Skip to main content
SpringerLink
Log in
Book cover

Substance Use and the Acute Psychiatric Patient pp 125–144Cite as

Substance-Induced Anxiety and Co-occurring Anxiety Disorders

  • Chapter
  • First Online:

Part of the book series: Current Clinical Psychiatry ((CCPSY))

Abstract

Substance-induced anxiety (SIA) is sparsely found in literature but is commonly seen in the emergency department (ED) and can be associated with a wide range of substances. It can be challenging in the acute setting to differentiate anxiety symptoms associated with intoxication or withdrawal from those associated with a primary anxiety disorder exacerbated by substance use, but it is important to try to distinguish SIA from non-substance-induced anxiety disorders to guide appropriate treatment. Patient history and, at times, laboratory findings are essential in diagnosing SIA. Treatment and disposition options vary and are guided by the severity of presenting symptoms, final diagnosis, and safety concerns.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Grant B, Stinson F, Dawson D, Chou S, Dufour MC, Compton W, et al. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders – results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry. 2004;61(8):807–16.

    Article  Google Scholar 

  2. Somers JM, Goldner EM, Waraich P, Hsu L. Prevalence and incidence studies of anxiety disorders: a systematic review of the literature. Can J Psychiatr [Internet]. 2006;51(2):100–13. Available from:. https://doi.org/10.1177/070674370605100206.

    Article  Google Scholar 

  3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, D.C.: American Psychiatric Association; 2013.

    Book  Google Scholar 

  4. Kushner MG, Krueger R, Frye B, Peterson J. Epidemiological perspectives on co-occurring anxiety disorder and substance use disorder. In: Stewart SH, Conrod PJ, editors. Anxiety and substance use disorders: the vicious cycle of comorbidity. New York: Springer; 2008. p. 3–17.

    Chapter  Google Scholar 

  5. Lai HMX, Cleary M, Sitharthan T, Hunt GE. Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, 1990–2014: a systematic review and meta-analysis. Drug Alcohol Depend. 2015;154:1–13.

    Article  Google Scholar 

  6. Moss HB, Chen CM, Yi H. Prospective follow-up of empirically derived alcohol dependence subtypes in wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC): recovery status, alcohol use disorders and diagnostic criteria, alcohol consumption behavior, health status, and treatment seeking. Alcohol Clin Exp Res. 2010;34(6):1073–83.

    Article  Google Scholar 

  7. Center for Behavioral Health Statistics and Quality. Key substance use and mental health indicators in the United States: results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51). 2016. Retrieved from http://www.samhsa.gov/data/.

  8. Goudriaan AE, Sher KJ. Alcohol. In: Verster JC, Brady K, Galanter M, Conrod P, editors. Drug abuse and addiction in medical illness: causes, consequences and treatment [internet]. New York: Springer; 2012. p. 123–36. Available from:. https://doi.org/10.1007/978-1-4614-3375-0_9.

    Chapter  Google Scholar 

  9. Barceloux DG. Medical toxicology of drugs abuse: synthesized chemicals and psychoactive plants [Internet]. New York: Wiley; 2012. [cited 2017 Sept 25]. Available from: ProQuest Ebook Central.

    Google Scholar 

  10. Matt G, Kenneth J, Bernard D. The relation between alcohol problems and the anxiety disorders. Am J Psychiatry. 1990;147(6):685–95.

    Article  Google Scholar 

  11. Robinson J, Sareen J, Cox BJ, Bolton JM. Role of self-medication in the development of comorbid anxiety and substance use disorders: a longitudinal investigation. Arch Gen Psychiatry. 2011;68(8):800.

    Article  Google Scholar 

  12. Mayo-Smith MF, Beecher LH, Fischer TL, Gorelick DA, Guillaume JL, Hill A, et al. Management of alcohol withdrawal delirium. An evidence-based practice guideline. Arch Intern Med. 2004;164(13):1405–12.

    Article  CAS  Google Scholar 

  13. Benowitz NL. Clinical pharmacology of caffeine. Annu Rev Med. 1990;41:277–88.

    Article  CAS  Google Scholar 

  14. Frary CD, Johnson RK, Wang MQ. Food sources and intakes of caffeine in the diets of persons in the United States. J Am Diet Assoc. 2005;105(1):110–3.

    Article  Google Scholar 

  15. Somogyi L. Caffeine intake by the U.S. population: Food and Drug Administration. Oakridge National Laboratory; 2010. [2015 27 July]. Available from: http://www.fda.gov/downloads/AboutFDA/CentersOffices/OfficeofFoods/CFSAN/CFSANFOIAElectronicReadingRoom/UCM333191.pdf.

  16. Winston AP, Hardwick E, Jaberi N. Neuropsychiatric effects of caffeine. Adv Psychiatr Treat [Internet]. The Royal College of Psychiatrists. 2005;11(6):432–9. Available from: http://apt.rcpsych.org/content/11/6/432.

    Article  Google Scholar 

  17. Bernstein GA, Carroll ME, Thuras PD, Cosgrove KP, Roth ME. Caffeine dependence in teenagers. Drug Alcohol Depend. 2002;66(1):1–6.

    Article  Google Scholar 

  18. Thomas H. Psychiatric symptoms in cannabis users. Br J Psychiatry. 1993;163:141–9.

    Article  CAS  Google Scholar 

  19. Budney AJ, Hughes JR, Moore BA, Vandrey R. Review of the validity and significance of cannabis withdrawal syndrome. Am J Psychiatry. 2004;161:1967–77.

    Article  Google Scholar 

  20. Schneir AB, Cullen J, Ly BT. “Spice” girls: synthetic cannabinoid intoxication. J Emerg Med. 2011;40(3):296–9.

    Article  Google Scholar 

  21. Louh IK, Freeman WD. A “spicy” encephalopathy: synthetic cannabinoids as cause of encephalopathy and seizure. Crit Care. 2014;18:553.

    Google Scholar 

  22. Vorspan F, Mehtelli W, Dupuy G, Bloch V, Lepine J-P. Anxiety and substance use disorders: co-occurrence and clinical issues. Curr Psychiatry Rep. 2015;17(2):4.

    Article  Google Scholar 

  23. Amato L, Minozzi S, Vecchi S, Davoli M. Benzodiazepines for alcohol withdrawal. Cochrane Database Syst Rev. 2010;(3):CD005063.

    Google Scholar 

  24. Baldwin DS, Aitchison K, Bateson A, Curran HV, Davies S, Leonard B, et al. Benzodiazepines: risks and benefits. A reconsideration. J Psychopharmacol. 2013;27(11):967–71.

    Article  CAS  Google Scholar 

  25. Soyka M. Treatment of benzodiazepine dependence. N Engl J Med. 2017;376(12):1147–57.

    Article  CAS  Google Scholar 

  26. Ashton H. Benzodiazepine abuse. In: Caan W, de Belleroche J, editors. Drink, drugs and dependence from science to clinical practice. London: Routledge; 2002. p. 197–212.

    Google Scholar 

  27. Schuckit MA. Treatment of opioid-use disorders. N Engl J Med. 2016;375:1596–7.

    Google Scholar 

  28. Van Bockstaele EJ, Reyes BAS, Valentino RJ. The locus coeruleus: a key nucleus where stress and opioids intersect to mediate vulnerability to opiate abuse. Brain Res. 2010;1314:162–74.

    Article  Google Scholar 

  29. Aghajanian GK. Tolerance of locus coeruleus neurones to morphine and suppression of withdrawal response by clonidine. Nature. 1978;276(5684):186–8.

    Article  CAS  Google Scholar 

  30. Christie MJ, Williams JT, North RA. Mechanisms of tolerance to opiates in locus coeruleus neurons. NIDA Res Monogr. 1987;78:158–68.

    CAS  PubMed  Google Scholar 

  31. Rasmussen K, Beitner-Johnson DB, Krystal JH, Aghajanian GK, Nestler EJ. Opiate withdrawal and the rat locus coeruleus: behavioral, electrophysiological, and biochemical correlates. J Neurosci. 1990;10(7):2308–17.

    Article  CAS  Google Scholar 

  32. Farrell M. Opiate withdrawal. Addiction. 1994;89(11):1471.

    Article  CAS  Google Scholar 

  33. Howard MO, Bowen SE, Garland EL, Perron BE, Vaughn MG. Inhalant use and inhalant use disorders in the United States. Addict Sci Clin Pract. 2011;6(1):18–31.

    PubMed  PubMed Central  Google Scholar 

  34. Perron BE, Howard MO, Vaughn MG, Jarman CN. Inhalant withdrawal as a clinically significant feature of inhalant dependence disorder. Med Hypotheses. 2009;73(6):935–7.

    Article  Google Scholar 

  35. McHugh RK. Treatment of co-occurring anxiety disorders and substance use disorders. Harv Rev Psychiatry. 2015;23(2):99–111.

    Article  Google Scholar 

  36. Taheri A, Dahri K, Chan P, Shaw M, Aulakh A, Tashakkor A. Evaluation of a symptom-triggered protocol approach to the management of alcohol withdrawal syndrome in older adults. J Am Geriatr Soc. 2014;62(8):1551–5.

    Article  Google Scholar 

  37. Bonnet U, Preuss UW. The cannabis withdrawal syndrome: current insights. Subst Abuse Rehabil. 2017;8:9–37.

    Article  Google Scholar 

  38. Hoch E, Bonnetn U, Thomasius R, Ganzer F, Havemann-Reinecke U, Preuss UW. Risks associated with the non-medicinal use of cannabis. Dtsch Arztebl Int. 2015;112(16):271–8.

    PubMed  PubMed Central  Google Scholar 

  39. Allsop DJ, Copeland J, Lintzeris N, Dunlop AJ, Montebello M, Sadler C, et al. Nabiximols as an agonist replacement therapy during cannabis withdrawal: a randomized clinical trial. JAMA Psychiat. 2014;71(3):281–91.

    Article  CAS  Google Scholar 

  40. Copeland J, Swift W, Roffman R, Stephens R. A randomized controlled trial of brief cognitive-behavioral interventions for cannabis use disorder. J Subst Abuse Treat. 2001;21(2):55–6.

    Article  CAS  Google Scholar 

  41. Lapoint J, James LP, Moran CL, Nelson LS, Hoffman RS, Moran JH. Severe toxicity following synthetic cannabinoid ingestion. Clin Toxicol (Phila). 2011;49(8):760–4.

    Article  CAS  Google Scholar 

  42. Douaihy A, et al. Medications for substance use disorders. Soc Work Public Health. 2013;28(3–4):264–78.

    Article  Google Scholar 

  43. Nissen C, Frase L, Hajak G, Wetter TC. Hypnotics – state of the science. Nervenarzt. 2014;85(1):67–76.

    Article  CAS  Google Scholar 

  44. Mariani JJ, Malcolm RJ, Mamczur AK, Choi JC, Brady R, Nunes E, et al. Pilot trial of gabapentin for the treatment of benzodiazepine abuse or dependence in methadone maintenance patients. Am J Drug Alcohol Abuse. 2016;42(3):333–40.

    Article  Google Scholar 

  45. Gowing L, Farrell MF, Ali R, White JM. Alpha2-adrenergic agonists for the management of opioid withdrawal. Cochrane Database Syst Rev. 2014;(3):CD002024.

    Google Scholar 

  46. Brigham GS, Amass L, Winhusen T, Harrer JM, Pelt A. Using buprenorphine short-term taper to facilitate early treatment engagement. J Subst Abuse Treat. 2007;32(4):349–56.

    Article  Google Scholar 

  47. D’Onofrio G, O’Connor PG, Pantalon MV, Chawarski MC, Busch SH, Owens PH, et al. Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial. JAMA. 2015;313(16):1636.

    Article  Google Scholar 

  48. Hofmann SG, Smits JAJ. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry. 2008;69(4):621–32.

    Article  Google Scholar 

  49. Stewart SH, Conrod PJ. Anxiety and substance use disorders: the vicious cycle of comorbidity [Internet]. 2008. Available from: http://uwo.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwlV3dS8MwED9kA5kIOj9qdULBJx9amn4mjzIVQR-d-FaSNdXhrB-roP71Xtpma-de9lTSpCXkLr_c5XK_APie49pLmCA4SXmc-SqRMaPSRYRQ2hVLN0WFS-kSZ5I338nIXxwdoCxxW6e-LYhh0bdT2dCIwiopWF19ORrNd1mUt4FOWB2mxaaUkZp2R5c9Hetc9dd.

  50. Center for Substance Abuse Treatment. Brief interventions and brief therapies for substance abuse. Rockville: Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 34.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK64947/.

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Boston University Medical Center, Boston, MA, USA

    Daryl Blaney Jr., Annise K. Jackson & Ozan Toy

  2. Department of Psychiatry, Boston Medical Center/Boston University School of Medicine, Boston, MA, USA

    Joanna Piechniczek-Buczek

Authors
  1. Daryl Blaney Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Annise K. Jackson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ozan Toy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anna Fitzgerald
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joanna Piechniczek-Buczek
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joanna Piechniczek-Buczek .

Editor information

Editors and Affiliations

  1. Massachusetts General Hospital, Boston, MA, USA

    Abigail L. Donovan

  2. Massachusetts General Hospital, Boston, MA, USA

    Suzanne A. Bird

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Blaney, D., Jackson, A.K., Toy, O., Fitzgerald, A., Piechniczek-Buczek, J. (2019). Substance-Induced Anxiety and Co-occurring Anxiety Disorders. In: Donovan, A., Bird, S. (eds) Substance Use and the Acute Psychiatric Patient. Current Clinical Psychiatry. Humana, Cham. https://doi.org/10.1007/978-3-319-23961-3_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-23961-3_8

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-319-23960-6

  • Online ISBN: 978-3-319-23961-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation