The abstinence phobias: links between substance abuse and anxiety.

This paper presents a new model to explain the observed relationship between anxiety and substance abuse. Specifically, the concept of "abstinence phobias," common across psychoactive substances, is developed. The evidence needed to support this concept is outlined, and relevant data from studies of opiate, alcohol, and tobacco dependences are reviewed. Parallel data obtained from the treatment of obesity are discussed. It is concluded that the abstinence phobia merits further study; clinical implications are also considered.