Few providers treat both OCD and Substance Use Disorder (SUD), yet the need is clear. A 2025 review estimates lifetime co-occurrence rates between 4.3–62.4% (Akosile et al., 2025). Even the lowest end of that range means most clinicians will encounter patients struggling with both. When OCD and SUD interact, the consequences can be devastating. Drinking to escape intrusive thoughts or being triggered after substance use can create a feedback loop that risks overdose and death. Treating one disorder in isolation often leads to relapse in the other. Because these conditions share underlying processes, effective care requires addressing both together. This presentation introduces a unified framework for conceptualizing OCD and SUD, highlighting how Acceptance and Commitment Therapy (ACT) can support their concurrent treatment and help close the current provider gap.