What Is Cross Addiction?

Thursday, October 20, 2016 | By JP Emerald Coast

multiple drugs

When dealing with a substance abuse addiction, it’s easy to focus your treatment on the one particular substance you are dependent upon. For example, if you have been diagnosed as an alcoholic, your treatment is likely based on avoiding the use of alcohol and the triggers that cause you to drink too much. You might not consider how other substances, like prescription drugs and illegal street drugs, can affect your sobriety since you haven’t come in contact with them in the past.

While most people assume their addiction problems are only focused on one substance, many people in recovery find it’s easy for them to become addicted to other substances as well, this is known as a cross-addiction. Even when the original substance abuse problem is a thing of the past, people in recovery need to stay vigilant to avoid developing another addiction, whether that’s a relapse into their old substance abuse problems or the use of a new drug.

Additional Substance Abuse

Consider someone who is in a drug treatment program due to a dependency on prescription painkillers. As this person recovers, they might be tempted to celebrate their recovery with a few alcoholic drinks, as this is a common way for many Americans to let off steam and celebrate an accomplishment. Since the original addiction was drug-based, most people think they are not likely to get addicted to other substances.

Unfortunately, the opposite might be the case for addicts, especially those who are new to recovery. Although alcohol might not be the addicted person’s main problem, indulging during happy hour can make you more likely to make reckless decisions, such as using the very substance you’ve worked so hard to get away from. Drinking alcohol lowers our inhibitions and puts us at risk of inappropriate behavior. Whether or not the decisions made during an alcoholic fog lead us back to our original drug of choice, it opens a pathway to new addictive behavior and can cause us to make regrettable and embarrassing decisions.

Dealing with the fallout from these actions may make some people in recovery more likely to return to their previous addictions as a way of dealing with their new problems. Imagine you’re a recovering cocaine user who drank too much at an office party. The next day, upon realizing that you got drunk and danced on the cafeteria tabletops, it’s easy to see how reaching for cocaine as a temporary way to forget about the night before can occur. However, such an impulsive move can plunge you back into the same addiction behavior you fought so hard to get away from. Even though many people relapse during their recovery, your best bet is to avoid any behavior that might cause you to return to your past addictive behavior.


Cross addictions are not limited to drugs and alcohol. Many people live with an impulse control disorder in addition to their substance use disorder. People can become dependent on almost anything that activates the brain’s dopamine receptors. The reason for these kinds of cross addiction is that certain activities reward the pathway of the brain in the same way as abusing substances. Some other impulse control disorders include:

  • Gambling. Approximately 1 percent of the U.S. population has a pathological gambling problem, according to the North American Foundation for Gambling Addiction Help, but those with substance use disorders have rates of pathological gambling four to five times higher than those of the general population. Some common thoughts and behaviors among gamblers with substance addictions can also perpetuate the severity of cross addictions. These unhealthy thoughts and actions include: gambling as a way to fund drug use, gamblers using drugs to maintain the focus and energy necessary to continue gambling, and gamblers selling drugs to obtain more money to gamble.
  • Compulsive sexual behavior. Characterized by continued sexual activity despite considerable negative consequences, roughly 9 percent of the general population lives with a compulsive sexual disorder, according to a study with the University of Minnesota. States of hypersexuality can be brought on by substance abuse, mental health conditions, and environmental triggers. Compulsive sexual behavior can also be used to replace substance abuse for those in recovery.
  • Pornography. Multiple surveys have found that about 9 percent of porn viewers reported an inability to stop watching porn. Many people become addicted to pornography because it activates the brain’s release of dopamine, in much the same way as drugs or alcohol.
  • Compulsive shopping. Compulsive shoppers receive a “high” whenever they purchase items, and so compulsive shopping can leads to financial troubles, which can further exacerbate substance use disorders.
  • Food. Food activates reward pathways in the brain in the same manner as drugs or alcohol and can cause addictions and eating disorders in some individuals.

Fortunately, treatment is available to people with addictions to these and other impulse control disorders.

The Risk of Cross-Addiction

While overusing addictive substances, as outlined above, is one obvious reason to avoid using other drugs, the serious ramifications of cross-addiction is another. Cross addiction is a psychological term that refers to the idea that people who have one addiction are more likely to develop an addiction to another substance. As we’ll discuss below, some studies suggest the likelihood of cross-addiction is relatively low, but it’s understandable how this can easily occur in people who might not be completely dedicated to the recovery program.

Let’s consider what causes most people to become addicted to a particular substance in the first place. For most people, the drug or alcohol is a way to deal with everyday stress, past abuse or trauma, or to make us temporarily feel better. Biology and mental health also play a role in making some people more susceptible to addiction, but having a major life problem is one of the leading causes of addiction.

This is why treatment for cross-addiction needs to focus on healing the individual rather than just dealing with the effects of cross-addiction of the substance being abused. Dealing with the problems that lead to the addiction is critical, otherwise, the person with an addiction will likely turn to another substance to replace the original one.

For example, if a woman was raped in college and started using alcohol at a young age to help her forget about the trauma, it’s not enough to just address the physical need for alcohol. Her counselors must also get to the root cause – in this case, her past rape – and help her deal with her feelings about it. Only by helping to resolve past issues, or learning to confront them, accept them, and move forward, can a person let go of an addiction that is being used as a crutch to mask psychological trauma.

Mark Willenbring, M.D., former director of the Division of Treatment and Recovery at the National Institute on Alcohol Abuse and Alcoholism and a world-renowned expert on addiction, explains how the neurobiological reasons behind addiction occur. Based on his research, he believes addiction happens when a genetically vulnerable brain is exposed to a drug over a period of time. Aside from cases of fetal alcohol or drug exposure, he says, most people are not born addicted. Rather, genetic makeup and an environmental trigger – such as abuse or high levels of stress – combined with a preference for using addictive substances is what leads to a drug or alcohol dependency.

Biology is another main factor since addiction is often a hereditary trait. This doesn’t mean everyone born to parents with addiction problems will become addicts themselves. Instead, it’s crucial that children of addicted parents learn about the triggers and warning signs that can lead to addiction. Understanding this path can help many people avoid developing their own addictive behavior, whether it’s by avoiding addictive substances altogether or entering a treatment or counseling program before addiction becomes a problem.

prescription drugs

The Difference Between Cross Addiction and Dual Diagnosis

Cross addiction and dual diagnosis are terms that are often confused when used in treatment programs. The National Alliance on Mental Illness defines dual diagnosis as the simultaneous occurrence of a substance problem along with a mental health problem. This, however, can cover a wide range of issues. A person who is an alcoholic might also suffer from depression. Someone with bipolar disorder might turn to certain illegal drugs to cope with manic episodes.

In many cases, the two problems go hand-in-hand – one is a coping mechanism or a side effect of the other problem. Many people who suffer from mental health problems turn to alcohol or drugs to self-medicate, especially if they don’t receive proper medical treatment. However, it’s also important to note that not everyone who is clinically depressed will turn to a substance like alcohol to cope with their problems. While many alcoholics are clinically depressed, most people who are clinically depressed are not alcoholics.

In fact, dual diagnosis occurs in about 33 percent of all patients with a mental health problem. At the same time, about 50 percent of people who suffer from a serious mental problem will also have addiction issues.

Cross addiction, on the other hand, refers to the fact that a person with one addiction is more likely to develop an addiction to a different drug, even after the original addiction has been dealt with in a treatment program. This is why many addiction counselors advise their patients to avoid using any substance that can lead to substance abuse problems.

It’s likely that someone with heroin addiction, for example, can drink alcohol without developing a problem. This is because the brain processes these substances differently and because past treatment programs have successfully dealt with the underlying cause of addiction. Still, for some people, it’s a great risk to start using another addictive substance after being diagnosed with another addiction.

If you have an addiction problem to a substance like heroin or cocaine but you are interested in drinking alcohol on occasion, talk to your addiction counselor or psychologist to make sure you are making healthy decisions for yourself and those around you. Although many people with addiction problems can use another substance without developing a problem, it’s important to consider your reasons behind wanting to use this substance. Make sure you are not simply looking for a substitute for your past addiction.

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 wouldn’t also have a problem with alcohol.

This is still a hotly debated topic among psychologists and addiction specialists. While we’ve shown that certain mental health issues increase one’s 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, there’s 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.

Researchers who worked on the project noted that the results were not what they expected. They were under the belief that when a person recovers from one addiction, they are more likely to replace it with another addiction, even after treatment. It seems, however, that dealing with the underlying reason for addiction, such as past trauma or current physical abuse, is a great motivating factor that will end addiction. People who deal with and triumph over the reasons for the addictions are much less likely to begin abusing another substance.

However, treatment counselors still caution that even if cross-addiction is rare, it’s still important to watch for the warning signs of a secondary condition. Although most people who complete a treatment program won’t 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.

So while studies show more than 10 percent of people with addictions find a new substance to abuse, it’s important to note that this group is based upon those who are committed to and completed treatment. The number is likely much higher for people who don’t finish treatment or those who quit their addictive substance on their own by going cold turkey, for example. Unfortunately, statistics don’t currently reflect the dangers of cross-addiction, nor do they demonstrate what happens if the treatment fails or if the individual drops out of the program before it’s completed.

Signs of Cross-Addiction

After someone has successfully completed a drug or alcohol treatment program, it can be easy to overlook a secondary addiction that occurs months or years later. For one reason, family members and loved ones do not want to believe the recovered person has developed another addiction. After years of dealing with the primary addiction, denial about a cross-addiction is tough to overcome. In many cases, loved ones will accept the new substance use as a temporary crutch, or will tell themselves that “at least he’s not using heroin again,” even if the person with the addiction is drinking to the point of blacking out on a regular basis.

However, the new addition makes it more likely for a person in recovery to return to their previous substance of choice, or they might develop a serious, life-threatening addiction to the new substance.

Many of the signs of cross-addiction are the same as the initial problem, and include:

  • Lying about how much or how often you are using the new substance.
  • Missing out on important events, like your work schedule, family responsibilities or social obligations due to your substance use.
  • Overspending on the new addiction or putting yourself in illegal situations to obtain the substance, such as working with drug dealers or stealing money to support your addiction.
  • Finding yourself unable to quit using the substance even when you want to stop.
  • Becoming anxious, physically ill or grouchy when you don’t have the new substance readily available.
  • Being unable to quit or cut back on using the substance even when family members or loved ones ask you to.

Since cross-addiction does not occur in everyone who has a substance abuse problem, it is possible you can use something without it causing an issue. For example, if you were addicted to heroin and are now in recovery, you might be able to drink on occasion without developing a cross addiction to alcohol.

If you are using a new substance and you don’t have any of the above symptoms of a cross-addiction, you might not be in danger of developing a cross or secondary addiction problem. However, if you suspect you are trading one addiction for another or if you have any of the problems listed above, seek help from your addiction counselor, medical doctor or therapist right away.

woman with cross addiction

Treatment of Cross-Addiction

How do we treat cross addiction? Finding a way to treat cross-addiction is slightly more difficult than treating the original addiction. During the first treatment, your counselor or addiction specialist will work with you to determine what aspects of your life, whether it’s stress, illness, trauma or another underlying factor, contributed to you turning to an addictive substance for release.

Once your initial treatment is complete and you are in recovery, it can be more difficult to determine why there is a secondary addiction. Did you not fully recover from your first addiction? Are there other personal reasons that led to your cross addiction? Are you not in a supportive environment that can help you continue with recovery? Is someone in your life, whether an old friend or a new acquaintance, hindering your ability to fully recover from your addiction?

Your addiction specialist or medical doctor will need you to be open and honest with them about the reasons behind your cross-addiction. They will also need to consider what type of addiction you had in the past and how that compares to what you are dealing with now.

For example, if you previously had an addiction to alcohol or a narcotic, those drugs were likely used as depressants, even if you didn’t realize how they would affect you. If you are now abusing cocaine, ecstasy or stimulants, you are choosing drugs that will give you an upper or will make you happier. If your new drug of choice is the opposite of what you previously used, you might need to dig deeper into therapy to figure out why you have turned to these addictive substances. If, on the other hand, you are now using drugs that are similar to the ones you used in the past, you’ll need to consider why your previous treatment failed and what issues you still need to work on.

Making a drastic change from one type of substance to another that has many different effects on your psyche can indicate you have more work to do in recovery. Your counselor will help you find the correct path through medication, therapy, and counseling that can address any new psychological problems that arise in your cross-addiction. If at any time, you feel like your counselor is not meeting your needs or if their availability is less than you need, don’t hesitate to find another therapist who can see you more often and who can help you address the specific problems that have led to your addiction.

Finding Help for Cross-Addiction

After an inpatient addiction treatment or an aggressive 12-step program, you might have thought you had successfully defeated your addiction problem. In many cases, you did. You addressed the issues that caused your addiction and you worked toward building a new life free from your previous substance abuse.

However, as you settled back in your old routine or when you found yourself facing new challenges – such as work-related stress, family demands or financial difficulties – maybe you needed a chemical boost to help you cope with the stress and demands of adult life. After all you’ve been through with your past substance abuse problems, you made an informed decision not to relapse with the same drug that caused your previous problems, which is commendable. You are dedicated enough to your recovery that you didn’t turn to heroin or alcohol, as you would have in the past.

Instead, however, you found a new substance to help you forget about your problems but, as you rely on it more often, you might be developing a cross-addiction. It’s important to note, however, that not everyone with addiction is susceptible to a cross-addiction. Most people who have dedicated themselves to a recovery system and are committed to living a sober life will not fall into a cross-addiction.

At JourneyPure Emerald Coast in beautiful Florida, we have a highly trained and sympathetic team ready to help you address any addiction problem, whether it’s a primary or cross addiction issue. Contact us today for more information.

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