Despite evidence from the general population indicating that roughly one in ten people with an AOD use disorder have co-occurring OCD (see Chapter A2), the treatment of these co-occurring disorders has not been rigorously investigated. Whether or not a person is in need of treatment will largely depend on the intensity and duration of symptoms, the impact of symptoms on their everyday life, whether or not there are any other co-occurring conditions (e.g., depressive or anxiety disorders), and whether there have been any other treatment attempts in the past. As with all treatment decisions, this decision should be informed by the relevant evidence-base, and decisions made in partnership with the client.
Although there is very little evidence regarding the treatment of co-occurring OCD and AOD use, the evidence which does exist suggests that treating both OCD and AOD use leads to better treatment outcomes than treating AOD use alone [1230]. There are several options available for the treatment of OCD, including psychotherapy, pharmacotherapy, e-health, physical activity, and complementary and alternative therapies. The evidence base surrounding each of these treatments is discussed below. Although the evidence is mixed, there is some evidence to suggest that the combination of psychotherapy and pharmacotherapy may be more effective than either approach in isolation, particularly among those with severe OCD [1227, 1231, 1232].