In 2015, Grammy award-winning artist and rapper, Eminem, opened up about his struggles with a prescription pill addiction to Men’s Journal. After an overdose in 2007 followed by a stay in a treatment center, Eminem knew he had to lose weight to remain healthy and sober. To do so, he turned to running. “It gave me a natural endorphin high, but it also helped me sleep, so it was perfect,” he stated in his interview. However, soon his healthy habit turned destructive. Running 17 miles per day, Eminem weighed as little as 149 pounds and was constantly injuring himself. Eminem’s story highlights the harsh truth of addiction. It’s a disease that’s compulsive tendencies and cravings don’t just disappear after treatment and must be thoroughly managed in sobriety. If not, those in recovery from substance addiction are at risk for transferring their addictive behaviors to a new substance or habit- a development known as cross addiction.
Understanding cross addiction
To put it simply, cross addiction is moving from one addiction to another. It’s unfortunately common for those that have struggled with substance addiction in the past to choose a new drug of choice that they feel they have more control over. “We certainly see a lot of people trying substances other than their drug of choice after treatment,” says Maeve O’Neill, the Director of Compliance at Vertava Health. “For example, a heroin addict could leave treatment and try drinking alcohol.” Having a few drinks in recovery from a heroin addiction certainly doesn’t guarantee that someone will develop a cross addiction, but it’s possible. When the addictive behavioral patterns are already present, those in recovery need to be cautious that their new habits don’t spiral out of control and develop into something far more destructive. [middle-callout] However, cross addiction can extend beyond using other substances. Like Eminem’s experience, cross addiction can also surface as an addictive behavioral pattern- better known as a process addiction. A process addiction can mimic the same high as a substance addiction, but feel less dangerous, which makes them an easy alternative to drug or alcohol use. “I like to call them numbing behaviors,” O’Neill states of the addictive behaviors people can develop after receiving treatment for a substance addiction. “We’ll do whatever it takes to numb our brains to get some sort of escape.” Although cross addiction comes in many forms, some of the most common ones are:
- Other drugs
- Binge eating
- Shopping
- Gambling
- Sex
- Overworking
- Exercising
Since many cross addictions develop in the form of a new behavior, it isn’t always easy to spot at first. Some of these habits, such as overworking and exercising, can seem harmless at first. What’s wrong with being a dedicated worker and frequenting the gym? It’s when the behavior becomes impulsive and starts to create physical or mental problems that a person can no longer control that the behavior becomes an addiction.
How does cross addiction develop?
During recovery, the substance is no longer in the body, but the brain can still crave and desire the feeling that drugs or alcohol provided. “Substance use hijacks the brain chemistry,” O’Neill states simply. Using substances activates the reward center in the brain. When the reward center is activated it releases a “feel-good” chemical called dopamine that makes the user feel high and reinforces the abusive behavior. Over time the brain and body become dependent on the substance to release the dopamine into the body so the user can feel any sort of happiness. This unfortunate cycle perpetuates the use of the addictive substance. Due to the rewiring of the brain’s chemistry, when someone seeks treatment for substance use and is no longer using, they can suffer from low dopamine levels. The lowered dopamine levels make it difficult for recovering individuals to feel happiness or excitement early on in the recovery process. The inability to feel peace of mind or positivity in recovery can often push people to seek out a new substance or behavior in order to produce the same high as their previous addiction. Low dopamine levels coupled with the stress and anxiety of life in recovery can create the perfect breeding ground for cross addiction- especially for those in the early stages of sobriety who are still learning to cope with it long-term. “Cross addiction can start as a way to manage feelings and challenges without actually having to face the deep-seated root of the actual problem,” O’Neill concludes.
Preventing and treating cross addiction
Just like any addiction, a cross addiction needs to be treated by addressing the underlying cause of the compulsive behaviors or substance use. “In treatment, we tell our clients to be on the lookout for how they behave when they’re trying to numb pain or avoid stressful situations. If we can identify the triggers and negative pattern right away, we’ll be able to incorporate tools into their recovery plan to help avoid cross addiction,” says O’Neill. Identifying the people, places and things that trigger a craving for the addictive substance or habit is critical to helping those in recovery avoid developing a cross addiction. As O’Neill mentions, once the triggers have been recognized, those in sobriety should set boundaries to prevent their disease from developing in new ways. Preventing these developments could mean eliminating unnecessary stressors, avoiding places that encourage the negative behavior or removing oneself from toxic relationships. “What we want is clients to be able to look at something, whether it be a behavior or decision, and be able to say ‘this isn’t serving my recovery anymore, and I want to make a change.’” O’Neill elaborates. Those in recovery need to make a conscious decision to focus their energy on building healthy relationships, participating in an aftercare program, following the advice of their treatment professionals and engaging in the unique recovery methods that work for them. Most importantly, those living in sobriety should remember that treatment is not a “fix-all” for addiction. The compulsive behavior patterns that persist in active addiction will not always end after treatment- but with the right tools, the impulses can be managed and cross addiction prevented.
