Alcohol and other substance use to cope with social anxiety
This article was first published in NIAAA Spectrum Volume 15, Issue 2.
Using alcohol to cope with social anxiety is associated with increased substance use and more consequences among young adults, according to a study by National Institute on Alcohol Abuse and Alcoholism (NIAAA)-supported researchers. The findings also suggest that young adults who drink to cope with social anxiety experience more negative consequences associated with their alcohol use, on average.
Many people use alcohol and other substances to cope with symptoms of social anxiety. For example, they may use substances to feel more sociable, to lessen their concerns about other people’s perceptions of them, or to feel more at ease in uncomfortable social situations. Although young adults with social anxiety may engage in alcohol use to experience what they may perceive as positive effects, they may also be more vulnerable to negative social and other consequences as a result of their substance use, which in turn can lead to more alcohol use to cope with stress.
To gain a better understanding of the relationship between substance use and coping with social anxiety among young adults, researchers examined daily data from 257 participants aged 18–25 years who were enrolled in a 2-year study of alcohol and cannabis use. For five 2-week periods during the study, participants completed daily online surveys that asked about their substance use, motives for use, and consequences. In the current study, data were analyzed from participants who reported using alcohol and/or cannabis to cope with social anxiety on at least 1 day during the study period.
The researchers found that on days when participants used alcohol alone or with cannabis to cope with social anxiety, the participants reported drinking more and experiencing a greater number of both perceived positive effects and negative alcohol-related consequences broadly, compared to days when social anxiety was not a motive for substance use. From a short-term, daily perspective, the use of alcohol with or without cannabis to cope with social anxiety was more likely to be associated with perceived positive effects such as being in a better mood or more social. However, the researchers found that the more frequently the young adults used substances to cope with social anxiety, the more negative effects they experienced overall, demonstrating that continuing to drink as a coping strategy may lead to more negative consequences in the long term, and the need to drink even more.
Taken together, these findings suggest that using alcohol and cannabis to cope with social anxiety increases the risk for elevated substance use and negative alcohol-related consequences among young adults and consequently a cycle of drinking to ameliorate the negative effects of alcohol misuse. The perceived positive effects, such as forgetting about one’s worries or feeling more sociable, ultimately may lead to continued substance use as a coping strategy and, in turn, increase the risk of future adverse consequences such as alcohol use disorder. Social anxiety coping motives may be an important target for intervening with alcohol misuse and preventing future substance use disorders in this population.
Walukevich-Dienst K, Calhoun BH, Fairlie AM, Cadigan JM, Patrick ME, Lee CM. Using substances to cope with social anxiety: associations with use and consequences in daily life. Psychol Addict Behav. 2022 Nov 28. PubMed PMID 36442020