What Is Cross Addiction and Cross Dependence?
![Reframe App Logo](https://cdn.prod.website-files.com/60d10433104bca13abce2c13/6524611f0bc6ca7db5aea21b_logo.webp)
It’s been years since you’ve caught up with this friend, and as you sit across from them at dinner, you’re happy to see how much they’ve changed. The last time you spoke, they were struggling with a serious addiction to painkillers. Now they’re fresh out of rehab. You’re still laughing at one of their jokes when they flag down a server.
You’re surprised when they order a glass of wine — then another, and another. By the end of the meal, they’ve finished a bottle’s worth all by themselves. They never really drank before. Why would they start now?
Your friend might be experiencing a phenomenon called cross addiction. Let’s dive into this recovery obstacle, why it happens, and what we can do to stay on track.
Cross addiction, also called addiction transfer, transfer addiction, or addiction substitution, occurs after we’ve overcome one maladaptive behavior (such as substance misuse) and become reliant on a new substance or behavior.
For example, although our friend overcame their opioid use disorder, they subsequently became dependent on alcohol. To understand why this happens, we need to unpack how addiction impacts the brain.
Substance use disorder hijacks our reward system. Every time we consume an addictive substance, we experience a rush of dopamine — the chemical messenger associated with pleasure, learning, and motivation. In an attempt to reach equilibrium, the brain then slows its own dopamine production, expecting an artificial dosage through drug or alcohol use. These changes reinforce substance use, and, over time, our brain becomes dependent.
Even after we stop drinking or using drugs, we may crave that spike of feel-good neurotransmitters. A cross addiction develops when we replace our original addiction with a new source of dopamine. Sometimes, we begin using different substances. In most instances, however, we chase that high through physically or emotionally stimulating activities. These everyday dopamine-boosting behaviors can become compulsive and morph into behavioral addictions, also known as process addictions. Here are a few examples of common behaviors that can become compulsive:
This is just a small sample of potentially addictive actions, and addiction transfer isn’t always the cause. Some people engage in compulsive behaviors due to obsessive-compulsive disorder (OCD). How do we know if we have a cross addiction or a dual diagnosis? Let’s read on to discover the difference.
Is “cross addiction” the same as “dual diagnosis”? we might wonder. The answer is no. Let’s compare the definitions to learn why.
Whereas addiction describes a mental and physical compulsion to perform a particular behavior such as substance use or gambling, dependence is a state of chemical and biological dependency on a substance. Cross dependence happens when we transfer one physical dependence to a new substance.
Substances produce chemical changes in our body, making them addictive. The physiological effects of withdrawal from substances can produce tangible symptoms such as sweating, fever, shakes, nausea, pain, and headaches. When overcoming addiction, the withdrawal period may be more a mental game, but that form of withdrawal is just as real and powerful as physical symptoms.
It’s possible to have an addiction and a dependency at the same time — in fact, many of us do. This adds another layer to the already complex process of maladaptive behaviors.
Now, let’s examine the factors that put us at risk for transfer behaviors that can fuel both addiction and dependence.
What makes us vulnerable to transfer addiction? A complex interplay of genetic vulnerabilities, mental health conditions, and social factors can potentially lead to new compulsions and affect our recovery.
If we identify with one or more of these points, how can we prevent cross addiction from progressing? Fortunately, developing an understanding of transfer addiction can protect us from unwanted compulsions in the future.
Often, cross addiction develops subtly. Consider the following example.
Imagine we’ve successfully overcome a reliance on opioid painkillers. Maybe we, like many people, also took those pills when we felt overwhelmed or stressed, which, come to think of it, we feel a lot now that we’re off our medication. Today, when we feel like we want to unwind, we decide to turn to a different substance instead. We pour a glass of wine. That works, so we decide that every time we really want to take an opioid, we’ll drink instead. In time, we may find ourselves dependent on alcohol. That’s cross addiction.
Why did we experience that addiction transfer? If you read the above paragraph carefully, you can spot some of the telltale signs:
1. We replaced painkillers with something similar.
First, we found a substitute for our previous addiction. By seeking out another substance that mimicked the effects of opioids, we found a way to relax and unwind. Just like opioid painkillers, alcohol is a depressant, and it affects the brain’s reward system in a similar way. We sought out a drug with a similar effect and have developed a similar dependence on it.
2. We used alcohol to cope.
Next, we used alcohol to control cravings, stress, and withdrawal symptoms. Many of us struggle to handle the physical and emotional challenges that come with recovery. We may not realize that the way we’re coping is unhealthy.
3. We didn’t address the root cause of our addiction.
Finally, we didn’t deal with the unresolved issues that contributed to our opioid use disorder. Why do we feel overwhelmed so often? What’s got us so stressed? Instead of digging into what upsets us, we’ve attempted to treat the symptoms — first with meds, then with booze.
But is there anything we can do to avoid this? Doesn’t this happen to everyone who gets sober?
While anyone can experience transfer addiction, it isn’t considered a normal part of the recovery process.
Recovery is more than just getting sober. In addition to stopping our alcohol use, we’ll need to make fundamental, lasting changes to our lifestyle, behaviors, and mindset. We might also seek professional help to address the issues behind our drinking. Without these reinforcements, we’ll be more vulnerable to future substance use disorders and process addictions.
If we build a solid foundation for our sobriety, however, we can successfully avoid cross addiction..
Putting down the booze is just the first step in our recovery journey. Once we quit drinking, we’ll need to avoid cross addiction by making sustainable, lasting changes. If you’re looking for direction in early recovery, we’ve put together eight tips just for you.
Let’s go back to that restaurant. Sitting across from your friend, you may have begun wondering about cross addictions of your own. Have you started smoking, shopping online, or doomscrolling after cutting back on alcohol? Are you worried about whether these behaviors are still within your control? If so, you may benefit from a sustainable alcohol cessation program — one rooted in scientific best practices.
Reframe offers the guidance you need to stop drinking (or drink less) while prioritizing your health and well-being. Our curriculum focuses on incremental, lasting change. We help you to unpack your relationship with alcohol while building safeguards against other potentially addictive behaviors. To learn more, visit the App Store or Google Play.
1. What does cross addiction and cross dependence mean?
Cross addiction describes the phenomenon of exchanging one addiction for another — adopting a new maladaptive substance or behavior. Cross dependence is a little more subtle and involves developing a physical dependence on some new substance. While cross addiction is more mental, cross dependence is a physical, chemical dependency.
2. What causes transfer addiction?
Transfer addiction, or cross addiction, can happen when we quit cold turkey, lack proper coping skills, have a genetic predisposition, struggle with a mental illness, or fail to resolve underlying issues fueling our cravings.
3. How do you avoid transfer addictions?
We can avoid cross addiction by prioritizing our health, educating ourselves about recovery, building a sober support network, and working with professionals to develop healthy coping skills.
4. Is cross addiction normal?
We should avoid normalizing addiction transfer. While cross addiction is something we’ll hear about from many of our friends in recovery, that doesn’t mean it’s an expected part of the recovery process.
Although it isn’t a treatment for alcohol use disorder (AUD), the Reframe app can help you cut back on drinking gradually with the science-backed knowledge to empower you 100% of the way. Our proven program has helped millions of people around the world drink less and live more. And we want to help you get there, too!
The Reframe app equips you with the knowledge and skills you need to not only survive drinking less, but to thrive while you navigate the journey. Our daily research-backed readings teach you the neuroscience of alcohol, and our in-app Toolkit provides the resources and activities you need to navigate each challenge.
You’ll meet millions of fellow Reframers in our 24/7 forum and daily Zoom check-in meetings. Receive encouragement from people worldwide who know exactly what you’re going through! You’ll also have the opportunity to connect with our licensed Reframe coaches for more personalized guidance.
Plus, we’re always introducing new features to optimize your in-app experience. We recently launched our in-app chatbot, Melody, powered by the world’s most powerful AI technology. Melody is here to help as you adjust to a life with less (or no) alcohol.
And that’s not all! Every month, we launch fun challenges, like Dry/Damp January, Mental Health May, and Outdoorsy June. You won’t want to miss out on the chance to participate alongside fellow Reframers (or solo if that’s more your thing!).
The Reframe app is free for 7 days, so you don’t have anything to lose by trying it. Are you ready to feel empowered and discover life beyond alcohol? Then download our app through the App Store or Google Play today!
Reframe supports you in reducing alcohol consumption and enhancing your well-being.