Substance/Medication-Induced Anxiety Disorder

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Substance or medication-induced anxiety disorder is the diagnostic name for anxiety or panic attacks that are caused by alcohol, drugs, or medications. While it is normal to have some feelings of anxiety in stressful situations, and even the transient feelings of anxiety or panic that can happen spontaneously during intoxication or withdrawal from alcohol or drugs, substance-induced anxiety disorder causes clinically significant distress or functional impairments.

Unfortunately, the same drugs that many people use to try and boost their confidence, help them relax, and lower their inhibitions are the ones most prone to causing substance-induced anxiety disorder or panic attacks. In some cases, people don't even realize that it is alcohol, drugs, or medications that are causing anxiety because they only associate those substances with feeling good.


When your doctor gives a diagnosis of substance/medication-induced anxiety disorder, they check to make sure that the anxiety wasn't there before the use of alcohol, drugs or medications thought to be responsible.

This is because there are several different types of anxiety disorders, and if the symptoms were there before the substance use, it isn't diagnosed as substance/medication-induced anxiety.

When Anxiety Begins After Taking the Drug

In some cases, anxiety or panic can occur straight away. There is even a category "with onset during intoxication," which means that the anxiety episode actually started when the individual was drunk or high on the drug. It can also occur during or shortly after withdrawal, during which symptoms of anxiety are common.

However, with anxiety which is simply a symptom of withdrawal, the person's symptoms will generally resolve within a few days of discontinuing alcohol or drug use, while with substance-induced anxiety disorder, the panic and anxiety symptoms are sufficiently severe to warrant independent clinical attention.

Generally, the diagnosis isn't given if the person has a history of an anxiety disorder without substance use, or if the symptoms continue for more than a month after the person becomes abstinent from alcohol, drugs, or medication.

For the diagnosis of Substance/Medication-Induced Anxiety Disorder to be given, the symptoms have to be causing a great deal of emotional upset or significantly affecting the person's life, including their work or social life, or another part of their life that is important.

Drugs That Cause Substance/Medication-Induced Anxiety Disorder

A wide variety of psychoactive substances can cause substance-induced anxiety, including:

  • Alcohol-induced anxiety disorder
  • Caffeine-induced anxiety disorder
  • Cannabis-induced anxiety disorder
  • Phencyclidine-induced anxiety disorder
  • Other hallucinogen-induced anxiety disorder
  • Inhalant-induced anxiety disorder
  • Amphetamine-induced anxiety disorder
  • Other stimulant-induced anxiety disorder
  • Cocaine-induced anxiety disorder
  • Other substance-induced anxiety disorder
  • Unknown substance-induced anxiety disorder

Several medications are known to cause substance/medication-induced anxiety including:

  • Anesthetics
  • Analgesics
  • Sympathomimetics
  • Anticholinergics
  • Thyroid medications
  • Antihistamines
  • Antiparkinsonians
  • Corticosteroids
  • Anticonvulsants
  • Mood stabilizers
  • Antipsychotics
  • Antidepressants

Specific heavy metals and toxins that can cause panic or anxiety symptoms include organophosphate insecticide, nerve gases, carbon monoxide, carbon dioxide, and volatile substances such as gasoline and paint.

5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Brady KT, Haynes LF, Hartwell KJ, Killeen TK. Substance use disorders and anxiety: a treatment challenge for social workers. Soc Work Public Health. 2013;28(3-4):407-23. doi:10.1080/19371918.2013.774675

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

  3. Kaplan K, Kurtz F, Serafini K. Substance-induced anxiety disorder after one dose of 3,4-methylenedioxymethamphetamine: a case report. J Med Case Rep. 2018;12(1):142. doi:10.1186/s13256-018-1670-7

  4. Smith JP, Book SW. Anxiety and Substance Use Disorders: A Review. Psychiatr Times. 2008;25(10):19-23.

  5. Anker JJ, Kushner MG. Co-Occurring Alcohol Use Disorder and Anxiety: Bridging Psychiatric, Psychological, and Neurobiological Perspectives. Alcohol Res. 2019;40(1) doi:10.35946/arcr.v40.1.03

Additional Reading
  • American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, fifth edition, DSM-5. American Psychiatric Association, 2013.

By Elizabeth Hartney, BSc, MSc, MA, PhD
Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada.