Cross addiction, also known as addiction transfer or Addiction Interaction Disorder, is when a person has two or more addictive behaviors. The addictions can include alcohol or other drugs, but can also include addictions to food, gambling, sex, gaming or other compulsive behaviors.
Addiction is the continued use of a substance or engagement in a behavior despite the potential for personal problems, harm and negative consequences. For example, consider a gambling addiction. If you continue to gamble to the point that you can no longer pay your bills, you lose your car or damage relationships, you may have an addiction. You feel compelled to continue to gamble despite negative consequences. Or in the case of sex addiction, you may continue to seek out a variety of sexual partners or consume pornographic material, despite the consequences it might have to your relationships. You may be unable to develop or maintain meaningful relationships because of your addictive behaviors. Damage to your self-esteem is another consequence because your behaviors may not align with your values or morals, yet you continue to engage in the behaviors. You may even want to stop but are unable to do so on your own because you are addicted.
Cross addictions don’t have to occur at the same time. For instance, you may be in recovery from alcoholism and may even be sober for many years, but develop an addiction to another drug or later engage in a compulsive behavior that triggers the brain’s dopamine reward center. People who have one addiction are more susceptible to cross addiction.
Cross addiction occurs for a variety of reasons, but often it is accidental. Someone may have surgery and be prescribed an opioid painkiller like Oxycodone or Tramadol. The good feeling they get from the drug reinforces continued use, eventually leading to increased use until it becomes an addiction.
Lack of understanding is another reason cross addiction can occur. People may know they’re addicted to a particular substance, for example, alcohol. Then perhaps they are prescribed opioids. Since they are not addicted to this new substance, they may think they can use it without becoming addicted. The addiction to the new substance may develop slowly with moderate use, but addiction can, and usually does, progress.
Another reason cross addiction can occur is if someone has unresolved mental health issues, otherwise known as co-occurring disorders or a dual diagnosis. If you have a history of trauma, depression or anxiety, you may start using alcohol and other drugs, or start engaging in compulsive behaviors to ease your emotional discomfort. For example, gaming can be used to escape reality and to avoid social situations that make you uncomfortable. This can lead to feelings of isolation and loneliness but because of the compulsive nature of gaming and the dopamine rewards to the brain, the behavior continues.
According to the National Survey on Drug Use and Health, approximately 20.1 million people age 12 or older had a substance use disorder (SUD) related to their use of alcohol or illicit drugs in the past year. The rates of addiction are different for different people as noted by the Surgeon General’s Report. Unfortunately, only one in 10 people receive treatment for their addiction. Many people do not seek a treatment program because they are not ready to stop or think they can do it on their own, while others do not think they have a problem.
At Hazelden Betty Ford, we believe a Twelve Step program helps with all cross addictions. A good treatment program will also address any co-occurring mental health issue by using evidence-based, proven-effective treatment modalities. Medication-assisted treatments should also be offered when needed to help with the withdrawal from opioid and heroin addictions.
There are Twelve Step programs for all cross addictions, and finding one specific to your addiction is important. A food or sex addict is going to be much more comfortable talking about their addiction with others that share the same addiction. If you cannot find a group meeting in your area, there are many online meetings as well.
The best way to avoid cross addiction is by educating yourself and others. If you already have an alcohol or drug addiction, you’re more likely to have or develop a cross addiction. Be aware of the risk and take inventory of what you may be doing to create a cross addiction. People in early recovery from alcohol and other drugs are also more susceptible to cross addiction because their brains are still looking for that feel-good dopamine rush they got when they were using. Knowing that you may be at more risk will help prevent cross addiction.
It's also important to be your own advocate by educating your doctors and letting them know you have an alcohol or other drug addiction. Avoid taking addictive medications, or if that’s not possible, don’t go home with a large supply. Sometimes having a family member dispense the medications can help ensure you take the medications as prescribed.
Be especially careful with pain medications because they can be extremely addictive. Opioids are the most common form of pain medication, which include morphine (e.g., Kadian, Avinza), codeine, oxycodone (e.g., OxyContin, Percodan, Percocet) and related drugs. Opioids can be used safely for short-term medical use, but alternative forms of pain relief should be explored with your doctor if you are dealing with chronic pain.
Avoid situations that make you want to use alcohol or other drugs. Limit your exposure to certain places and people such as bars, nightclubs, people who are active addicts or other situations where there are temptations to use. Addiction often carries with it a sense of shame and guilt. Addiction is a disease not a moral failing. Keeping it in the dark only perpetuates the stigma. Avoid isolating yourself and instead find new ways to spend your time. People in recovery from alcohol and other drugs enjoy fun, fulfilling lives and relationships. Resolve to fill your life with healthy activities such as exercising, enjoying nature and healthy relationships with sober friends and family.