Cross Addiction And Cross Dependence
While cross addiction involves a person exchanging one substance of choice for another, cross dependence is an entirely different beast. It involves the physical dependence to multiple drugs at the same time and can be brought on by a person trying to alleviate the symptoms of one substance by taking another.
For example, this type of addiction can occur when a person who is addicted to a substance like crack cocaine switches to heroin to counteract the effects of the crack theyve ingested to meet social obligations or daily responsibilities.
It is definitely a dangerous balancing act, but one that someone who experiences cross dependence has learned to routinely navigate.
Is Cross Addiction A Myth
For many years, cross-addiction was believed to be a myth. Many care providers believed that a person addicted to one substance was only susceptible to that product or those that were similar. So under this belief, a person who is addicted to heroin wouldnt also have a problem with alcohol.
This is still a hotly debated topic among psychologists and addiction specialists. While weve shown that certain mental health issues increase ones likelihood of developing addiction problems, does one addiction lead to another?
In spite of obvious assumptions that a person with addiction problems can easily develop other addictions, theres very little evidence to suggest this is true. A recent study published in the Journal of the American Medical Association looked at a group of 35,000 people who were addicted to a wide variety of drugs, including alcohol, prescription painkillers, cocaine, heroin, and sedatives. The study found that people who fully commit themselves to recovery are less likely to develop a secondary addiction to another substance.
However, treatment counselors still caution that even if cross-addiction is rare, its still important to watch for the warning signs of a secondary condition. Although most people who complete a treatment program wont become re-addicted, about 13 percent will. A Columbia University study found that single men with other mental health issues are the most likely group to develop a secondary addiction.
Cross Addiction In Recovery
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 dont 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 in 2014.
What If You Do Develop a New Addiction?
Am I Susceptible to a Cross Addiction Or Cross Dependence?
The Ultimate Goal
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A Recent Study Changes The Game
Despite the relative popularity of the notion of cross addiction in many addiction treatment program descriptions, and in many 12-Step groups such as Alcoholic Anonymous, there is actually very little empirical evidence to suggest that such a phenomenon exists. This lack of research was noted by a team of researchers at Columbia University Medical Center who performed an exhaustive study on the notion of cross addiction in over 34,000 adults as part of the National Epidemiological Study on Alcohol and Related Conditions . The findings of their study were reported in the November 2014 edition of the Journal of American Medical Association Psychiatry. The participants in the study were surveyed in 2001 and again in 2004. There were three questions/goals of the study:
- How many of the participants with a substance use disorder developed a new substance use disorder in the three-year period?
- How many individuals who developed a new substance use disorder had overcome or successfully treated their initial substance use disorder?
- What factors could help explain why some individuals with substance use disorders may be more likely to develop new substance use disorders later?
The findings have some interesting implications regarding the notion of cross addiction:
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How To Avoid Cross Addiction
Fortunately, there are many ways to avoid cross addiction. It is important that such attempts are individualized and personally resonate with the individual. The better aligned any actions are to the needs and preferences of the individual, the better the likelihood of success. What works for one person may not work for another. If a strategy falls short, its important to continue trying other strategies.
Here are seven ways to avoid cross addictions:
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The Impact Of Drug And Alcohol Addiction
A negative impact of some drugs, including drugs such as alcohol and opiates, has long been acknowledged. For instance, Commissioner Lin of the Chinese Empire wrote to Queen Victoria of the British Empire, urging her to take action against opium export. Lin stressed the negative consequences of opium use on Chinese society . The Quran, the holy book of Islam, written in the early 7th century, states:
Satan’s plan is to excite enmity and hatred between you, with intoxicants and gambling, and hinder you from the remembrance of Allah, and from prayer .
In England, in 1436, Bishop Chandler warned the monks at the Monastery of Abbotsbury that, wine and women cause men to err .
However, condemnation of intoxicants is far from universal. Even when substance use causes problems, some observers suggest temperance, others abstinence, yet others prohibition. But the observation that use of intoxicants cause harm to society is common across time and place.
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What Are Cross Addictions
Cross addictions occur in several ways. First, in the absence of a preferred substance, an individual might begin using another substance. For example, someone using opioids might try to replace that substance with cannabis.
Second, an individual might become addicted to a substance of abuse while concurrently engaging in compulsive, maladaptive behavioral patterns . In this case, the person could be addicted to alcohol and simultaneously have a shopping addiction. Third, an addictive behavior may precede a chemical addiction or vice versa.
This article will focus on cross-addiction as replacing one addiction to drugs with another that is behavioral in nature , especially during or after a long period of recovery.
Symptoms of addiction include:
- Active use longer than expected
- Desire and/or unsuccessful attempts to stop
- Significant time and effort spent using and coming down
- Cravings or strong desire to use
- Recurrent use that impacts an ability to fulfil important responsibilities
- Recurrent social and/or interpersonal problems caused by or exacerbated by use
- Reduction in social, occupational, and/or recreational activities that were previously enjoyable
- Using despite the high risk and adverse consequences
- Continued use despite harmful physical and mental consequences
- Tolerance as defined by a need to increase use to receive the desired effect
- Signs and symptoms of withdrawal when individual stops using
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Why Does Cross Addiction Happen
Cross-addiction often begins accidentally, but because addiction itself is defined by the internal process rather than physical dependence, those who struggle with chemical addiction are at increased risk of developing cross addictions.5 This piece of the equation is often hardest to treat because even if the substance is removed, someone can still be afflicted by the addiction process.
For example, a client is prescribed opioids for a sports-related injury. While taking the opioid prescription, they develop physical dependencea natural occurrence that may or may not lead to addiction. Because they are physically dependent on opioids, they experience withdrawal symptoms when they no longer have access to the opioid prescription, and as a result, begin seeking ways to continue taking the medication or replace it with another addiction.
This may include returning to exercise in hopes of numbing the pain. With heightened pain reduction and euphoria, exercise can be undertaken at an extreme level, leaving them now addicted to exercise.
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What You Should Know About Cross Addiction
Weve all heard the saying having an addictive personality. For someone who is dealing with an actual substance use disorder, this can indicate that their behavioral inclinations tend to draw them toward repetitive and addictive impulses. Meaning, they go from one addiction to the next much easier than the average person. This can increase the likelihood that they will exchange an addiction to one substance to an addiction to another.
When an individual presents addictive patterns like this, they may not simply be struggling with a textbook substance use disorder they may actually be facing a cross addiction and breaking free from its grip can prove to be a difficult task.
What Does Cross Addiction And Cross Dependence Mean
Cross addiction and cross dependence are the same thing.
The terms are 100% interchangeable.
Yet, in my opinion, there is a reason behind the variation.
It appears it would be the drug companies that favored the term dependence.
Think about it, its easier to pedal pharmaceuticals without all the baggage associated with the addiction label.
I havent discovered any research to suggest this who would fund that project?
I arrived at this conclusion with my own marketing expertise and common sense.
The label cross addiction doesnt sell.
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How To Help A Loved One With Cross Addiction
When attempting to help a friend or loved one, its important to become as informed as possible. In addition to learning about the addiction and considering applicable treatment options, try to become knowledgeable about helpful ways to approach the topic with love, support, and personal boundaries. Our article on how to help a friend with an addiction provides some additional guidance.
What Are Some Common Cross Addictions
People in recovery from substance or alcohol use disorders may end up replacing their primary addiction with something else. They may resort to:
- Behavioral addictionssuch as gambling, compulsive sexual behavior, excessive shopping, overeating, or overexercising.
- Other chemical addictionssuch as nicotine, opioid, stimulant, or benzodiazepine use.
Additionally, some believe that people with alcohol or substance use disorders are prone to cross addictions involving similar substances. For example, someone with a history of alcohol issues may be more likely to abuse opioids in the future because both substances have depressant qualities.
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Addiction In Specific Groups
Some people may be more prone to addiction or have a harder time overcoming addiction. Specific groups such as women, young people, physically disabled, elderly, or those in the military , have additional factors in their lives that can increase their chances of becoming addicted.
Women, for example, tend to have more psychological and physical damage from alcohol and/or drug use. For example, their organs are more sensitive to the detrimental effects from too much alcohol, hence liver and brain damage develops faster in women than men. Emotional consequences such as depression, trauma, stigma and abuse, are common amongst women with addictions. They are also more susceptible to relapse.
Young people are also at a higher risk for a number of factors. One is that their brains, especially the prefrontal cortex that controls impulses and decision-making, is not fully developed. So they may end up taking more risks than a full-grown adult. Young people are also more likely to use social media, which not only exposes them to peer influence but is also a widely used tool for drug dealers in the modern age.
Quit Everything All At Once
Although most alcoholics, for example, might balk at the idea of quitting cigarettes and caffeine at the same time as quitting drinking, it actually makes sense in practice. In the short term, it means overcoming several addictions at once, but in the long term, you are breaking the habits ingrained in the brain all together in one phase.
Many alcoholics go on to quit smoking several years after they have stopped drinking anywayand report it to be even more difficult than giving up alcohol. This is because in quitting nicotine, they may be letting go of one of their last vestiges of dopamine-promoting substances.
Getting clean from everything that produces an inflated reward effect as early as possible is one of the only ways to truly beat cross-addiction. However, most addicts do not take that route, preferring instead to retain some healthier substitutes rather than risk finding the zero-tolerance approach too difficult and therefore failing to conquer the primary addiction.
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What Is An Addiction To Alcohol
Alcohol addiction is a dependency on alcohol and can exhibit itself in several ways.
While some people drink in a responsible fashion, others start doing so in an abusive manner.
Occasional binge drinking, excessive drinking, or a general inability to control ones drinking are all signs of alcohol addiction. Just like other drugs, an alcohol dependency can result in both psychological and physical withdrawal symptoms.
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What Causes Cross Addictions
Many people speculate about what causes cross addictions to occur. However, despite how common cross addictions can be, there remains limited research into this topic. What has been seen is that individuals who recover from one addiction and go on at some point in their lives to develop another addiction often do so after facing a serious life problem or change.
For example, someone who is in recovery from alcohol addiction may lose a loved one and be in great pain. Instead of being able to cope in healthy ways, they find themselves wanting other methods to help cope, so instead of drinking again, maybe they begin to spend all of their time on the internet as a way to escape and develop an internet addiction disorder.
For those who have previous addiction issues, the chances of developing a cross-addiction are somewhat high. One study found that someone with previous alcohol addiction was 18 times more likely to abuse prescription pills in the future. Its important if you or a loved one are in recovery to be aware of the cross addictions that can develop.
