Substance Use and Anxiety Disorders: A Scoping Review

We aimed to evaluate the significance and directionality of the relationship between substance use disorders (SUDs) and anxiety disorders (ADs), as this remains unclear.

Following PRISMA guidelines and a scoping review methodology, 25 articles met inclusion criteria and were searched using PubMed, Ovid, MEDLINE, and PsychInfo through June 2023. Our results reveal strong associations between substance use and ADs, with alcohol and cannabis exhibiting the most robust relationships. Preliminary evidence points to a potential bidirectional relationship between substance use and ADs, however, more longitudinal and experimental studies are needed to demonstrate causal results. Importantly, individuals with comorbid ADs and SUDs were shown to experience greater symptom severity, have poorer treatment response, and increased rates of relapse compared to those with either disorder alone.

Our scoping review thus highlights the need for integrated treatment approaches to address comorbid substance use and ADs and improve treatment outcomes for those experiencing dual diagnosis.