what is oppositional defiant disorder


What is Oppositional Defiant Disorder (ODD), and how does it relate to addiction? These are common questions. ODD is a common co-occurring diagnosis along with substance use disorder. So what does all this mean? Below, we explain.


What is Oppositional Defiant Disorder?

ODD is something that’s most often initially seen in children and teens. Of course, no matter their age, there are times when children and teens are challenging, as they’re known for pushing the boundaries and seeing what they can get away with.

There are times when behavior can go beyond what’s considered normal, and that can be characterized as an oppositional defiant disorder or ODD. If you have a child or teen who’s frequently angry, irritable, or argumentative or seems to be inherently opposed to authority figures, it could be ODD.

For many children, ODD symptoms begin to appear as early as preschool ages but can develop later. It’s almost always something you’ll see in your child’s behavior before they reach their teen years. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), emotional and behavioral symptoms must be present for at least six months to diagnose ODD. These symptoms can include:

  • Frequently losing their temper
  • Being easily annoyed
  • Often being angry and resentful
  • Arguing with people in authority
  • Not complying with rules or requests from adults
  • Trying to annoy or upset people purposely
  • Blaming others for their mistakes
  • Spitefulness or vindictiveness

The symptoms can be mild, moderate, or severe. The symptoms might only occur in one setting with mild ODD, like at home but not at school. Moderate ODD means symptoms occur in at least two settings, and a severe diagnosis indicates there are symptoms in at least three settings. ODD can be treated with therapy, but if not, complications can include impulse control problems, performance issues at school and work, and antisocial behavior. Substance use disorders are also considered a complication of untreated ODD.


Oppositional Defiant Disorder Treatment

To begin treatment, first, there has to be an official diagnosis of ODD. A mental health professional can make a diagnosis by doing a psychological evaluation. The assessment might include assessing overall health, family member interactions, and the intensity and frequency of symptomatic behaviors.

From there, treatment can include:

  • Parent training: Many of the treatments for ODD are family-based interventions. That can include parent training. A mental health professional can work with you to develop parenting skills that are positive and consistent and will be helpful for your child.
  • Parent-child interaction therapy: Also called PCIT, therapists will coach parents in their interactions with their child during this treatment. This helps parents learn how to improve their parenting techniques, enhancing their relationship with their children.
  • Individual and family therapy: Your child might learn how to express feelings healthily and manage anger; family therapy may be a way for everyone to improve their communication and relationships.
  • Social skills training: Some children with ODD will participate in social skills training, a type of therapy that teaches positive interaction strategies to engage with peers.
  • Cognitive problem-solving training: This type of therapy helps children identify and change the thought patterns that contribute to behavior problems.

It’s not common to use medication as treatment unless there’s another condition that’s also happening, like ADHD, depression, or anxiety. There’s not any medication right now that’s exclusively for the treatment of ODD.


What is a Co-Occurring Disorder?

Suppose you recognize signs of ODD in your child. In that case, it’s essential to start working with a professional therapist on a treatment plan as soon as possible, because again, this can reduce the risk of complications. Complications can include the development of a co-occurring disorder, such as substance abuse. The term co-occurring refers to a situation where someone has both substance use and another mental health disorder. We see that the most commonly diagnosed co-occurring are mood and anxiety issues.


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What’s the Link Between ODD and Substance Abuse?

Another question we commonly hear is why it is linked to substance abuse, particularly in teens? There is often a relationship between what are broadly categorized as disruptive behaviors and substance abuse. ODD is just one type of disruptive behavior disorder.

Younger people who report using drugs are four times more likely than those who don’t have a disruptive behavior issue. A child or teen with a DBD is six times more likely to have an addiction. Additionally, adolescents and teens with addiction and ODD are more resistant to treatment. With that in mind, we have to wonder why there are such significant links. It’s complex, but some of the likely reasons include:

  • There could be genetic and biological links between ODD and substance use. For example, a young person with both could be more prone to impulsive behavior. When you’re impulsive, you’re more likely to do things that could cause harm to you, including using substances.
  • For a young person who’s dealt with ODD in their life, they may turn to substances as a way of self-medicating. For example, they may feel like drinking or using drugs helps them experience fewer ODD symptoms.
  • There is also the possibility that life experiences factored into both the development of ODD and a substance use disorder. For example, a child from a chaotic home could be at a higher risk of developing both.



Oppositional Defiance Disorder is, relatively speaking, fairly common in children and adolescents; it’s also highly associated with addiction. Early intervention, including therapy and parental training, are significant ways to reduce the symptoms of ODD and lower the risk of later co-occurring issues like addiction.

With that being said, if someone has both ODD and a substance use disorder, they may be more resistant to treatment. That can make it challenging for you if you’re a parent or a loved one.

If you’re looking for treatment programs, you want one that’s going to offer in-depth treatment for co-occurring disorders. It’s almost impossible to treat substance abuse without also treating the symptoms of any other underlying conditions, including ODD, and vice versa.

If you have questions or want to learn more about treatment for co-occurring disorders, Anchored Tides Recovery is here and can talk to you any time, so reach out to our team at 866-600-7709.