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In the United Kingdom, it is believed that almost one million people are living with obsessive-compulsive disorder (OCD). OCD can affect men, women and children, and it often begins in childhood, adolescence or early adulthood.
OCD involves intrusive obsessions and compulsive behaviours that can become time-consuming, distressing and difficult to control. When untreated, it can affect relationships, work, study, sleep, self-care and overall quality of life.
For some people, OCD also overlaps with alcohol or drug use. Substances may be used to cope with intrusive thoughts, anxiety, shame or exhaustion, but they can also worsen symptoms and make recovery more complicated. In those cases, treatment planning should consider both OCD and addiction together.
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Recovery Scotland can help you prepare questions about OCD, addiction, dual diagnosis treatment and aftercare before speaking with providers.
In some cases, untreated OCD can become so severe that everyday life feels difficult to manage. This can be especially complicated if alcohol or drug use is also present.
If OCD and substance use overlap, it is worth asking providers how they assess both conditions together. You may see this described as dual diagnosis treatment, co-occurring disorder support or integrated mental health and addiction care.
The right route may involve a GP, NHS mental health services, specialist OCD therapy, private therapy, addiction support, detox planning where substances are involved, or residential treatment if a structured setting is clinically appropriate.
What Causes OCD?
There isn’t one cause of OCD. Many factors can contribute to an individual’s likelihood of developing this condition, which can include a combination of genetic and environmental factors.
Many obsessive-compulsive disorders are worsened by anxiety, but it is not defined as an anxiety disorder.
There are four main OCD themes. Common OCD themes include contamination fears, checking and doubt, symmetry or ordering concerns, and intrusive unwanted thoughts. However, OCD is not limited to four types, and symptoms can overlap or change over time.
- Contamination OCD – people with this type of obsessive-compulsive disorder (OCD) will fear contamination or germs. As a result, they will clean either themselves, surfaces or objects repeatedly.
- Perfection OCD – people with this type of obsessive-compulsive disorder (OCD) will crave symmetry and balance. As a result, they may excessively arrange and count items.
- Doubt OCD– people with this type of obsessive-compulsive disorder (OCD) will worry for their safety. As a result, they may repeatedly check that a door is locked, for example.
- Intrusive thoughts – people with this type of obsessive-compulsive disorder (OCD) will have aggressive thoughts. As a result, they may continuously seek reassurance from others.
How Is OCD Treated?
OCD treatment should be based on assessment. There is no single approach that suits everyone, because symptoms, triggers, compulsions, mental health, substance use and home circumstances can vary widely.
Common OCD treatment routes can include cognitive behavioural therapy, exposure and response prevention, medication review, specialist mental health support and relapse prevention planning. Where addiction is also present, providers should consider withdrawal risk, cravings, coping strategies and whether substances are reinforcing compulsions or avoidance.
When comparing providers, ask whether therapy is delivered by suitably qualified clinicians, how OCD symptoms are assessed, whether family involvement is available, how confidentiality is handled and what aftercare is offered. If substance use is involved, also ask how detox, relapse prevention and mental health support are coordinated.
A strong plan should help the person understand intrusive thoughts, reduce compulsive behaviours safely, manage anxiety and build support for life after the first stage of treatment.
What OCD Treatment Options May Be Considered?
If you are living with OCD and also struggling with drug or alcohol addiction, treatment planning should look at the full picture rather than treating each issue separately.
Options may include GP support, NHS mental health services, private therapy, addiction counselling, outpatient support, detox planning or residential care. What matters is whether the provider can explain why a route is suitable after assessment.
Cognitive Behavioural Therapy
OCD UK describes cognitive behavioural therapy as a key treatment route for OCD. CBT can help people understand intrusive thoughts, reduce compulsive responses and build healthier coping strategies.
Exposure and Response Prevention
Exposure and response prevention is often used within OCD-focused therapy. It involves carefully and gradually facing feared situations while learning to resist compulsive behaviours. This should be handled by appropriately trained professionals.
Addiction and Dual Diagnosis Support
If alcohol or drug use is present, ask whether the provider can assess substance use, withdrawal risk and mental health together. Detox or addiction treatment may be needed before, alongside or after OCD-focused therapy depending on the circumstances.
Aftercare
Aftercare may include ongoing therapy, relapse prevention, family guidance, peer support and crisis planning. This is especially important where OCD symptoms, anxiety or cravings may return after a structured programme ends.
Finding OCD and Addiction Support in Scotland
If OCD, anxiety, alcohol use or drug use is affecting daily life, it is worth seeking advice early. Recovery Scotland can help you compare treatment routes and prepare questions before making an enquiry.
You can contact Recovery Scotland for confidential guidance. For urgent danger, overdose risk or severe withdrawal, call 999. For non-emergency medical advice in Scotland, contact NHS 24 on 111 or speak with a GP.
John Gillen
- Author
- Last updated: June 17, 2026
John has travelled extensively around the world, culminating in 19 years’ experience looking at different models. He is the European pioneer of NAD+ (Nicotinamide Adenine Dinucleotide) treatment to Europe in 2010; and recently back from the USA bringing state of the art Virtual Reality Relapse Prevention and stress reduction therapy. His passion extends to other metabolic disturbances and neurodegenerative diseases. The journey continues. In recent times, John has travelled to Russia to study and research into a new therapy photobiomudulation or systemic laser therapy working with NAD+ scientists and the very best of the medical professionals in the UK and the USA, together with Nadcell, Bionad Hospitals own select Doctors, nurses, dieticians and therapists. Johns’ passion continues to endeavour to bring to the UK and Europe new developments with NAD+ Therapy in preventive and restorative medicine and Wellness. In 2017 John Gillen was made a visiting Professor at the John Naisbitt university in Belgrade Serbia.