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Cross-Addictions
An individual who abuses or is dependent on a substance will commonly identify a primary substance of abuse. This does not necessarily mean that the individual will not abuse other addictive substances or engage in other addictive behaviors. An individual with addictive tendencies may seek multiple addictive sources of reinforcement throughout their lifetime; this tendency is known as cross-addiction. This behavior typically occurs by successively replacing one addictive behavior with another. These cross-addictions may manifest in the use of another substance within the same drug class, the use of a substance belonging to a different class, or engagement in other addictive behaviors (e.g., compulsive gambling, sexual addiction, Internet addiction, overeating). This entry focuses on the proposed mechanisms behind cross-addictions, subtypes of cross-addictions and their associated risks, and barriers to substance abuse treatment that cross-addictions may present.
Mechanisms behind Cross-Addiction
A number of mechanisms have been proposed to explain the presence of cross-addictions and the maintenance of addictive behaviors. There is no consensus among substance abuse researchers on the primary underlying mechanism behind cross-addictions. Two processes that have empirical support are impulsivity and genetic predisposition to substance abuse.
Impulsivity
Several researchers have identified a correlation between substance abuse and impulsivity that may serve to explain the presence of cross-addictions. Impulsive behavior involves the pursuit of thrills, adventure, new experiences, lowering of inhibitions, sensation seeking, and avoidance of the mundane. Individuals who display impulsive behaviors are more likely to experiment with drugs at an early age, consume substances at a higher quantity and frequency than nonsensation seeking peers, and experiment with multiple substances of abuse over their lifetime. When the patient decreases use of or ceases to use the primary substance of abuse, his or her impulsive and sensation seeking behaviors will likely be directed toward another source of reinforcement. This commonly results in the presence of a cross-addiction to another substance of abuse or addictive behavior. As such, those patients who demonstrate difficulties with impulsivity and sensation seeking should be monitored closely for the development of a cross-addiction.
Genetic Predisposition to Addiction
Additionally, research has identified a genetic component or predisposition to substance use that may serve to facilitate the tendency to replace one addiction with another. Although perspectives on genetic predisposition to substance abuse have been varied, researchers have presented evidence that a genetic predisposition is commonly a factor in substance abuse and substance dependence, particularly among alcohol use disorders. This genetic predisposition would also increase the likelihood of the patient developing a cross-addiction once they have completed substance cessation treatment for his or her primary substance of abuse.
Substance Abuse Treatment
Once the individual takes steps to obtain sobriety from their primary substance of abuse, many researchers believe that their addictive tendencies may be channeled into other addictive sources of reinforcement. When treating a patient who has successfully ceased use of their primary substance of abuse, the possibility of a cross-addition should be included as a component of relapse prevention education. Substance use treatment providers should be aware of the possible presence of cross-addictions in order to monitor for signs of relapse to the patient's primary substance of abuse and to monitor abuse and dependence symptoms that may emerge related to the novel addictive substance or behavior.
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- Behavioral Addictions
- Classifications of Drugs of Abuse
- Alcohol
- Amphetamines
- Amyl Nitrite
- Anabolic Steroids
- Anxiolytic Drugs
- Barbiturates
- Benzodiazepines
- Buprenorphine
- Caffeine
- Central Nervous System Depressants
- Central Nervous System Stimulants
- Club Drugs
- Cocaine and Crack
- Drugs, Classification of
- Ecstasy
- Fentanyl
- Hallucinogens
- Heroin
- Illicit and Illegal Drugs
- Inhalants
- Levo-Alpha Acetyl Methadol
- Marijuana
- Methadone
- Methamphetamine
- Methods of Drug Administration
- Morphine
- Naltrexone
- Opioids
- Over-the-Counter Drugs
- OxyContin
- Prescription Drugs
- Tobacco
- Criminal Justice System and Substance Abuse
- Engagement and Intervention
- Family and Community Issues
- Adult Children of Alcoholics
- Al-Anon
- Alateen
- Behavioral Couples Therapy
- Binge Drinking
- Brief Strategic Family Therapy
- Children of Alcoholics
- Codependency
- Community Reinforcement and Family Training
- Community Reinforcement Approach
- Enabling
- Experimental Substance Use
- Family Behavior Therapy
- Family Therapy
- Fetal Alcohol Syndrome
- Fetal Effects of Alcohol and Other Drugs
- Multidimensional Family Therapy
- Violence, Intimate Partner and Substance Abuse Treatment
- Models of Addiction
- Neurobiology of Addiction
- Prevention Theories, Research, Techniques, Strategies, and Effectiveness
- Alcohol Marketing
- Alternative Activities
- Behavioral Risk Factor Surveillance System
- Community-Based Processes
- Drug Abuse Resistance Education
- Environmental Approaches
- Evidence-Based Prevention
- Evidence-Based Prevention and Treatment, Dissemination and Adoption of
- Expectancies
- Fidelity of Prevention Programs
- Gateway Drugs Theory
- High-Risk Behaviors
- Information Dissemination
- Institute of Medicine Classification System
- Mentoring
- Monitoring the Future
- National Clearinghouse for Alcohol and Drug Information
- National Media Campaign
- National Outcome Measures
- National Registry of Evidence-based Programs and Practices
- National Survey on Drug Use and Health
- Prevention Education
- Prevention Evaluation
- Prevention Populations
- Prevention Resources
- Prevention Strategies
- Problem Identification and Referral
- Public Policy, Prevention
- Racial and Ethnic Minorities, Issues in Prevention
- Refusal Skills
- Risk and Protective Factor Theory
- Risk Factors for Addiction
- School-Based Prevention Programs
- Social Norms Marketing
- Social Skills Training
- Tobacco Marketing and Countermarketing
- Tobacco Master Settlement Agreement
- Underage Drinking
- Violence Prevention
- Professional Issues in Addictions
- Addiction Technology Transfer Centers
- American Society of Addiction Medicine
- Business Improvement Practices
- Centers for the Application of Prevention Technologies
- Certification and Licensing
- Clinical Supervision of Addiction Counselors
- College on Problems of Drug Dependence
- Confidentiality
- Dual Relationships
- Electronic Health Records
- Ethical Standards for Addiction Professionals
- Ethics
- Health Insurance Portability and Accountability Act
- Impaired Professionals
- Informed Consent
- International Coalition for Addiction Studies Education
- NAADAC, the Association for Addiction Professionals
- Network for the Improvement of Addiction Treatment
- Qualified Services Organization Agreements
- Single State Authorities
- State Provider Associations
- Public Policy Development
- Access to Recovery
- Center for Substance Abuse Prevention
- Center for Substance Abuse Treatment
- Comprehensive Drug Abuse Prevention and Control Act
- Decriminalization
- Demand Reduction
- Discrimination, Addicted and Recovering Individuals
- Drug Testing
- Drug-Free Schools and Communities Act
- Economic Costs of Alcohol and Drug Abuse
- Harm Reduction, Public Health
- Indian Health Services
- Insurance Parity
- Join Together
- Legal Action Center
- Legalization of Drugs
- Medical Use of Marijuana
- Moderation Approaches to Alcohol Problems
- National Council on Alcoholism and Drug Dependence
- National Drug Control Strategy
- National Epidemiologie Survey on Alcohol and Related Conditions
- National Institute of Mental Health
- National Registry of Evidence-based Programs and Practices
- Needle Exchange Programs
- Office of National Drug Control Policy
- Public Policy, Alcohol
- Public Policy, Drugs
- Public Policy, Prevention
- Public Policy, Treatment
- pulse Check
- Single State Authorities
- State Provider Associations
- Substance Abuse and Mental Health Services Administration
- Supply Reduction
- Synar Amendment
- Tobacco Master Settlement Agreement
- War on Drugs
- Recovery
- Al-Anon
- Alateen
- Alcoholics Anonymous
- Big Book, The
- Bill W.
- Cocaine Anonymous
- Double Trouble
- Dry Drunk Syndrome
- Gamblers Anonymous
- Moderation in Use
- Moderation Management
- Narcotics Anonymous
- Natural Recovery
- Peer Recovery Support Services
- Rational Recovery
- Recovery
- Recovery Community Organizations
- Recovery Community Services Program
- Recovery Schools
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- Secular Organizations for Sobriety/Save Our Selves
- Sobriety
- Social Drinking
- Spiritual Issues
- Stigma
- Support Groups
- Twelve Steps
- Twelve-Step Recovery Programs
- Women for Sobriety
- Relapse Prevention
- Research and Evaluation Issues in Substance Abuse Prevention and Treatment
- Cannabis Youth Treatment Study
- College on Problems of Drug Dependence
- COMBINE Study
- Drug Abuse Treatment Outcome Studies
- Evidence-Based Prevention
- Evidence-Based Prevention and Treatment, Dissemination and Adoption of
- Evidence-Based Treatment
- Fidelity of Prevention Programs
- National Institute on Alcohol Abuse and Alcoholism
- National Institute on Drug Abuse
- National Institute on Drug Abuse Clinical Trials Network
- National Treatment Improvement Evaluation Study
- Prevention Evaluation
- Project MATCH
- Research Issues in Prevention
- Research Issues in Treatment
- Screening, Assessment, and Diagnosis
- Addiction Severity Index
- Alcohol Testing
- Alcohol Use Disorders Identification Test
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- Alcoholism
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- Drug Testing
- Experimental Substance Use
- Inventory of Drinking Situations
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- Post-Traumatic Stress Disorder
- Problem Oriented Screening Instrument for Teenagers
- Psychosocial History
- Screening
- Screening Instruments
- Self-Report Inventories
- Substance Abuse
- Substance Abuse Subtle Screening Inventory-3
- Substance Dependence
- Substance Use Disorders
- Substance-Induced Disorders
- Substance-Induced Withdrawal Delirium
- Timeline Followback
- Tolerance
- Urine Toxicology Testing
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- Sociocultural and Historical Perspectives on Drug use
- Special Populations: Etiology, Prevention, and Treatment
- Adolescents, Substance Abuse and Treatment
- Antisocial Personality Disorder
- Anxiety Disorders
- Athletes and Drug Use
- Borderline Personality Disorder
- Children of Alcoholics
- Co-Occurring Disorders
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- Substance Abuse Health-Related Issues
- Alcohol-Related Birth Defects
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- Antipsychotic Drugs
- Antiseizure Drugs
- Anxiolytic Drugs
- Attention Deficit Hyperactivity Disorder
- Blood Alcohol Concentration
- Drug Abuse Warning Network
- Fetal Alcohol Syndrome
- Fetal Effects of Alcohol and Other Drugs
- Grief, Loss, and Substance Abuse
- Health Care System and Substance Abuse
- Hepatitis C
- HIV/AIDS
- Injection Drug Use
- Insurance Parity
- Maternal Drug Use
- Medical Consequences
- Medical Use of Marijuana
- Methods of Drug Administration
- Pain Management
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- Suicide
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- Treatment Theories, Research, Techniques, Strategies, and Effectiveness
- Abstinence Violation Effect
- Acamprosate
- Acceptance and Commitment Therapy
- Antabuse (Disulfiram)
- Antisocial Personality Disorder
- Anxiety Disorders
- Aversive Therapy
- Behavioral Couples Therapy
- Borderline Personality Disorder
- Brief Interventions
- Brief Strategic Family Therapy
- Buprenorphine
- Cannabis Youth Treatment Study
- CENAPS Model
- Client Engagement
- Client/Treatment Matching
- Co-Occurring Disorders
- Cognitive Behavioral Therapy
- Cognitive-Social Learning Model
- COMBINE Study
- Community Reinforcement and Family Training
- Community Reinforcement Approach
- Contingency Management
- Continuum of Care
- Counseling Approaches
- Court-Mandated Treatment
- Covert Sensitization
- Craving
- Depression
- Detoxification
- Drug Abuse Treatment Outcome Studies
- Evidence-Based Prevention and Treatment, Dissemination and Adoption of
- Evidence-Based Treatment
- Family Behavior Therapy
- Family Therapy
- Gender Issues
- Grief, Loss, and Substance Abuse
- Group Therapy and Counseling
- Harm Reduction Psychotherapy
- Inventory of Drinking Situations
- Levo-Alpha Acetyl Methadol
- Matrix Model
- Methadone Maintenance Treatment
- Minnesota Model
- Moderation Approaches to Alcohol Problems
- Moderation in Use
- Motivational Enhancement Therapy
- Motivational Interviewing
- Multidimensional Family Therapy
- Naloxone
- Naltrexone
- National Outcome Measures
- National Treatment Improvement Evaluation Study
- Nicotine Replacement Therapy
- Outpatient Treatment
- Patient Placement Criteria
- Pharmacological Approaches to Treatment
- Post-Traumatic Stress Disorder
- Project MATCH
- Public Policy, Treatment
- Qualified Services Organization Agreements
- Racial and Ethnic Minorities, Issues in Treatment
- Rapid Opioid Detoxification
- Relapse
- Relapse Prevention
- Residential Treatment
- Resistance in Treatment
- Solution-Focused Therapy
- Stages of Change Model
- Substitute Addictions
- Support Groups
- Synanon
- Therapeutic Communities
- Tobacco Cessation Programs and Treatments
- Treatment Access and Retention
- Treatment Approaches and Strategies
- Treatment Effectiveness
- Treatment Facilities
- Treatment in Jails and Prisons
- Treatment of Alcohol and Drug Use Disorders
- Treatment Plans and Treatment Planning
- Treatment Programs for Alcohol or Drug Abuse
- Treatment Settings
- Treatment, Nontraditional Approaches
- Twelve-Step Facilitation
- Veterans, Substance Abuse and Treatment
- Violence, Intimate Partner and Substance Abuse Treatment
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