The National Survey on Drug Use and Health reports that about 20 million people over the age of 12 have an addiction problem in the United States. Given this statistic, it is estimated that about 80 percent of those with a substance use problem are at risk of developing a cross addiction. Sussex Publishers. (n.d.). The Challenge of Cross Addiction. Psychology Today. Retrieved October 31, 2022, from 

This newer term, cross addictions, refers to when an individual replaces one addiction with another or has multiple addictions. It is important to note that cross addictions are not dual diagnosis; cross addictions refers to one or more addictions that develop during or after recovery of a prior substance use disorder. To fully understand this issue of cross addiction, it is best to take a closer look at what they are and how they develop. 

What does Cross Addiction Mean?  

Cross addiction describes a person who has two or more addictive behaviors or substance use disorders. The addictions can include alcohol or other drugs, but can also include addictions to food, gambling, sex, or other compulsive behaviors. Cross addictions don’t have to occur at the same time.What Is Cross-Addiction? | Hazelden Betty Ford. (n.d.). Retrieved October 31, 2022, from For example, an individual may be in recovery from opioid use disorder and may even be sober for many years, but develop an addiction to another drug or later engage in compulsive behavior. People who have one addiction are more susceptible to cross addiction.

One of the early researchers of cross addictions was Patrick J. Carnes, specifically focusing on sex addiction. In the early 1900s, he completed a five-year study of one thousand sex addicts. In his conclusions, he found that less than 13% of this group reported only one addiction with the rest reporting multiple addictions, typically all interacting with each other.1 As research continues, it is important to understand that cross addiction does not always involve an immediate jump from one addiction directly into another. This multi-addiction disorder can involve addictions that exist between years of an individual’s life. 

How Do Cross Addictions Happen?

Cross addictions can be explained in relation to the brain’s reward system. Dopamine, a neurotransmitter that is essential for many brain functions, notably for transmitting pleasure, is thought to play a role in how cross addictions happen for some people. Substance use disorders that share similar neural pathways to the brain’s reward system (dopamine regulation) can explain a vulnerability to developing cross addictions.What is cross-addiction? What is Cross Addiction? | Hazelden Betty Ford. (n.d.). Retrieved October 31, 2022, from  This vulnerability can be found in those recovering from substance use disorders, as these individuals may have a deficiency of dopamine or are working to rebuild their brain’s reward system in the absence of a substance. It is important for those in recovery to be aware of their susceptibility to developing other addictions and work with a trained professional to develop avoidance strategies.  

Cross addictions can also happen to those who have an active substance use disorder. Published findings from a Columbia University Medical Center study found that people with active substance use disorders were about two times more likely to develop another substance use problem (27%) compared to individuals whose substance use disorder was in remission (13%).What is Cross Addiction? (Signs & Statistics). American Addiction Centers. (2022, September 15). Retrieved October 31, 2022, from  This illustrates how those who were unable to address their original substance use problem were more likely to develop other addictions than those who found successful treatment. 

Unfortunately, cross addictions can also happen by accident. Unexpected life circumstances like being prescribed an opioid for a medical reason can lead to cross addictions, especially with those with a history of substance use disorder in their family. Lacking an understanding of addictive substances can cause the onset of cross addictions for those with other substance use disorders, such as alcoholism. In addition to accidents, unresolved mental health issues increase the likelihood of developing multiple addictions. 

Common Cross Addiction Drugs 

In general, it is often considered that substances that produce similar effects can result in a higher vulnerability to cross addiction.3 Both depressants and stimulants are kinds of drugs that are common in multiple addiction disorders. 

The depressants which are commonly used together include: 

  • Alcohol
  • Narcotic pain-relieving medications (Vicodin, OxyContin, etc.) and heroin
  • Anti-anxiety drugs, such as benzodiazepines (e.g., Valium, Xanax) or barbiturates (e.g., Seconal)
  • Sedatives and sleep aids
  • Cannabis and other types of hallucinogenic drugs

Stimulants associated with cross addiction include:

  • Cocaine
  • Diet medications and over-the-counter diet aids that contain stimulants
  • Ecstasy, MDMA, and similar derivative drugs
  • Caffeine
  • Different types of hallucinogenic drugs (mescaline, Psilocybin) and different inhalants

Common Cross Addiction Behaviors

Since cross addiction happens because of dopamine activity in the brain, certain impulsive behaviors can also provide a fix that leads to problems. Here are common behaviors that can become addictive. 

  • Gambling, as approximately 1 percent of Americans have a pathological gambling problem.U.S. Department of Health and Human Services. (2022, March 22). Treatment and recovery. National Institutes of Health. Retrieved October 31, 2022, from 
  • Compulsive sexual behavior
  • Pornography use
  • Shopping 
  • Food 

How Do You Treat Cross Addiction?

Treatment is similar to other models of addiction therapy and is based on the individual and condition severity. Treating cross addiction also depends on the kind of substance or behavior involved in the addictive disorder. 

When treating cross addictions with opioids, research shows that medication should be the first line of treatment, usually combined with some form of behavioral therapy or counseling.Carlos Blanco, M. D. (2014, November 1). Testing the drug substitution hypothesis. JAMA Psychiatry. Retrieved October 31, 2022, from  Medications are also used to treat addictions with alcohol and nicotine, proven to be most effective when combined with behavioral therapy and support groups. 

For people with addictions to drugs like stimulants or cannabis, treatment primarily consists of behavioral therapies. Successful treatment is achieved when a program is tailored to address each patient’s drug use patterns and drug-related medical, mental, and social problems. Consistent accountability and dedication to one’s treatment plan is crucial in treating cross addiction.

How Do You Avoid Cross Addiction? 

There are many strategies available to avoid cross addiction. Avoidance begins with education, so it helps to know these beneficial ways to mitigate the risk of developing multiple addictions or picking up another during recovery. 

Lean On A Support System

Checking in with friends, family, and others is a great way to find the needed support to avoid developing an addiction. A support system of close people creates the basis for accountability when faced with temptations. Talking with loved ones can also help recenter oneself if a relapse happens. Remember, relapse can be a normal part of the recovery process. 

Quit Everything At Once 

Sometimes, the best way to avoid multiple addictions is to quit them at all once. This can alleviate the risk of trading one for the another, and allows the ability to focus attention solely on reaching a point of freedom.

Take Inventory of Emotions 

Cravings that come with addiction are emotional. Learning to deal with emotions, especially anger, irritation, and sadness can have immense benefits. Mindfulness meditation and cognitive behavior therapy (CBT) are powerful ways to learn how to handle negative emotions that can lead to cross addiction. 

Speak With a Professional

Receiving professional treatment and addiction therapy is one of the best recommendations for handling cross addiction. Even if one or multiple addictions does not seem harmful, talking with a professional can lead to early prevention before addiction(s) completely overtakes one’s life. 

The Commitment House Wants to Help You 

The Commitment House is where treatment meets recovery. With trained professionals and proven treatment models, we are able to provide the best-quality help for cross addiction. 

If you or a loved one are dealing with one or multiple addictions, our team at The Commitment House is ready to help. We are able to help through every step of your recovery journey. Our supportive community will also help provide you with support and stress management techniques to avoid risks of relapsing.

Contact us or give us a call at (270) 900-0373 to get started.

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