Cross Addiction & Cross Dependence
Understanding cross addiction & preventing relapse
The terms cross addiction and cross dependence are thrown around a lot in the recovery community and on the clinical end of recovery. Cross addiction refers to when someone who is in recovery from addiction develops a new addiction. Often, this is described as substituting or replacing one addiction with another and many believe that people who have suffered from addiction before are likely to develop a new one. It is commonly believed that the new addiction will likely be to a substance that has similar properties to the original.
For example, someone who is in recovery for Opiate Pain Killer abuse might turn to a different Central Nervous System Depressant like Alcohol or Benzodiazepines. It is also thought possible to develop a cross addiction to an activity or behavior, rather than a substance, such as gambling, sex, shopping or over-eating. Cross addiction is considered something to be wary of by many, and for good reason, but there is also much disagreement about the concept’s legitimacy.
In 2014, 21.5 million adults in the US battled an addiction.
A new addiction may seem mistakenly justified by being somehow less severe, keeping the individual away from the original addiction or by simply being different. Many people have the mindset that a specific substance or behavior is their problem, and that other addictive substances or behaviors won’t be an issue, but this is often not the case.
Some may excuse their new addictions for being prescription instead of illicit drugs or for being activities instead of substances, but any of these can have negative consequences on their lives. They may have repercussions of declined health, destroying relationships and work life, and so on.
With new addictions to substances and non-substances alike, engaging in the new behavior could be a back door to relapse into the original addiction.
A person may enter triggering environments or situations due to a new addiction or open their mind to the patterns of thought linked to unhealthy behaviors.
For example, if a person is in recovery for Opiate Pain Killer abuse and becomes addicted to Benzos, he or she may end up doctor shopping for Benzos as previously done for Pain Killers. This could reopen the temptation to get Pain Killers and start taking them again.
A person recovering from Alcohol Use Disorder, but then becomes addicted to gambling may feel more compelled to drink again when in a casino surrounded by partying. The bottom line is: if the new substance use or behavior results in negative consequences like the ones caused by the original addiction, then it is probably a new addiction and it is certainly a problem.
If an individual avoids duties and responsibilities due to the new behavior, withdraws from activities that used to be valued, starts lying about the new activity or substance use or experiences a decline in health, then a new addiction has likely developed.
The concept of cross addiction seems based on the notion that having developed one addiction before, or the actual recovery from that addiction itself, makes a person more susceptible to new addictions. This is where the controversy sprouts as some studies suggest that there is no scientific correlation here.
One particularly large study suggests that people who are in recovery from an addiction are actually less likely to develop a new addiction than people who have not achieved a period of sobriety or refrained from using. While the concept of cross addiction appears to be accepted in the clinical world of addiction treatment, the lack of scientific evidence of a correlation has driven some to consider cross addiction as clinical lore or myth that has become widely accepted for inaccurate reasons.
The larger matter in question seems to be if one can ever truly rid oneself of addiction. Many believe that addiction can only be replaced with a new obsession and will never truly be overcome. If this is the case, then a person who quits one substance is surely liable to replace it with another addiction. The thing is, when someone develops an addiction and then, in recovery, refrains from using, that person necessarily develops skills and techniques for coping with the lack of that substance. This means that whatever need the substance abuse was somehow meeting is now being met in a new way. Once a person has developed alternatives like this, there doesn’t seem to be any particular likelihood that he or she would turn to a new addiction.
Studies about breaking habits show that to rid oneself of a habit, one must develop a new habit to replace it with. This is because there is a need that must be met and once the brain associates one solution with that need, the urge to utilize this solution will exist. In the case of substance abuse, the solution perceived by the brain is to use the substance.
If there is another method for that same need to be met and it is exercised, then the urge to use the old method will dissipate. This is the case with all habits, not just drugs and Alcohol or activities that have negative consequences, which suggests that cross addiction is a logical thing to worry about. What if, though, the replacement does not have negative effects?
Some propose the argument that 12-step Anonymous groups and religions are kinds of cross addiction, in that they are new obsessions that replace the original addictions. The thing is though, these things are not hurting the individual or others and they don’t have negative consequences. For many, these activities are a way to cope with feelings that before would have triggered them to use.
Positive alternative methods of coping are the main desired result of treatment for addiction, whether these take the form of AA meetings or exercising or going to church or journaling or anything else that helps. Once someone has gone through rehab or other forms of treatment for addiction and abstains from using substances, it is likely that this individual has developed other habits to meet the needs that the substance had met previously. As long as the new habits, even if they are somewhat obsessive, are not harming anyone, it is unreasonable to equate these with any kind of cross addiction. So, it is important to be careful about how we use these terms.
Almost 8 million adults in the US battled co-occurring disorders (substance use disorder and a mental health disorder) in 2014.
While individuals in recovery may not be especially prone to developing new addictions, it is, of course, possible and it does happen. It is important to always remember that addiction is a relapsing condition by nature. This is why treatment is continuous and recovery is usually considered a life-long commitment. If a cross addiction does develop, the course of action should consist of continued or reinstated treatment for the original addiction in addition to new aspects of treatment targeting the new addiction.
Cognitive Behavioral Therapy (CBT) is known to be a particularly successful tool in treatment for addiction and cross addiction. CBT will help the individual identify the emotions and thought patterns that lead to the addictive behavior so that they can become more aware of these processes. From there, the person can begin to develop solutions with new healthier thought patterns. The goal is always to create new, positive, healthy mechanisms with which to cope so as to avoid using substances or partaking in negative behaviors.
It is believed that individuals who are newer to recovery are more susceptible to cross addiction, which may be in part due to their new coping methods being less developed. If these new methods are not meeting the individual’s needs effectively, the person will be more likely to relapse or turn to an unfamiliar substance or negative behavior for relief.
If you are in recovery, it is advised that you avoid using any substances or partaking in activities that could be addictive. If you need to be medicated for any reason, it is a good idea to address your history of addiction with your doctor so you can develop a secure plan together. Even when positive coping mechanisms are firmly established, if you frequently place yourself in situations or environments that make it hard to avoid triggers, you will be more tempted to use. If you frequently partake in activities that engage your old way of coping, with substances or detrimental behaviors, you will be more likely to fall into old habits.
The idea is that addiction treatment gives you the tools needed to eliminate any perceived need for an addictive substance or behavior. If this has been done successfully, then hopefully there is no strong desire to partake in these kinds of activities whether they involve the original addiction or a new addictive substance or behavior. There is hope because much research suggests just that.
Regardless, self-care should always come first in addiction treatment and this includes the elimination of any possibility of relapse or cross addiction. Don’t put yourself in a position for this to happen. Stay engaged with your recovery and enthusiastic about your personal growth and achievement and be cautious about any substances or activities that could damage that growth. Establishing some solid guidelines for maintaining recovery is essential.