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Research Summary

People with Social Anxiety Drink to Cope

People with social anxiety are twice as likely as the general population to have an alcohol use disorder. Several hypotheses that try to account for this association suggest that people with social anxiety drink more than others to reduce their anxiety. Over time, this self-medication may lead to dependence. No study, however, has investigated whether people who are socially anxious are more likely to drink to cope with their social fears than are controls without anxiety.

This study compared 23 patients with high social anxiety with 23 matched controls without social anxiety. Participants were asked via questionnaire about their alcohol use in social situations. Compared with controls, the group with social anxiety was significantly more likely to report

  • using alcohol to feel more comfortable before (74% versus 39%) and during (87% versus 61%) social situations;
  • avoiding social situations at least some of the time if alcohol was unavailable before (47% versus 0%) and during (55% versus 7%) a social situation;
  • experiencing greater relief of anxiety from alcohol (mean 5.2 versus 3.3, on a scale from 0 to 10).


This study confirms that people who are socially anxious intentionally drink alcohol to cope with their social fears and are able to endure social situations as a result of alcohol’s anxiety-reducing effects. Although these data support the self-medication hypothesis, they do not explain whether the relationship between social anxiety and alcohol use is causally related to developing dependence. Nevertheless, the associations reported in this study are compelling for the primary care clinician who should consider social anxiety as a risk factor for alcohol problems.

Joseph Conigliaro, MD, MPH


Thomas, SE, Randall CL, Carrigan, MH. Drinking to cope in socially anxious individuals: a controlled study. Alcohol Clin Exp Res. 2003;27(12):1937–1943.
(view abstract)