I once met a woman who became addicted to alcohol relatively late in life, after she had bariatric surgery. She had needed that surgical procedure to address obesity, which had resulted from food addiction. After her surgery, she could no longer eat large quantities of food, and her addiction transferred from food to alcohol. She was experiencing cross addiction. While she never relapsed on her food addiction, she did relapse into chronic alcohol abuse.
What Is Cross Addiction?
Alcoholics Anonymous describes cross addiction (also known as substitute addiction, addiction transfer and addiction interaction disorder) as replacing an old addiction with a new one, instead of replacing it with healthy coping skills.
Why Does Cross Addiction Occur?
When the thing that a person was initially addicted to is no longer available, they may seek out distraction, comfort, escape, etc. from a new source. In a study of bariatric patients, up to 30 percent developed a cross addiction to something other than food, so the article recommended pre-surgery counseling and support groups for people who were deemed high-risk for cross addiction.
What Addictions Can Develop in Abstinence?
When a person abstains from using their drug of choice but doesn’t replace their old habit with healthy new habits, they can become addicted to other things, which may or may not include substances:
- Other drugs – nicotine, alcohol, prescription medication, over-the-counter or illicit substances
- Gambling
- Disordered eating or exercising
- Internet/social media
- Shopping
- Relationships/sex
- Risk-taking
How to Prevent or Address Cross Addiction
Understanding the underlying cause of one’s own addiction can make it much easier to get and stay in recovery. Cognitive behavioral therapy (CBT) is often recommended. CBT can help with substance abuse by:
- Teaching ways to deal with stress
- Helping clients learn how to manage emotions
- Providing tools to resolve interpersonal conflict
- Improving communication skills
- Assisting with the grieving process
- Offering ways to cope with mental or physical illness
Dialectical behavior therapy (DBT) is also recommended. DBT is most focused on:
- Distress tolerance – being able to manage difficult, intense feelings without having a big reaction
- Emotional regulation – being able to recognize and appropriately respond to one’s own emotions
- Mindfulness – having greater awareness of oneself, other people and the present moment
- Interpersonal effectiveness – being able to get along harmoniously with other people
Both CBT and DBT can teach a person new, healthy coping skills that they can use to replace substance abuse, instead of leaving themselves open for a cross addiction to develop later.
In addition to professional guidance, a person can develop new habits to fill the time when they would normally use their drug of choice. By having a non-alcoholic beverage, eating a snack, going for a walk, meditating, or attending a recovery meeting, the person builds new habits and coping skills–and rewires their brain to take pleasure in these new things.
Learning From the Experience of Others
While many people struggle to learn from the choices that others have made, therapist Peggy L. Ferguson suggests doing just that to avoid cross addiction. By attending recovery meetings and listening to others who have been in denial about a cross addiction, people in recovery can become better equipped to spot their own errors in thinking that could set them up for addictive behavior. By recognizing another person’s bargaining, justifying, or other maladaptive behaviors, they may find it easier to spot these things in themselves before a relapse with a new addiction occurs.
Openness with the Whole Team
If you’re in recovery from addiction, it’s important to bring your whole healthcare team on board. Be honest about your addiction with all medical professionals, including primary care and mental health doctors, as well as dentists and pharmacists. Decline mood-altering drugs if they are prescribed by mistake and reach out to your pharmacist if you are unsure if a medication could be mood-altering. For example, a medication that says, “may cause drowsiness” might be considered mood-altering. This applies to over-the-counter meds as well as prescriptions.
If you are concerned that you or someone you love might be struggling with a cross addiction, the professional staff at Safe Harbor Recovery Center is available to answer questions and help determine the best course of treatment.