What is cross-addiction?

Causes

Scientists now understand that addiction is a physiological problem caused both by nature and by nurture. A person who becomes an addict 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 his or her 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, he or she 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 a 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 more secretive than alcoholics 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, 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 it 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 totally 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.

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 he or she develops 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

Christopher, James. How to Stay Sober: Recovery without Religion. New York: Prometheus, 1988. Print.

Johnson, Marlys C., and Phyllis Alberici. Cross-Addiction: The Hidden Risk of Multiple Addictions. New York: Rosen, 1999. Print.

Kipper, David, and Steven Whitney. “Cross-Addiction.” The Addiction Solution: Unraveling the Mysteries of Addiction through Cutting-Edge Brain Science. New York: Rodale, 2010. Print.

Ries, Richard, and Shannon C. Miller. Principles of Addiction Medicine. Philadelphia: Lippincott, 2009. Print.