Cross Addiction and Addiction Transfer

By Angie Carter, CRADC, SAP

Cross Addiction: Individuals who are addicted to a specific substance and are in remission from active use can sometimes find themselves manipulating another substance in order to achieve a desired effect. This is called addiction transfer or substitution. Some individuals quit using their 'drug of choice' and begin casually or sporadically taking some other mood or mind altering substance. For instance, their drug of choice may be marijuana and they never took pills. Once they stop using marijuana they may start to use and abuse pain medication, or vice versa. If they took pain meds and stopped, they may start to use marijuana.

Cross Addiction Leads to Relapse


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I have worked with quite a few addicts who struggle with the concept of not drinking after they get clean because alcohol was not their drug of choice and they did not drink excessively. The danger in this thinking is that once these individuals begin to consume alcohol the first area of the brain that is affected is the decision making center. Once this part of the brain becomes anesthetized from alcohol the impulse to return to the primary substance once used may occur, therefore, it puts them at high risk. Drinking alcohol jeopardizes their recovery even if alcohol is not something that was initially problematic. Alcohol is a drug and cross addiction to it can lead to relapse for the individual who has stopped using. The best policy is abstinence.

The term cross addiction or polysubstance dependence is when an individual uses three or more substances in a 12 month period and typically does not have a primary preference. For example, a person may use alcohol, marijuana and tranquilizers or cocaine, amphetamines and alcohol.

The following is a list of symptoms associated with substance dependence:

  • Tolerance: using increased amounts to achieve desired effect
  • Withdrawal: experiences withdrawal symptoms when they stops using
  • Loss of control: uses more than they planned to use
  • Financial problems
  • Inability to stop using: unsuccessful in cutting down or stop
  • Time: spends time obtaining, using, or being under the influence of the drug
  • Interference with activities: gives up or reduces amount of time spent on recreational, social and/or occupational activities
  • Harm to self: continued use despite physical or psychological problems caused by the drug

Three or more of these symptoms occurring in a 12 month period meets the criteria for dependence.

Cross Addiction takes place in the reward center of the brain and the neurochemical that is primarily responsible for stimulating the chemical reaction that occurs is dopamine. Pleasurable behaviors or specific substances can release a surge of dopamine in certain individuals which creates a desired mood or effect. This is one of the reasons some individuals have a higher susceptibility to dependency. The activity or substance has to ‘flip the switch’ so to speak in order for the desired effect to occur. Once this happens, the urge to repeat the behavior or use the substance is very enticing and hard to resist.

I am in long term recovery from drugs and alcohol. I experienced cross addiction while in my active use, but I did have a primary substance which was alcohol. I actually used other substances in order to stay awake longer to use more alcohol. As time went on I felt a strong pull towards cocaine and other stimulants.

Being clean and sober means I have stop using all mood and mind altering substances once I got into recovery. I have struggled with other compulsive behaviors since getting sober though. Shopping, overeating and excessive working to name a few. I need to pay attention to any mood changing behavior that causes negative consequences in my major life areas. Left unchecked it can become problematic and create another dependency, i.e. cross addiction.

I use the same tools in dealing with these behaviors as I did with my substance abuse issues. Therapy, journaling, talking to someone, prayer and meditation are a few things I do to deal with compulsive behaviors. I also experienced a significant problem with family members and their addictions once I got sober. I attend a 12-step meeting in order to deal with the negative impact that it has on my life and how those dynamics can make my life unmanageable. We are fortunate to have such a variety of support groups in our community in order to deal with addiction, alcoholism, and the negative impact that dependencies has on family members.

Awareness and education about addiction transfer and cross addiction will help individuals who are newly clean and sober realize the risks involved. Potential relapses can be prevented by understanding that addictive thinking may try to lead an individual into using a “less favorable” substance and that it would be alright. Working a recovery program can lead to a life of freedom from the binding chains of addictive substances and behaviors.

About the Author

Angie Carter, CRADC, SAP is a certified reciprocal alcohol and drug counselor and DOT certified Substance Abuse Professional. She is in private practice at Carter Counseling & Consulting Services. Angie sees local clients in office and is also available for telephone coaching and/or consultation. Click here to contact Angie with appointment requests, questions, or feedback.

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