Stressed out? You could be at a higher risk for both adjustment disorder and substance abuse.

An adjustment disorder occurs when stress overwhelms a person’s coping skills, leading to changes in their emotions and actions. In short, a person has trouble adjusting to new circumstances, and this stress causes abnormal behavior. Because stress is also linked to substance abuse, it is common for people who have an adjustment disorder to also have a substance use disorder.

In some cases, a person may have substance abuse problems before they experience life stress that causes an adjustment disorder. In other cases, they may start using substances to cope with the kind of stress that led to their adjustment disorder. If you or a loved one has an adjustment disorder, it is important to be aware of the risk for substance abuse problems.

Effects of Drug Use on Adjustment Disorder

Many classes of drugs are addictive, including opioids, benzodiazepinesalcohol and sleep aids. Sometimes, people with an adjustment disorder become dependent on these drugs, which may be prescribed to them for anxiety, pain, depression, or sleep. Besides the risk of dependence, the dangers of misusing these drugs also include blackouts. During a blackout, a person may not be aware of what they’re doing. Therefore, they might do things that can lead to injury or legal problems. For people with adjustment disorders, this adds more stress to their life and may worsen symptoms.

Adjustment Disorder and Alcohol

Alcohol temporarily stops negative thinking patterns, lessens anxiety and creates a sense of mild well-being. Drinking is also generally more accessible and socially acceptable than other substances. For these reasons, people with adjustment disorders often struggle with alcohol use.

Unfortunately, alcohol abuse can cause serious problems for people with mental health conditions. Drinking raises the risk of dangerous and self-destructive behavior and can increase the risk of suicidal behavior, which is already higher for people with adjustment disorders. Drinking also tends to worsen depression and anxiety when a person is sober. Therefore, in the long-term, adjustment disorder symptoms can be worsened by drinking.

Marijuana and Adjustment Disorder

People with adjustment disorders may turn to marijuana for relief. Marijuana is increasingly accessible and, much like alcohol, produces calming effects. However, marijuana can also cause people to feel disconnected from real life. Marijuana is known to cause the following states:

  • Depersonalization, or feeling disconnected from thoughts and sensations
  • Derealization, or feeling as if the world is distorted or unreal
  • Physical dissociation, or out-of-body experiences

Like alcohol, marijuana often causes symptoms of anxiety and depression to worsen as the effects of the drug wear off. Marijuana can also cause severe episodes of anxiety and panic in some individuals, worsening symptoms for people with anxiety.

Adjustment Disorder and Prescription Medications

Depending on a person’s adjustment disorder symptoms, their doctor may prescribe medications for mood, anxiety or sleep. These medications can include antidepressants, sedatives or sleep aids. Because these drugs tend to depress the central nervous system, they should not be used with alcohol or other drugs. Combining them with other drugs can lead to unsafe side effects. In addition, some of the medications prescribed have a risk for dependence and should only be used as directed by a doctor.

Statistics on Adjustment Disorders and Addiction

Approximately 16 million people in the United States have had an episode of adjustment disorder within the past year. In addition, as many as 75% of people with adjustment disorders also abuse substances.

Can Adjustment Disorder Lead to Substance Abuse?

For many people, the first step on the road to addiction is using substances to try to cope or feel better after they suffer an unexpected loss or setback. When stressors aren’t quickly resolved, people may shift their attention from trying to solve the problem of trying to feel better. This can cause them to use substances more often and in greater amounts.

One study showed that in people with known adjustment disorder, 59% were later diagnosed with a new substance abuse problem. In fact, some doctors think that people choose the substances that will best compensate for their underlying mental health problems. For example, someone who is anxious may select a substance that is a depressant to alleviate their anxiety.

Treating Adjustment Disorder and Co-Occurring Substance Abuse

Treatment options are available for people with adjustment disorders who struggle with substance abuse. Treatments that combine group and individual therapy can help you heal from your pain while also learning how to control cravings and avoid triggers to use substances.

If you struggle with substance use and adjustment disorder, help is available. Trained professionals at The Recovery Village are here to help. Contact us today to learn more.

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Editor – Megan Hull
Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

Duffing TM, Greiner SG, et al. “Stress, Substance Abuse, and Addiction.” Current Topics in Behavioral Neurosciences, 2014. Accessed May 5, 2019.

Carta MG, Balestrieri M, et al. “Adjustment Disorder: Epidemiology, Diagnosis and Treatment.” June 26, 2009. Accessed May 5, 2019.

Karg RS, Bose J, et al. “Past Year Mental Disorders Among Adults […]h Surveillance Study.” Substance Abuse and Mental Health Services Administration, October 2014. Accessed May 5, 2019.

Khantzian EJ. “The Self-Medication Hypothesis of Addict[…]d Cocaine Dependence.” American Journal of Psychiatry. November 1985. Accessed May 5, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.