/SUD. These physical symptoms include:

• Difficult sleeping
• Muscle tension
• Easily startled
• Nausea, diarrhea or irritable bowel syndrome

The fact of co-occurrence and the overlap between the symptoms of anxiety, addiction, and withdrawal often complicate an accurate diagnosis of both addiction and anxiety. That’s why it’s important for clinicians to offer a complete assessment of any individual with addiction: there may also be anxiety present.

Early Intervention and Integrated Treatment

Clinicians working with individuals with AUD/SUD may need to enhance anxiety screening to best tailor treatment plans. Most initial assessments for addiction do attempt to assess mental health disorders. With that said, the high prevalence of co-occurring AUD/SUD and anxiety makes additional assessment for anxiety logical – and may improve treatment outcomes.

For example, if a given AUD/SUD appears alongside a panic disorder, clinicians may need to consider different pharmaceutical treatments in addressing both disorders. While the panic disorder may have preceded the addiction, earlier treatment of the panic disorder with benzodiazepines may have accelerated the development of the AUD/SUD.

In addition, the people who create public health and addiction awareness campaigns designed to prevent or reduce AUD/SUD among certain populations should consider special features among these populations that make individuals prone. For example, campaigns that target adult professionals in high stress jobs can clearly elucidate the problematic interaction of medications such benzodiazepines – often prescribed to manage anxiety – and alcohol.

An accurate diagnosis of both the addiction and the anxiety are crucial for a full and efficient recovery. When one disorder is treated and the other is ignored, both disorders get worse: that’s a fact backed up by decades of research. However, when co-occurring disorders are treated simultaneously with a holistic, integrated treatment model, the likelihood of full recovery from both disorders improves dramatically.