Substance/Medication-Induced Anxiety Disorder

Anxiety caused by alcohol, drugs, or medications is called substance-induced anxiety disorder. This disorder is characterized by anxiety or panic that is caused by or worsened by the use of a substance, such as alcohol, drugs, or medications. While intoxication or withdrawal from alcohol or drugs can cause anxiety or panic, substance/medication-induced anxiety disorder causes significant distress or functional impairment.

Key Points to Remember

• Anxiety levels can be increased by illicit and prescription drugs, over-the-counter medications, and other substances.
• Substance-induced anxiety disorder can develop after just one use of a drug.

Diagnosis of Substance/Medication-Induced Anxiety Disorder

Anxiety symptoms causing emotional upset or significantly affecting a person's life may indicate substance-induced anxiety disorder. This can impact work, social life, and other important aspects of life.

Healthcare providers check if anxiety existed before alcohol, drug, or medication use, as other anxiety disorders may be present. Continued anxiety symptoms more than a month after abstinence suggest an independent mental health issue.

Timeline of Substance-Induced Anxiety Disorder

Anxiety or panic can occur immediately after taking drugs, alcohol, or medication. Some people develop the disorder after just one use.

Substance-induced anxiety disorder "with onset during intoxication" means anxiety starts when the individual is intoxicated.

Anxiety can also occur during withdrawal from drugs, alcohol, or medication. While anxiety is a typical withdrawal symptom, it is usually resolved within a few days of discontinuing use. However, in substance-induced anxiety disorder, panic and anxiety are severe and require clinical attention.

Causes of Substance-Induced Anxiety Disorder

Substances that increase anxiety levels fall into three categories: drugs, medications, and other substances.

Drugs:

• Alcohol
• Caffeine
• Cannabis
• Hallucinogenic drugs (LSD, PCP, ecstasy, etc.)
• Hypnotics
• Stimulants (amphetamines, cocaine, etc.)
• Tobacco

Medications:

• Antihistamines
• Blood pressure medications (calcium channel blockers and beta blockers)
• Corticosteroids
• Hypnotics
• Opioids
• Psychiatric medications (including antidepressants and anxiety medications)
• Sedatives
• Stimulants (i.e., attention-deficit hyperactivity disorder (ADHD) medications)
• Steroids
• Respiratory medications (i.e., bronchodilators and decongestants)
• Thyroid medications

Other Substances:

• Heavy metals and toxins, such as carbon dioxide and volatile substances like gasoline and paint.

Getting Help for Substance/Medication-Induced Anxiety Disorder

If anxiety is increasing and may be due to a substance, contact your healthcare provider. They can identify the cause by confirming or ruling out specific substances.

If substance-induced anxiety disorder is diagnosed, the first step is typically to remove the substance causing the anxiety. Treatment may also include behavioral therapy and/or certain medications.

Honesty with your healthcare provider about substance use, even on a single occasion, can help them identify the cause of anxiety and create a resolution plan.

They can also devise a plan to address problematic substance use. If you have an addiction or substance negatively impacting your life, talk to your physician or a mental health professional. Help is available, and they can connect you to resources for successful recovery.