College Students with OCD Have Higher Rates of Cannabis, Alcohol, and Tobacco Use
College students with OCD conditions had 11-14% higher odds of moderate/high-risk substance use and more than double the odds of disordered eating compared to peers without OCD.
Quick Facts
What This Study Found
Among 92,757 undergraduates, OCD conditions were associated with increased odds of moderate/high-risk tobacco (aOR=1.12), cannabis (aOR=1.11), alcohol (aOR=1.14), and disordered eating (aOR=2.28). Effects persisted after adjusting for stress, depression, and anxiety. Gender differences emerged: cis-female students with OCD had elevated risk across all substances, while male students only showed increased disordered eating risk.
Key Numbers
92,757 students from 216 colleges. OCD and cannabis: aOR=1.11 (95% CI 1.04-1.18). OCD and alcohol: aOR=1.14 (95% CI 1.05-1.24). OCD and tobacco: aOR=1.12 (95% CI 1.05-1.21). OCD and disordered eating: aOR=2.28 (95% CI 2.13-2.43). TGNC students with OCD: aOR=1.24 for tobacco, aOR=2.14 for disordered eating.
How They Did This
Analysis of 92,757 undergraduate students aged 18-24 from 216 colleges using the ACHA-NCHA III (Fall 2021-Fall 2022). Regression models adjusted for covariates and school clustering.
Why This Research Matters
OCD is increasingly recognized in young adults, and understanding its association with substance use can help college health services screen for and address these co-occurring risks.
The Bigger Picture
The finding that OCD independently predicts substance use risk even after controlling for depression and anxiety challenges the assumption that substance use in OCD is simply driven by comorbid mood disorders.
What This Study Doesn't Tell Us
Cross-sectional design. Self-reported OCD conditions may include subclinical presentations. College students may not represent all young adults. Cannot determine if OCD drives substance use or vice versa.
Questions This Raises
- ?Do students use cannabis specifically to manage OCD symptoms?
- ?Would treating OCD more effectively reduce co-occurring substance use?
Trust & Context
- Key Stat:
- College students with OCD had 2.28x higher odds of disordered eating and 11-14% higher odds of substance use
- Evidence Grade:
- Very large, multi-institutional sample (92,757 students, 216 colleges) with appropriate statistical adjustments. Cross-sectional design is the main limitation.
- Study Age:
- 2025 publication with 2021-2022 data.
- Original Title:
- Substance use and disordered eating risk among college students with obsessive-compulsive conditions.
- Published In:
- PloS one, 20(1), e0316349 (2025)
- Authors:
- Jacobs, Wura(7), DeLeon, Angela, Bristow, Alane(2), Quinn, Patrick, Lederer, Alyssa
- Database ID:
- RTHC-06727
Evidence Hierarchy
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-06727APA
Jacobs, Wura; DeLeon, Angela; Bristow, Alane; Quinn, Patrick; Lederer, Alyssa. (2025). Substance use and disordered eating risk among college students with obsessive-compulsive conditions.. PloS one, 20(1), e0316349. https://doi.org/10.1371/journal.pone.0316349
MLA
Jacobs, Wura, et al. "Substance use and disordered eating risk among college students with obsessive-compulsive conditions.." PloS one, 2025. https://doi.org/10.1371/journal.pone.0316349
RethinkTHC
RethinkTHC Research Database. "Substance use and disordered eating risk among college stude..." RTHC-06727. Retrieved from https://rethinkthc.com/research/jacobs-2025-substance-use-and-disordered
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.