Summary

There are currently no evidence-based integrated treatments for co-occurring OCD and AOD use disorders, and evidence from only one RCT among people with co-occurring OCD and AOD use favouring the concurrent treatment of these disorders [1233]. Although there is limited evidence for the treatment of co-occurring OCD and AOD use, results from single disorder OCD studies suggest there is strong and consistent evidence to recommend the use of ERP, behavioural and cognitive therapies as the first line of treatment in single disorder OCD.

Box 19 illustrates the continuation of case study F, following Ayla’s story.

Box 19: Case study F: Treating co-occurring OCD and AOD use: Ayla’s story continued

Case study F: Ayla’s story continued

The AOD worker conducted a suicide risk assessment and although Ayla spoke of ending her life, she was not at immediate risk for suicide. The AOD worker organised for Ayla to see a clinical psychologist who specialised in ERP, along with a psychiatrist who specialised in OCD. Ayla’s AOD worker coordinated the treatment approach, and together with Ayla’s GP, the clinical psychologist, psychiatrist, Ayla and her parents devised a treatment plan. Ayla’s treatment consisted of concurrent pharmacotherapy and CBT with ERP, which addressed her OCD and cannabis use. Ayla’s treatment took place over several months, with long-term plans for ongoing monitoring and support put in place to ensure Ayla was able to maintain her treatment gains.

Key Points

Symptoms of OCD can be mistaken for anxiety.
People with OCD commonly use substances that reduce their levels of anxiety, but may not necessarily reveal their use of AOD to health professionals.
There is a need to monitor ongoing physical health complications of co-occurring OCD.