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Relationship Between Substance Abuse and Panic Attacks

Learn about the connection between substance abuse and panic disorder and where to find treatment.

Panic Attacks and Panic Disorder

A panic attack is a flash of severe worry that occurs when no genuine risk exists. The person will experience intense worry, anxiety, discomfort, and a feeling akin to having a heart attack or dying. Unfortunately, these sensations increase fear, exacerbating panic disorder symptoms.Panic disorder is one of several forms of anxiety disorders and is characterized by frequent and persistent panic attacks. In any given year, around 6 million Americans suffer from panic disorder symptoms, with women suffering twice as frequently as men. About one-third of people will experience a panic attack in their lives, but only 10% of this number will develop panic disorder symptoms. 1

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Panic disorders and panic attacks usually ensue for no apparent reason. It is not rare for panic attacks to occur without any stressor that produces a fear reaction. However, panic attacks can also be caused by specific factors.


When someone has a panic attack, they may experience periods of fear resulting in various physical panic disorder symptoms. Some of these symptoms are:
  • Breathing difficulties
  • Chest aches
  • Heart palpitations
  • Dizziness
  • Stomach troubles
  • Numbness in certain body parts
  • Sweating and chills
  • Shaking body parts

What Is Substance Abuse?

Substance abuse, or substance use disorder, is the uncontrollable urge and misuse of a substance despite its negative consequences. Substance use disorder can involve illicit (e.g., heroin, cocaine, ecstasy) and legal (e.g., prescription medications, cigarettes, alcohol) substances.The term refers to the repeated use of a substance that produces severe behavioral, psychological, and physical issues. For example, substance abuse may result in missing important events, such as trips, work, or school, or using it in potentially hazardous conditions, like driving. In addition, it can result in substance-related legal issues, substance-induced anxiety disorder, or prolonged substance use that interferes with friends and family.

Commonly Abused Substances

  • Alcohol
  • MDMA
  • Marijuana
  • Inhalants
  • Cocaine
  • Opiates
  • Prescription medicines, such as pain pills, stimulants, or anxiety pills
  • Hallucinogens
  • Methamphetamine

Risks of Substance Misuse

People commonly turn to drugs to feel better, and while many are aware of the consequences, others are not. The risks of substance misuse are substantial, and the fact that some drugs are legal does not make them less hazardous. Regular or habitual drug usage results in dependence and eventually addiction over time, adding to the stress. Some risks of substance abuse are:
  • Death
  • Asthma
  • Intestinal decay
  • Insomnia
  • Aggression
  • Brain damage
  • Coma

Relationship Between Substance Abuse and Panic Attacks

As previously intimated, it is not unusual for people with panic disorder to attempt to minimize the intensity and severity of their symptoms by using alcohol or drugs. One study found that 39% of patients who experience panic attacks have abused at least one substance. Everyone needs to be aware that while these substances can create a sense of serenity, comfort, and peace, it is very short-lived and will cause serious damage in multiple aspects of their lives.2 As soon as the effects of the ingested substances wear off, panic disorder symptoms return, leading to more frequent and greater amounts of drugs or alcohol ingested to suppress these unwanted and unpleasant feelings. Hence, tolerance, anxiety, and addiction begin to develop. Drug-induced panic episodes or substance-induced anxiety disorder can also result from this.

Drug Abuse as a Hindrance to Panic Disorder Treatment

Most co-occurring panic disorders are hampered by substance use disorder. For example, persons with an addiction are less likely to keep appointments and follow treatment suggestions than those without an addiction. This may be more severe in individuals who suffer from panic disorder symptoms and substance-induced anxiety disorder.
Furthermore, when a person stops using substances, they may have panic attacks that are more intense than previously. This is the result of withdrawal symptoms, which commonly lead to treatment discontinuation.

Drug Abuse as a Hindrance to Panic Disorder Treatment

Most co-occurring panic disorders are hampered by substance use disorder. For example, persons with an addiction are less likely to keep appointments and follow treatment suggestions than those without an addiction. This may be more severe in individuals who suffer from panic disorder symptoms and substance-induced anxiety disorder.
Furthermore, when a person stops using substances, they may have panic attacks that are more intense than previously. This is the result of withdrawal symptoms, which commonly lead to treatment discontinuation.

Drugs That Can Worsen the Symptoms of Panic Attacks

Some drugs that can worsen panic disorder symptoms will be detailed below.


Ephedrine is a performance-related stimulant. Because it causes high body heat and increased body rate, this stimulant creates instability in the heart’s electrical activity.


Cocaine is a stimulant that can be smoked, snorted, injected, or orally ingested via rubbing the drug on the gums. It produces a false impression of power and vitality, which can swiftly escalate to behaviors like violence, promiscuity, or paranoia. This substance is especially harmful to the heart since it causes rapid and abrupt increases in heart rate. Cocaine and panic attacks are common denominators in cocaine addiction cases. People who use cocaine also frequently experience anxiety symptoms or full-fledged panic attacks.


Methamphetamine is another stimulant that may lead to a rise in stimulant-induced anxiety, meth panic attacks, and substance-induced anxiety disorder.


MDMA is a stimulant that can cause unprecipitated death and severe heart attacks. An estimated 2.9 million people aged twelve and older in the United States used MDMA in 2020. 3


Alcohol is both a depressant and a stimulant. Intoxicated persons may become agitated from the effects of alcohol, such as losing control over their bodies and minds, resulting in panic attacks. Furthermore, when people first stop drinking, they may have withdrawal symptoms such as panic attacks. Some patients relapse due to their fear of having further withdrawal-related panic episodes and will undergo lengthy substance abuse treatment.


Many people think of marijuana as a depressive, meaning it relaxes the body and mind; however, this drug is also a stimulant. As a result, marijuana abuse can exacerbate the sensations associated with panic attacks.

Long-Term Effects of Substance Abuse

Substance abuse can significantly affect the body, often causing long-term and irreversible damage. Some of the most common long-term side effects of substance abuse include:
  • Cancer
  • Heart attacks
  • Liver disease
  • Kidney failure
  • Increased mental health issues

What Treatments Are Available?

If you are experiencing panic attacks due to substance abuse, the symptoms will usually disappear once substance use ceases. For those with a dependency and addiction to a substance, seeking substance abuse treatment is the first and best step to a better and healthier life.Although it might be difficult for people with disorders to seek care, it’s important to remember that clinicians and mental health professionals are available to offer support, patience, and treatment. The most effective treatment strategies address both the symptoms and causes of panic disorder and substance use disorder.

Coping Mechanisms for Panic Attacks

There are many coping mechanisms for panic attacks. Some of them are listed below:
  • Creative Expression: Allowing patients to express themselves creatively can provide calming and freeing effects.
  • Regular Exercise: Regular exercise is a valuable tool that aids recovery during treatment for substance use abuse and panic attacks
  • Engage in Hobbies and Interests: Finding joy in hobbies and interests can help infuse new life and give them a sense of focus and responsibility.
  • Volunteer Work:  Another coping mechanism for panic attacks is volunteer work. It offers a sense of focus and well-being.
  • Communication With Friends and Therapists Communicating with friends and therapists can help decrease panic attacks. When friends and therapists know what is wrong, they will be willing and able to help and care for them better.
  • Cognitive Reframing: Cognitive reframing is the process of rethinking a situation by seeing it from a different angle. Changing a problem’s intellectual or emotional framework may alter views of its severity and offer alternatives for resolution. In psychotherapy, for example, a client’s first framing of an issue may be self-defeating. Part of the therapist’s reaction may be to reframe the situation to present different ways to analyze it.

Prescription Medications

Therapists frequently prescribe medication to supplement panic attacks and anxiety treatments.

Selective Serotonin Reuptake Inhibitors (SSRIs)

The most typically recommended drugs for the combined diagnosis of panic disorder and substance abuse disorder are selective serotonin reuptake inhibitors (SSRIs). A meta-analysis reviewed eight-seven studies on the effectiveness of various medications for panic disorder, examining remission, depression and anxiety scores, dropout rates, and adverse effects. Overall, SSRIs were considered the most effective treatment method, with 66.7% of patients entering remission, 97.5% experiencing reduced anxiety symptoms, and lower dropout rates and adverse effects compared to other medications.4
Doctors may prescribe topiramate for those who have panic disorder and struggle with cocaine abuse. Similarly, paroxetine and sertraline are commonly recommended medications for people suffering from alcoholism and panic disorder. Doctors administer medicine to each patient, examine their reactions, and change the dosage or propose a different prescription based on the responses.

Other Treatment Plans

Because panic disorder and substance abuse disorder are so complex, concurrent treatment plans usually include multiple types of therapy for both conditions. In these circumstances, each patient’s team of therapists and physicians collaborates to develop the optimum treatment plan. For example, group therapy and psychoeducational therapy are excellent treatment methods that can successfully aid recovery. Some patients also spend time in rehabilitation institutions, where they are isolated from environmental triggers in their homes and surroundings.

Helping a Loved One Get Through Panic Disorder and Substance Abuse

Talking about panic attacks, anxiety, and addiction with a family member or friend can be difficult, especially if it involves substance abuse. These are highly personal and sensitive topics, and believing they would resolve the issue or seek treatment themselves can do more harm than good. Taking the effort to convey your worry to a loved one and providing support can significantly help and might be the component that propels the person to the next stage of recovery.

Be Compassionate and Nonjudgmental

Addiction and mental illness may negatively impact the quality of one’s relationships, work performance, and general quality of life. Rather than emphasizing the negative effects of the individual’s substance misuse, emphasize the advantages of rehabilitation and the good outcomes of healing.

Be Prepared for Denial or Defensive Behavior

Denial is a typical sign of addiction, and many patients will become defensive or aggressive when confronted with their condition. An intervention may be more effective if it involves two or more close friends or family members. Crisis intervention professionals can also be helpful, especially if furious or violent reactions are teeming.

Remember That Substance Abuse and Panic Disorders Are Both Disease Processes

Drug and alcohol addiction were formerly thought to be symptoms of moral weakness. Fortunately, the evidence and research over the years have proved that addiction is a chronic mental illness, steering the stigma further away from negativity and closer to understanding. Similarly, panic is a mental disorder, not just a personality trait. Panic and addiction can be managed with therapeutic approaches and the assistance of trained specialists.

Offer Specific Solutions

When discussing solutions, it’s helpful to provide specific recovery options, such as the name of a therapist or rehab facility specializing in treating clients with dual diagnoses of anxiety and drug misuse. It helps eliminate time wastage and shows how ready you are to help.

Client-Specific Treatment Opportunities

Client-specific treatments are vital to a successful recovery. Thus, seeking help from a mental health facility that offers high-quality treatments and experienced medical professionals is the best option. That way, a team of specialized staff can formulate a specific, personalized treatment plan to maximize the chances of recovery.

Treatment at Ripple Ranch Recovery

Battling anxiety and addiction can feel like an overwhelming burden. At Ripple Ranch Recovery, we are here to offer support and help you through this difficult time. We will provide you with the necessary tools, treatments, and care to achieve long-lasting wellness and sobriety, enabling you to live the life you deserve.