Relationship Between Substance Abuse and Panic Attacks

Learn about the causes, symptoms, and treatments for co-occurring panic attacks and substance abuse.

What is a Panic Attack?

Panic disorders are a specific form of anxiety disorder characterized by repeated and unwanted (often expected) episodes of overwhelming fear.¹  When someone experiences a panic attack, they will have bouts of fear that cause a range of physical symptoms. These can include difficulty breathing, chest pains, heart palpitations, dizziness, and stomach problems.²  Unfortunately, these symptoms produce further fear, worsening the symptoms of panic.

Panic disorders and panic attacks typically occur without cause or reason. It is not uncommon for a panic attack to happen without any stressor that can cause a fear response; however, it is also possible to experience panic attacks from certain factors, including substance abuse and other mental health conditions.

Understanding the Relationship Between Substance Abuse and Panic Attacks

It is not uncommon for people who struggle with panic disorder to use drugs or alcohol to reduce the intensity and severity of their symptoms. Although substances may produce a sense of calm and relaxation, the relief provided by drugs and alcohol is often short-lived.

As soon as the effects of substances begin to fade, panic symptoms often quickly return. This process leads to more frequent and higher doses of drugs or alcohol to keep unpleasant and painful emotions at bay. Over time, tolerance and addiction develop. This can lead to drug-induced panic attacks or substance-induced anxiety disorder.

Studies on the prevalence of co-occurring alcohol and panic disorder symptoms indicate between 10% to 40% of all people with a panic disorder also have an alcohol use disorder. The same study showed that up to 20% of people with panic disorder symptoms abuse other substances.³ 

Substances That May Cause Anxiety and Panic Attacks

The effects of substance use are unique to each person. Although two people may abuse the same substance, they may not experience the same effects during or after taking the drug. For this reason, addiction and anxiety disorders can co-occur from a wide range of substances. Nonetheless, some substances are more likely to lead to a panic attack after use. This is sometimes referred to as substance-induced anxiety disorder, as anxiety symptoms develop during, immediately after, or when detoxing from drugs.

Alcohol

Alcohol abuse and panic disorder frequently co-occur. Alcohol abuse can lead to new or worsening panic attacks, and panic attacks can lead to alcohol abuse when someone struggling with alcohol and panic attacks uses substances to self-medicate. Some studies suggest that alcohol and panic attacks co-occur in up to 16% of the population.⁴ 

Cocaine and Methamphetamine

Cocaine and methamphetamine are stimulant drugs. Using either can contribute to increased instances of stimulant-induced anxiety. If someone abuses cocaine frequently, especially to manage symptoms related to other conditions, co-occurrence of cocaine use and panic attack symptoms may increase. Stimulant-induced anxiety can also develop when someone uses prescription stimulants, such as medications prescribed to treat ADHD.

Marijuana

Although many people believe marijuana or weed is a harmless drug, frequent use of marijuana can lead to mental health challenges, including anxiety and panic attacks. Although panic attacks from marijuana do not affect everyone, some research indicates lifetime marijuana use is associated with an increased risk for panic disorder symptoms.⁵ 

Opioids

Another drug that can lead to substance-induced anxiety disorder is opioids. Patients are prescribed opioids for a range of conditions, including pain management; however, opioid drugs are also available in illicit forms, and many are heavily abused. Panic disorder symptoms are prevalent during opioid detox and withdrawal. Some research suggests as many as 38% of people who struggle with opioid addiction also have a panic disorder.⁶ 

Effects of Substance Abuse on Panic Disorder Symptoms

Some people who struggle with panic disorder turn to drugs or alcohol to dull their symptoms. Unfortunately, this can significantly worsen their problems. Some may experience a panic attack after using drugs, and others may develop a substance-induced anxiety disorder.

Alcohol

Alcohol abuse can lead to new anxiety symptoms, worsen existing anxiety, and contribute to the onset of panic disorder symptoms and panic attacks. While alcohol acts as a depressant, it can also lead to significant impairment to one’s mental and physical functioning, which can be a significant source of panic-inducing stress. Also, withdrawing from alcohol may cause new or worsening anxiety during the detox process.

Marijuana

Marijuana abuse can worsen existing anxiety and panic disorder symptoms in those who currently struggle with a panic disorder. For some, the effects of marijuana on the body can mimic those of a panic attack. This effect is also known as weed-induced anxiety. Additionally, withdrawing from marijuana after long-term addiction can lead to anxiety during the early stages of withdrawal.

Stimulants

Stimulants are frequently associated with new and worsening anxiety and panic disorder symptoms. Symptoms of a panic attack after drug use are more often reported after stimulant use due to how the drugs affect the brain. In addition, stopping stimulant use leads to a rapid change in the brain’s chemical composition, causing significant anxiety.

Treatment for Substance Abuse Related Anxiety

Treating panic disorder requires treatment at a specialized treatment center where treatment staff understand the unique nature of dual-diagnosis conditions. At a dual-diagnosis treatment center, treating panic disorder symptoms will occur in conjunction with managing addiction. Ideally, the therapy models applied during treatment will address both conditions. Fortunately, multiple treatment options are available for treating panic disorder and a co-occurring substance use disorder.

Behavioral Therapy

Behavioral therapies (either alone or as part of a MAT program) are a crucial component of any successful program for treating a panic disorder or a dual-diagnosis condition. Behavioral therapies, such as cognitive-behavioral therapy (CBT), are often the first-line treatment for someone struggling with co-occurring addiction and panic disorder.

Medication

For some, medications have proven effective in helping manage co-occurring panic disorder and addiction. It is important to remember that medications are not suitable for everyone. The patient’s treatment team will conduct an assessment of their treatment needs and goals and their current physical health to determine if medications are a good fit.

Other Therapy Models

In addition to CBT, other therapy models such as eye-movement desensitization and reprocessing (EMDR), family therapy sessions, 12-step programs, and alternative therapy models like equine-assisted therapy have all shown success as part of a comprehensive treatment program to address both conditions.

Getting Help for Panic Disorders and Co-Occurring Substance Abuse

If you or a loved one struggles with panic disorder and a co-occurring substance abuse disorder, seeking help at a dual-diagnosis treatment center is a vital first step towards recovery. Unfortunately, not all treatment programs offer the level of care and therapeutic options needed to help an individual overcome the challenge of co-occurring disorder symptoms.
At Alta Centers, our skilled team of treatment professionals will work with each patient to develop a personalized treatment plan to help them heal from panic disorder and addiction. Our holistic approach to treatment is designed to ensure our patients heal physically, emotionally, and spiritually.
Although it may feel like it at times, you do not have to face the recovery journey alone. Our team is prepared to guide you through each step and discover a healthy lifestyle once again. To learn more about how our programs can help, contact us at Alta Centers today.

Resources

• https://www.nimh.nih.gov/health/
• statistics/panic-disorder
• https://pubmed.ncbi.nlm.nih.gov/
• 10574314/
• https://pubmed.ncbi.nlm.nih.gov/
• 2256896/
• https://www.ncbi.nlm.nih.gov/pmc/
• articles/PMC2528232/
• https://www.ncbi.nlm.nih.gov/pmc/
• articles/PMC2917792/
• https://jamanetwork.com/journals/
• jamapsychiatry/fullarticle/482045

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