Quite simply cross addiction is a pattern of replacing one addiction with another and is one of the commonest features those undertaking treatment for their primary addiction.
For example, someone uses cocaine regularly, manages to stop, but their use of alcohol skyrockets. Or someone stops their alcohol use but starts smoking cannabis instead. Replacing one drug with another is not the only cross addiction that goes on many individuals will switch to other addictive behaviours such as gambling, sex, porn, shopping, or food.
Those that have been through treatment know the dangers of cross addiction and many that underplay the risk of it find themselves back in treatment with their new addiction. This is why many addiction treatment services ask their clients to be abstinence from both non-prescribed drugs and alcohol even if one of these is not their primary problem. This is not a popular request by any means, many clients rail against it and many will not come into treatment at all because of this request. However, it is done for a good reason and because those working in the field now how common cross addiction is especially in the area of swapping one drug for another.
Therefore, the issues of cross addiction is a topic of any good treatment programme as it is something that those in treatment need to be mindful off particularly when is comes to things like shopping, food or sex as unlike non-prescribed drugs and alcohol none of these are things that can be totally avoided as part of a healthy life style.
When looking and drug and alcohol use one of the common features is the activation of dopamine, the brain chemical responsible for reward response. This chemical makes us feel good and reinforces the chase for more of this feel-good sensation. Dopamine also acts as a regulator for many nerve cells throughout the brain. At every moment of our lives, dopamine is responsible for keeping those cells operating at the appropriate levels of activity to accomplish our needs and aims. Whenever we need to use our muscles or want our mind to work harder or faster, dopamine drives some of the involved brain cells to step up to the challenge.
Dopamine also plays a vital role in cross addiction development. When someone decides to quit alcohol or drugs, they often face a dopamine deficiency. In the build up to someone quitting their primary drug of choice the brain has become dependent on the substance to produce the release of dopamine. So, it is very common for those quitting one substance to turn to a new substance that produces the dopamine-induced high they are lacking to prevent withdrawal or alleviate discomfort, even if they are not aware that they are doing it.
But as indicated before it is not just substances that produce a dopamine response, impulsive behaviours such as sex, porn gambling and eating also cause the brain to release dopamine. The impulsive behaviour often then becomes a replacement for someone’s former primary drug of choice because these behaviours activate the same brain pathway and produce effects similar to those produced by drugs or alcohol.
Evidence suggests that the most effective way to address drug and alcohol issues is through intensive psychotherapy and peer support. This approach is also deemed the most effective when it comes to other forms of impulse behaviours such as gambling, eating disorders, porn and sex. Addressing the primary problem and co-occurring disorder simultaneously through integrated treatment is generally the most effective way to help people recover from cross addiction. Identifying and reducing triggers for substance use and impulsive behaviours is a key focus of relapse prevention and this together with other psychotherapy methods to address the underlying reasons for the reliance on substances as a coping mechanism is the key to long term behaviour change.
Psychotherapy in group and individual settings allows individuals to explore thought patterns and feelings that contribute to their substance use and compulsive behaviours.
Peer support also adds value to the change process. Peer support can be best defined as the process of giving and receiving nonprofessional, nonclinical assistance from individuals with similar conditions or circumstances to achieve long-term recovery from alcohol, and/or other drug-related problems and behaviours. This is the sort of provision found in AA, NA, CA, MA and SMART recovery where people in recovery voluntarily gather together to receive support and provide support by sharing knowledge, experiences, coping strategies, and offering understanding.
All the talk in the world is not going to bring about behaviour change and self-medicating your problems away through alcohol or drugs is not the solution. But as we have said before when you’re drinking or using drugs, it’s common to try to rationalize your substance use, deny how much or how often you use, or simply deny that you or your drinking or drug taking is creating problems.
Admitting that your drinking or drug taking is creating problems is the first step. The next step is doing something about it before you have a major personal crisis or serious health issue.
Help Me Stop has been constant in our practice to maintain our standards of care since the start of COVID-19 while ensuring the protection of our clients and staff. The procedures we put in place at the beginning of lockdown have prepared us for any policy changes caused by COVID-19, including the government implementing tighter lockdown rules which was announced in January 2021.
Under the new Tier 5 rules, it is still legitimate for you to attend treatment or attend an assessment so please do not be put off seeking treatment. Our Dayhab centre, which is based in Acton, West London, will remain open as usual and of course we have our tried and tested 6-week online service for those that can’t make it into West London.
If you are concerned that things are getting to much and you are hitting the bottle or taking drugs to cope and want to know how get your life back on track, or you are concerned about someone you know then call us now on 0208 191 8920 or jump onto Live Chat/email us directly at https://helpmestop.org.uk/contact-us
Chris Cordell is Help Me Stop's General Manager and is a senior associate member of the Royal Society of Medicine, Certified International Recovery Specialist, member of the International Society of Addiction Medicine and a member of the Federation of Drug and Alcohol Professionals
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