by Peggy L. Ferguson, Ph.D.
Early addiction recovery is a fragile thing. One of the most frequent contributing factors in relapse is something we call “cross-addiction.” Essentially what cross-addiction means is that if you are alcoholic or addicted to other mood-altering drugs, you are potentially addicted to all mood-altering drugs.
To truly understand cross-addiction, you must appreciate the character of addiction and the nature of mood/mind-altering drugs.
Addiction is a disease. It is frequently described as a primary, chronic, progressive and relapsing disease. Research in the last decade tells us that addiction is a brain disease.
People are often reluctant to acknowledge addiction as a disease because of voluntary first use of the chemical. Although someone chooses to use alcohol or other drugs initially, the changes that occur in the brain over time do not reflect a deliberate choice.
Addiction changes the neuropathways of the mind. These changes are suspected of creating the thinking and feeling distortions that lead to the compulsion to consume drugs despite the obvious negative consequences. Thus, the nature of addiction is that of compulsive drug use despite negative consequences. This “compulsive use despite negative consequences” observation has become part of an accepted definition of addiction.
Addiction-induced brain changes are common to all drug addictions and some process addictions (e.g. compulsive behavioral addictions such as gambling addiction, compulsive overeating, sexual addiction). Addiction also involves a biopsychosocial combination of factors in its genesis, maintenance and recovery. It has been said in the addictions field for a long time that certain people are “hardwired” for addiction, due to biology (i.e. genetics), and become addicted with first use of any mood-altering drug.
The nature of mood/mind-altering drugs is that they drug your feelings, thoughts, and behavior. They distort your reality or they allow you to escape or ignore reality. Any mood/mind-altering drug can be cross-addictive. It is the mood-altering effects of drugs that people are addicted to. You choose a particular drug for its unique pharmaceutical effects, based on your own individual needs. As your needs change, your drug of choice may change. The effects of the drug on your body can change over time as well.
Other variables are often involved in an addict’s choice of drug. Consciously or unconsciously, other factors like availability, “social acceptability,” perceived lack of negative consequences, and cost, may be part of the selection process.
Mood-altering drugs operating in the altered brain neuropathways are self-reinforcing in a number of ways. They meet specific individual needs (relaxation, numbing of feelings, reducing behavioral inhibitions, etc.), which is self-reinforcing. The altered neuropathways help maintain the compulsion. The specific drug(s) selected meets individual needs over time so that living skills to meet those same needs do not develop.
A common example is where a drug is chosen for its anxiety reduction properties because the addicted individual has few if any anxiety reduction skills. When stress and anxiety levels exceed some threshold, relief will be sought. Without skills to reduce the anxiety, a pharmaceutical solution will be sought, regardless of whether the drug is the drug of choice or a substitute. This is one reason why it is so crucial to identify the roles that these chemicals have played in a recovering person’s life, and to develop the living skills with which to replace those roles.
When a person in recovery acknowledges the problems caused by the drug of choice and believes that s/he can safely use a different drug of choice, they are not taking into account the fact the “new drug,” like the “old drug,” will still operate in the brain in the same way(s). When an addict substitutes one drug for another they are not abstinent. His/her brain is still in an active state of addiction. Thus, someone who is addicted to one mood-altering drug is addicted to all mood-altering drugs.
An addicted brain is qualitatively changed. Changing drugs of choice does not return an addict to a non-addicted state. An addicted person will continue to experience the same negative consequences of drug use. You cannot regain persistent control over drug use by changing drugs.
Many people, in the process of trying to regain control over their life, chase an “illusion of control,” believing that the latest attempt at control (switching drugs) has and will have a lasting effect, and that control has once again been re-established. It has not. It is only a matter of time, usually a short amount of time.