Addiction Care · 3 min read · Updated November 13, 2026
Anxiety and substance use can become connected in ways that are difficult to untangle alone. A person may use a substance to cope with fear, while use or withdrawal may also affect anxiety. An assessment should consider both concerns and any other medical explanations instead of assuming that one diagnosis accounts for everything.
Explain what anxiety stops you from doing
NIMH: Anxiety Disorders describes anxiety disorders as more persistent or disruptive than ordinary occasional worry. Tell the clinician about avoided places, missed activities, panic-like episodes, and the effect on work or relationships. A concrete example might be drinking before social events or avoiding appointments because of fear. Include what happens on days when you use less or do not use. You do not need to decide whether the symptoms meet a diagnosis before asking for help.
Bring a timeline and medication list
Note when symptoms began, changes in substance use, and any prescribed or nonprescription medicines. NIMH: Co-Occurring Substance Use and Mental Disorders explains why coordinated assessment matters when substance use and mental health concerns overlap. Tell the prescriber about medicines obtained elsewhere and about any difficulty taking them as prescribed. If benzodiazepines are involved, do not make abrupt changes on your own. Our benzodiazepine guide explains why planning with a clinician is important.
Ask how treatment will address both concerns
Find out whether the program can provide anxiety assessment and treatment or coordinate with another professional. Ask which therapy approaches are proposed, what they involve, and how they will be adapted to your circumstances. Our therapy guide offers questions about different methods. Do not assume that a general group about stress replaces individualized care for a diagnosed anxiety disorder. Ask how progress in both anxiety and substance use will be reviewed.
Discuss participation barriers openly
If groups, transport, phone calls, or crowded waiting rooms make attendance difficult, tell staff before you stop attending. Ask about realistic accommodations or gradual ways to engage that fit the clinical plan. A trusted person may help with notes or the first appointment if you want support. The aim is to address avoidance thoughtfully, not simply remove every uncomfortable situation or force yourself through symptoms without guidance. Agree on one workable next step with the treating professional.
Know when symptoms need medical attention
Do not automatically label new chest pain, severe breathing difficulty, fainting, or other concerning symptoms as anxiety. Seek urgent medical assessment when appropriate, and call 911 for a medical emergency. Ask the team how to distinguish routine follow-up questions from symptoms needing prompt evaluation. Over time, useful care should help you understand patterns, build coping options, and adjust treatment when symptoms or circumstances change, without making you prove that one problem is more deserving of help than the other.
Sources & further reading
General educational information. This guide is not a substitute for advice from a qualified treatment professional.
