Hoarding and Substance Use Disorder

One disorder that receives quite a bit of media attention is hoarding. It may seem odd, but hoarding can co-occur with substance use disorders. Hoarding occurs when an individual attaches meaning to things, typically in one’s home, which makes it difficult to discard such items even if not needed. Over time, the items take over the person’s home and a hoarding situation begins. Hoarding is a compulsion that creates anxiety and uncertainty that can overwhelm the individual.

Hoarding can become so pervasive that it can create health and safety issues within the home. Doorways and windows are blocked with items and old food left out can turn into infestations of bugs and rodents. When hoarding is taken to an extreme, it is considered a symptom of a disorder. If someone attempts to discard items, the hoarder will experience overwhelming anxiety and emotional distress. They may even become angry and hostile toward the person who wishes to discard treasured and sentimental items. A hoarder’s environment is defined by their clutter. Most have no space in which to sleep or eat, as most surfaces are covered with things.

Hoarding and substance use disorder is not that uncommon, as drinking or using drugs alleviates the anxiety and emotional distress that a hoarder experiences. Both hoarding and substance use are considered to have addictive qualities; therefore, it is not surprising that hoarding can co-occur with substance use disorders. Many mental health problems can co-occur with Substance Use Disorder

As with any co-occurring disorder, treatment is available. For the hoarder, it may be challenging to treat the hoarding behavior as many will not leave their residence for fear that someone will alter the environment in the same way. In addition, hoarding cannot be treated by simply removing items from the home just as substance abuse cannot be treated simply by removing drugs or alcohol from the individual’s environment.

There are psychological considerations for co-occurring hoarding behavior and substance use disorders. Hoarders are unlikely to seek help for their problem, as they do not see it as an issue. Hoarders can live in a state of denial that is difficult to address and treat. If you add that to a co-occurring substance use disorder, the likelihood of seeking treatment is minimal. Typically, a friend or family member will engage in an intervention designed to get the hoarder on a path to recovery.