Social Anxiety & Substance Use Disorders

Social Anxiety and Alcohol

Alcohol is among the most common substances socially anxious people use in order to reduce their anxiety and arousal.

While the rates of alcohol abuse and dependence are already high in the general population, they are significantly higher for people diagnosed with SAD (Kessler et al., 1997).

Women with SAD have been found to display a greater risk for suffering from an additional alcohol use disorder than socially anxious men. In four out of five cases, social anxiety disorder develops prior to the substance use disorder (Buckner et al., 2008; Kushner et al., 2008, Marmorstein, 2012).

Social anxiety and alcohol show a strong association.
Many people with social anxiety use alcohol in order to face, handle, or enjoy social events.

A significant proportion of SAD sufferers reports “self-medication” as their main drinking motive (Robinson, Sareen, Cox, & Bolton, 2009).

Alcohol is often used in order to calm down before or during social events. Around half of SAD sufferers report engaging in drinking for this reason (Thomas, Randall, Book, & Randall, 2008). In the same study, eighty percent of people with SAD stated they had used alcohol to face and handle certain social situations.

Social Anxiety and Tobacco

Similar to drinking alcohol, smoking cigarettes has been socially accepted in Western countries. About every fifth person in the United States smokes (Lasser et al., 2000).

For people suffering from SAD, the numbers double. It has been suggested that some SAD sufferers start smoking as an attempt to cope with their anxiety (Szafranski, Talkovsky, Farris, & Norton, 2014). For four out of five smokers with SAD, their social anxiety appeared before their smoking habit (Cougle et al., 2010).

Social anxiety and tobacco use often co-occur. For most people, SAD comes first, smoking cigarettes follows.
Smoking cigarettes can be an attempt to cope with social anxiety disorder.

Social Anxiety and Cannabis

Cannabis is among the most consumed substances in the world, ranking number three behind alcohol and tobacco in the United States (Tepe, Dalrymple, & Zimmerman, 2012; Conway et al., 2006).

Among people with cannabis addiction, the probability of suffering from a psychiatric disorder at some point in their lives is considered to be around ninety percent (Agosti, Nunes, & Levin, 2002).

Cannabis is also the most commonly consumed illegal drug among people suffering from social anxiety disorder (Conway et al., 2006). Almost every fifth person with SAD immerses in cannabis abuse.

In fact, socially anxious people are much more likely to suffer from cannabis dependence than individuals suffering from other anxiety disorders (Agosti et al., 2002; Buckner, Schmidt, et al., 2008).

For more than half of SAD sufferers who also experience cannabis use disorder, their social anxiety had already appeared when they started smoking marijuana (Buckner, Schmidt, et al., 2008; Tepe et al., 2012).

Social Anxiety & Substance Use Disorders 1 Almost every 5th person with social anxiety disorder smokes weed. 1
Social anxiety disorder is associated with an increased risk for cannabis dependence.

Just as with alcohol and tobacco use, it has been documented that SAD sufferers who consume cannabis tend to do so in order to calm down, reduce tension, and improve their ability to deal with their social anxiety (Buckner, Heimberg, Matthews, & Silgado, 2012; Buckner, Bonn-Miller, Zvolensky, & Schmidt, 2007).

Since socially anxious people often rely on cannabis to reduce their tension and anxious states, a habit can quickly develop. The correlation between SAD and cannabis dependence might exist because individuals start believing they need the substance in order to cope (Buckner, Schmidt, Lang, Small, Schlauch, & Lewinsohn, 2009).

Thus, the likelihood of learning and engaging in more adaptive coping strategies decreases over time. The belief of being unable to cope without the substance leads to a significant risk of developing a dependence.

Therapy should address better and sustainable coping strategies, in order to reduce the perceived need to keep consuming the drug.

Since we specialize in social anxiety disorder, but not in problems related to drug addiction, we kindly refer you to the Addiction Center for further information and support regarding substance dependence.


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