Is Cross Addiction Real?

5 minute read

Cross addiction, also known as an addiction transfer or substitute addiction, is the term for replacing one addiction for another. For example, say you recover from a substance use disorder, but develop another type of addictive behavior around food, sex, or gambling. Cross addiction can occur by substituting one substance for another as well. Perhaps you start to abuse alcohol after you’ve quit heroin or begin taking large amounts of ADHD medications after recovering from cocaine addiction.

Some people argue that there is such a thing as a healthy “cross addiction” if it’s not a compulsive behavior that you continue regardless of negative consequences.

What Causes Cross Addiction?

Cross addiction could be tied to low levels of dopamine in the brain. In the example of a substance use disorder, repeated drug or alcohol abuse can deplete the brain of dopamine. This is one of the brain chemicals responsible for pleasurable feelings. Abuse of some substances tells your brain to release dopamine in large, abnormal amounts. Over time, the brain begins relying on alcohol and other drugs to produce even normal amounts of dopamine.

When you have a chemical dependency on drugs or alcohol and quit using them, your body and brain go into overdrive. You experience physical withdrawal symptoms while the central nervous system tries to rebalance itself without the substances it’s accustomed to. The time it takes to physically detox from drugs or alcohol is different for everyone, but typically ranges from a couple of days to a week. However, it usually takes longer for brain chemicals to fully rebalance. This period is known as post-acute withdrawal syndrome (PAWS). During this time, you’re at risk for mental health issues like anxiety and depression symptoms as well as mood swings and low motivation.

To ease PAWS, some people start engaging in other dopamine-rewarding, addictive behaviors to achieve similar feelings as substance abuse. Common cross addictions include:

Sex addictions
Compulsive shopping
Eating disorders
Compulsive gambling
Compulsive exercising

Another theory around cross addiction is the “addictive personality.” This line of thought is that some people always find some type of compulsive behavior to satisfy an underlying need. The idea of an addictive personality is not evidence-based and it’s controversial. Research has yet to find a character trait common to all addicted people. Developing an addiction is usually a complex interplay of biological, developmental, and environmental factors.

It’s critical to address the underlying issues that led to substance abuse to help prevent cross addictions. All types of maladaptive behaviors are fueled by similar challenges. Alcohol or drug abuse, gambling, shopping, disordered eating, and other behaviors are usually symptoms of core issues like trauma and mental health disorders. Identifying why you’re abusing substances and/or engaging in unhealthy compulsive behaviors, addressing those issues, and learning healthy coping skills can stop you from continuing to self-medicate in other ways when you’re in addiction recovery.

Is Cross Addiction Different From Dual Diagnosis?

Cross addiction is different from a dual diagnosis. Also known as co-occurring disorders, a dual diagnosis is when you meet diagnostic criteria for a substance use disorder and one or more mental health disorders. Co-occurring disorders occur simultaneously. Cross addictions occur sequentially.

Co-occurring disorders are common in people struggling with addiction. Over 9 million Americans who have a substance use disorder also have a mental health disorder. Mental health disorders that frequently co-occur with alcohol and drug addiction include:

Generalized anxiety disorder
Panic disorder
PTSD/complex trauma
Depression
Bipolar disorder
Attention-deficit hyperactivity disorder (ADHD)
Borderline personality disorder
Antisocial personality disorder
Schizophrenia

Is There Any Evidence for Cross Addiction?

Empirical evidence for cross addiction is scarce. Much of the information on cross addiction is anecdotal or from case studies. There is some research around cross addiction between substances. For instance, one study found that people may be at higher risk for addiction within the same substance classification. An example: you recover from alcohol addiction but begin abusing marijuana, another substance in the depressant category. However, another study found that people who were in addiction recovery had under half the risk of developing another substance use disorder than those not in recovery. These protective factors could be the relapse-prevention skills people learn in addiction treatment as well as understanding the reasons they use substances.

Even with the limited research on cross addiction, recovery programs recommend that people who’ve struggled with substance abuse be wary of substitute addictions. The disease model of addiction postulates that substance abuse changes the brain’s reward pathways and therefore using any substance puts you at risk for dependency. It’s recommended that people in recovery refrain from all forms of substances. For example, people who’ve recovered from heroin addiction shouldn’t drink or smoke pot because they may think it’s a less harmful substance. Opioid-based pain medication for medical procedures or chronic pain are also not recommended to the extent possible for people in recovery.

Looking for Help?

The best path to sobriety is addressing the root causes of substance abuse so you can heal fully. At Footprints to Recovery, we help you safely detox from substances and then guide you through the work you need to do to stay sober and refrain from other unhealthy coping skills. You’ll explore trauma and emotional pain in a safe, accepting space where you’ll feel supported and cared for. We offer a full continuum of care including:

Depending on which Footprints’ substance abuse and mental health treatment centers you attend, your treatment plan may include: