What Is Cross Addiction, and Is It a Real Thing in Recovery?

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Cross addiction—also known as addiction interaction disorder or addiction transfer—is a phenomenon you might’ve heard of in recovery. In a nutshell, it refers to a new addiction following in the footsteps of another. This often happens after a person has quit one substance, and is looking for new ways to cope.

But is cross addiction real? If you successfully overcome a substance use disorder (SUD), what are your chances of becoming addicted to something else later on? And is it really always a “bad” thing to find a substitute to replace a more harmful behavior?

With at least 46.3 million Americans struggling with an SUD as of 2021, these questions are more relevant than ever.1 Below, we’ll cover how common cross addiction really is, when using other substances might qualify as harm reduction, and how to know if you’re developing a cross dependence.

Cross Addiction Definition

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Photo by Andres Siimon on Unsplash

What do cross addiction and cross dependence mean?

The definition of “cross addiction” is when a person with an addiction becomes dependent on a new substance or behavior, either at the same time or during the recovery process. For example, if someone overcomes alcohol use disorder but smokes cigarettes heavily instead, this might qualify as a cross addiction. Cross dependence means essentially the same thing.

Keep in mind that this phenomenon is not the same as dual diagnosis (when a substance use disorder coincides with another mental health issue, such as depression or PTSD).2

How Does Cross Addiction Work?

The concept of cross addiction has some basis in the idea that those with past substance use disorders are highly prone to future addictions. Since addiction is a disease affecting the reward pathways in the brain, this theoretically makes sense.3

There is some scientific support for this idea. For example, research suggests “cross-sensitivity” is possible for sugar and alcohol among some individuals. This could lead someone who quits drinking to crave sweets, and develop sugar addiction.4

But, long-term, does a history of substance or alcohol dependence really make you more vulnerable to future addictions?

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Is Cross Addiction a Real Thing?

Cross addiction is real and possible, but it may not be as likely as you’ve heard.

One 2014 study investigated whether or not those in recovery are actually more prone to developing another addiction in the future. Researchers interviewed over 34,000 participants at the beginning of the study, and again three years later.

In the results, those who successfully recovered from a substance use disorder were significantly less likely to struggle with a cross dependence after three years, compared with those who did not recover from their first addiction. The researchers suggest that this outcome is partially linked to the coping skills that come with recovery.5

This is not to say that cross dependence doesn’t happen in recovery. But for those going strong in sobriety, it may not be as probable as you might have read.

What are Some Common Cross Addictions?

People in recovery from substance or alcohol use disorders may end up replacing their primary addiction with something else. They may resort to:

  • Behavioral addictions—such as gambling, compulsive sexual behavior, excessive shopping, overeating, or overexercising.
  • Other chemical addictions—such as nicotine, opioid, stimulant, or benzodiazepine use.

Additionally, some believe that people with alcohol or substance use disorders are prone to cross addictions involving similar substances. For example, someone with a history of alcohol issues may be more likely to abuse opioids in the future, because both substances have depressant qualities.

Some substances have an especially common relationship with one another. For example, many people look for a cigarette when they are out drinking, and the combination of cocaine and alcohol is known to multiply the euphoric effects of both substances.6 A person who quits drinking might begin smoking more in recovery, while a person who quits cocaine may drink more heavily when out at the bar. Either could be an example of cross addiction.

However, the order in which the behaviors developed, and the needs a person is trying to fill by using these substances are significant factors to consider. The idea of cross dependency on its own may be an insufficient explanation when it comes to treating that person’s addiction.

Read more: Alcohol and Other Substances

How to Know If You Have a Cross Addiction

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Photo by Inspa Makers on Unsplash

It’s not always easy to tell if you’ve developed a cross dependence, especially when it comes to behavioral addictions. For instance, exercise may have helped calm your anxiety early in recovery. But over time, you could begin to obsess over exercise, and may even overexercise your body to the point of harm.

On the other hand, you might more easily identify a cross addiction when you’ve swapped one substance for another. Common examples of this would be replacing opiates with alcohol, or replacing cocaine with ADHD medication.

In any case, there’s cause for concern when a behavior or substance creates any level of harm in your life (or meets any criteria for addiction).

If you’re concerned about your drinking while recovering from another addiction, take our alcohol use assessment to see where you stand.

Is Substitution Always a Bad Thing?

In the rehab community, you’ll see two common viewpoints: harm reduction and total abstinence. Some believe that “a drug is a drug is a drug,” and that if you’re in recovery from anything, you should avoid everything.

And for certain people, this is true.

However, abstinence isn’t always practical for everyone. For example, one person may not be able to drink alcohol without going overboard, but may be fine using cannabis occasionally. Moderate marijuana use might even help that unique individual reduce anxiety and avoid alcohol relapse, while causing fewer harms than drinking.

As another example, someone with a past stimulant addiction may be able to have a glass of wine from time to time, without ever having issues.

The harm reduction perspective understands that some people will not be perfectly abstinent from all substances in recovery. The idea that any substance use equals relapse may actually increase the chances of relapse in some people. From this viewpoint, the most crucial thing is to avoid new addictions, not all substances.

What Can You Do About Cross Addiction?

If you’re struggling with a cross addiction in recovery, you’re not alone. Many people find themselves engaging in unhealthy behaviors to cope when giving up a substance like alcohol.

Fortunately, there are solutions. Joining a coaching program can help you build adaptive skills for long-term recovery, and healthier habits to replace addiction. And prescription medications can help rebalance your brain chemistry, reducing your cravings for certain substances and behaviors.

Ria Health offers one way to access these types of support, all from an app on your smartphone. Our program is an affordable alternative to in-person rehab, and can allow you to work towards change without turning your life upside down.

Get in touch with our team today, and learn how we can support you towards a sustainable recovery.


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Written By:
Alicia Schultz
Alicia is a Minnesota-based freelancer who writes for Ria Health and various other brands in the health and wellness space. Beyond addiction and recovery, she also covers topics relating to general well-being, mindfulness, fitness, mental health, and more. When she’s not writing, you can find her relaxing with her three-legged cat, trying new workout routines, and spending time with her loved ones.
Reviewed By:
Evan O'Donnell
Evan O’Donnell is an NYC-based content strategist with four years’ experience writing and editing in the recovery space. He has conducted research in sound, cognition, and community building, has a background in independent music marketing, and continues to work as a composer. Evan is a deep believer in fact-based, empathic communication—within business, arts, academia, or any space where words drive action or change lives.

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