compulsion vs addiction

OCD and Addiction | Compulsion vs Addiction

by Pat Fontana

When dealing with a mental health or substance use issue, understanding more about what causes it and how to manage it can help you take steps toward living a healthier life. This holds true for people who experience obsessive-compulsive disorder (OCD) as well, particularly knowing the connection between OCD and addiction. It’s also helpful to know the differences between compulsion vs addiction.


The American Society of Addiction Medicine (ASAM) defines addiction as a “treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.” Someone with an addiction to a substance or a behavior will not be able to stop using drugs or alcohol or to stop engaging in the behavior, even though it can cause them harm, mentally and physically.


Playing a role in the addiction process, compulsion is much narrower. It describes the intense urge to do something that can lead to a certain behavior. As an individual’s addiction develops, they will develop a feeling of compulsion to take the addictive substance or carry out the addictive behavior.

Compulsion is one of the primary symptoms of OCD. When someone has OCD, they may have a compulsion to engage in a certain behavior. This compulsion is related to obsession, a repeated thought that generates distress for them. An individual with OCD may have a compulsion to wash their hands or constantly check door locks as a way to try to alleviate their anxiety.

Compulsion vs Addiction

A major distinction between a compulsion and an addiction is connected to the individual’s awareness and acceptance of reality. A person with OCD may be aware that they are not being realistic with their obsessions. They may know that their compulsions are illogical or excessive. It’s possible a person with OCD will feel disturbed by their own thoughts and by their need to carry out their compulsive behavior, but they need to do it anyway as a way to relieve their distress.

Someone with an addiction is often detached from the logic of their actions. They may not recognize that their addiction has negative consequences, as they are in denial that they have a problem or that the problem is causing issues in their life. Denial is a core component of addiction.

Compulsive Behaviors

A person who exhibits compulsive behaviors is driven by repetitive urges and may have limited voluntary control over those urges. They may have a diminished ability to delay or inhibit their compulsive behavior, displaying a tendency to perform repetitive acts habitually or even in a stereotypical manner.

Being compulsive is a central characteristic of OCD and is crucial to addiction. OCD is proposed to be included in the concept of behavioral addiction along with certain other disorders that share compulsivity but are not related to drugs, including pathological gambling and compulsive eating.

OCD and Addiction

Almost 30% of individuals diagnosed with OCD also have had a substance use disorder at some point in their lives, a number that is nearly double that of the general population. The rate of addiction is high among people with OCD but is lower than that associated with other forms of mental illness, such as schizophrenia. Most people report that their OCD symptoms appeared long before they developed a substance use disorder.

A number of people diagnosed with OCD start to use drugs or alcohol as a form of self-medication to reduce the severity of their compulsive behaviors or to decrease the distress they experience while living with OCD. They may experience problems in relationships or difficulties at work as a result of their compulsions and obsessions.

Substance use is a particularly poor coping strategy, however, as it can lead to additional mental and physical health issues. An individual’s OCD symptoms will continue to get worse as the substance enables them to avoid dealing with the actual source of their distress. People with OCD who develop an addiction are at greater risk for hospitalization and suicide.

South Miami Recovery is Here to Help

At South Miami Recovery, we understand the struggles of OCD and addiction. If you recognize the signs and symptoms in yourself or your loved one, please contact us for help. Our professional staff includes licensed mental health professionals and certified substance abuse therapists. We offer HIPAA-compliant telehealth services as well as safe outpatient services during COVID-19 so you can get the help you need. To learn more, contact us today. Call South Miami Recovery at 305.661.0055.