Cross-addiction
Cross-addiction, also referred to as addiction transfer, is a phenomenon where an individual shifts their addiction from one harmful substance or behavior to another. This condition is characterized by the simultaneous abuse of multiple mind-altering substances, such as drugs and alcohol. Research indicates that addiction has both genetic and environmental components, making some individuals more susceptible to developing substance use disorders. The brain's reward system, particularly involving dopamine receptors, plays a crucial role in this process, as repeated substance use can lead to changes that intensify cravings.
Individuals with cross-addiction may use a new drug to cope with cravings for their original substance, thus keeping their brain's reward pathways active. Symptoms of cross-addiction include chemical dependency, impaired control over substance use, and denial of the problem. Effective treatment necessitates intensive therapy aimed at fostering self-awareness and promoting long-term sobriety. The path to recovery can be challenging, with withdrawal symptoms lasting weeks and potential post-acute symptoms lingering for years. Preventive strategies, such as avoiding high-risk situations and practicing rigorous honesty, are vital for individuals in recovery to mitigate the risk of relapse or addiction transfer.
Cross-addiction
ALSO KNOWN AS: Addiction transfer
DEFINITION: Cross-addiction involves the transfer of an addiction from one harmful substance or behavior to another. It also involves the abuse of more than one mind-altering substance at a time.
Causes
Scientists now understand that addiction is a physiological problem caused both by nature and by nurture. A person who develops a substance use disorder often inherits a sensitive brain and develops behavioral habits that lead to chemical changes in the brain. These changes, in turn, lead the person to use toxic substances against their will.
Research confirms that all drugs of abuse, including alcohol, marijuana, nicotine, amphetamines, barbiturates, opiates, and heroin, work on the same neurological pathways in key areas of the brain—in particular, dopamine receptors and the limbic system, a primitive area focused on meeting basic needs. Dopamine is a “feel-good” chemical that tricks the limbic system into equating drugs with pleasure or relief, and even with survival.
In people who are genetically predisposed to addiction, the release of dopamine is more intense, and it unleashes what is known as the phenomenon of craving. Such persons cannot limit their intake of an addictive drug because of this craving. People who do not come from a family of addicts or alcoholics can, through force of habit, still become addicted to toxic drugs and experience the same phenomenon.
Often, when a person attempts to quit a drug of choice, they will use another drug to satisfy the craving and essentially keep the reward pathways of the brain in hypersensitive mode. Alternatively, cross-addicts who have no desire to quit will mix a cocktail of drugs to get the desired effect.
Risk Factors
The dopamine hypothesis suggests that if a person is addicted to one drug, they are at higher risk of becoming addicted to another. For people who are trying to quit a particular drug, cross-addiction can lead to a relapse of the original drug-taking behavior because of the sustained craving and because of impaired decision-making abilities.
Symptoms
The symptoms of addiction feature three characteristics: chemical dependency, drug-taking habits, and denial of dependency and habits. Chemical dependency involves four components: craving, or the compulsion to ingest a mood-altering substance; impaired control of the amount ingested on any given occasion; physical dependence, which produces a period of withdrawal when the drug is discontinued; and tolerance, or the need for more of the drug to feel its effects.
Cross addicts are often in extreme denial. They tend to be secretive and will hide their behavior from friends and family members. Because most drugs are illegal, cross addicts often suffer from paranoia.
Screening and Diagnosis
Cross-addictions are far more dangerous than alcoholism alone or an addiction to a single substance because mixing drugs and alcohol can lead to death sooner. As with alcoholism, cross-addiction requires a certain amount of self-diagnosis to be treatable.
Dependence can be diagnosed when the person admits to three or more of the following: taking substances in greater amounts than intended; a persistent desire to cut down or stop using fails to change the behavior; frequent intoxication or presence of withdrawal symptoms that interfere with functioning; spending significant amounts of time acquiring drugs or dealing with the consequences of use; giving up activities in order to use drugs; persistent use despite adverse consequences; marked tolerance; withdrawal symptoms; and the use of drugs to treat withdrawal symptoms.
Treatment and Therapy
Intensive therapy and treatment are required to break an addiction without transferring that addiction. The first step is building self-awareness and an understanding of the nature of addiction. Sobriety must be the first priority and should be affirmed and nurtured daily.
If a person transfers an addiction from one substance to another, the brain remains in addictive mode; the neural associations and pathways have no opportunity to become disabled and dormant. Thus, the cycle of cross-addiction can be broken only by stopping the drug-taking and by remaining abstinent from all mind-altering drugs.
Acute withdrawal symptoms, such as sweating and nausea, can last a couple of weeks. Postacute withdrawal symptoms can happen for two years. These bouts tend to last three or four days and produce irritability, mood swings, variable energy, low enthusiasm, disturbed sleep, and difficulty concentrating. The first two years are the most difficult; after five years of abstinence, relapse is uncommon.
Individuals attempting recovery from substance abuse disorder must be cognizant of the threat of addiction transfer or cross-addiction as they learn to cope with the underlying issues that led them to abuse substances initially. Substances and behaviors share similar brain pathways, especially concerning reward systems and dopamine release. This raises the instance of addiction transfer. The recovery period is a particularly vulnerable time for those recovering from substance abuse disorder. Those susceptible to cross-addiction have complex recovery needs and a high instance of repeated relapse to either the original drug of choice or a new substance or behavior.
Prevention
Recovery is a lifelong process that requires new coping skills. Relaxation is chief among them; rigorous honesty and avoiding high-risk situations also will help prevent a relapse.
People who have been addicted to one drug must be vigilant because cross-addiction can occur by happenstance. A recovering alcoholic, for example, may go to the dentist and be prescribed pain medicine, to which they develop a chemical dependency. Without thinking about it, the patient begins to increase the dosage and frequency of the pain medication and may seek unnecessary refills. Not all doctors learn about the physiology of addiction, so to protect oneself, a recovering addict must be wary when taking prescription medications.
Bibliography
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Gaba, Sherry. "The Challenge of Cross Addiction." Psychology Today, 15 Apr. 2019, www.psychologytoday.com/us/blog/addiction-and-recovery/201904/the-challenge-cross-addiction. Accessed 23 Aug. 2024.
Johnson, Marlys C., and Phyllis Alberici. Cross-Addiction: The Hidden Risk of Multiple Addictions. New York: Rosen, 1999.
Kipper, David, and Steven Whitney. "Cross-Addiction." The Addiction Solution: Unraveling the Mysteries of Addiction through Cutting-Edge Brain Science. New York: Rodale, 2010.
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"What Is Cross Addiction?" Hazelden Betty Ford, 17 Jan. 2019, www.hazeldenbettyford.org/articles/what-is-cross-addiction. Accessed 23 Aug. 2024.