What is Cross Addiction?
Dear Dr. Steve:My daughter has been home from
rehab for about six months now. We have received the miracle that my husband and I have
been praying for the last ten years—she’s no longer drinking. But in the last
few weeks I’ve noticed something that concerns me greatly. She has started smoking
marijuana. I mean really smoking it—not just when she’s out with her friends for
the evening, not just once and a while to relieve the stress of a hard day at work, but
every day, every night. At first we thought she was just acting strange. But now we can
smell it on her clothes and in her room, we can see it in her eyes, she leaves her smoking
paraphernalia out on her desk in plain sight. It’s almost like she’s drinking
again but I know she’s not drinking. I’ve confronted her about her using
marijuana and she tells me that I’m overreacting. She tells me that marijuana
isn’t addictive, that she doesn’t have a problem with marijuana the way she did
with alcohol and that she has no problem controlling her use of marijuana. Do I have any
reason to be concerned?
In a
word, yes! Let me explain to you why. There is a phenomena known as cross-addiction.
What that means is if an individual becomes alcohol and/or drug dependent on one mood
altering substance, then they will become alcohol and/or drug dependent on all
mood-altering substances, whether or not they have ever previously used a specific drug or
alcohol other than their original drug(s) of choice. I’m going to make the assumption
for the sake of our discussion here that your daughter was diagnosed as being alcohol
dependent and is suffering from the disease of chemical dependency. To further our
discussion let me say that chemical dependency is a disease characterized, in part, by the
following four symptoms:
1.)
Craving—A strong need or compulsion to ingest a mood altering substance
2.)
Impaired control—The inability to limit one's ingestion of a mood altering substance
on any given occasion
3.)
Physical dependence—Withdrawal symptoms, such as nausea, sweating, shakiness, and
anxiety, when their drug(s) of choice are stopped after a period of heavy using
4.)
Tolerance—The need for increasing amounts of one’s drug of choice in order to
feel its effects
When
I say that chemical dependency is a disease, I mean that chemical dependency is a primary,
progressive, chronic, relapsing, and potentially fatal disease of the
mind, body, and soul.
When I
say that chemical dependency is a primary disease, I mean that chemical
dependency is not caused by any other disease, condition, deficiency of character, lack of
willpower and/or self-control, type of personality, and/or moral weakness—it is a
disease in and of itself.
When I say that chemical dependency is a progressive disease, I mean that
chemical dependency gets worse over time if it goes untreated and unmanaged. Even if an
individual maintains long-term abstinence from their drug of choice, because chemical
dependency is a progressive disease, if an individual were to relapse, they would quickly
start consuming their drug(s) of choice as if they had been drinking and drugging all
along.
When I
say that chemical dependency is a chronic disease, I mean that chemical dependency
is long-term by nature. Once an individual is chemically dependent, that individual will
always be chemically dependent—it never goes away.
When I say that chemical dependency is a relapsing disease, I mean that this
disease is characterized by a vulnerability to relapse. Because it is chronic in nature,
no matter the period of time that the disease of chemical dependency is treated and
managed, the chemically dependent individual will always be vulnerable to
relapse—that is returning to drinking and drugging in an excessive out of control
manner.
When I
say that chemical dependency is a fatal disease, I mean that chemical dependency
can be and is often times deadly. Chemical dependency can cause death by causing damage to
one’s vital organs such as heart, kidneys, and liver. Chemical dependency can also be
fatal when it is associated with overdose, suicide, and accidental deaths.
So the
simple truth is that your daughter is acting out of either ignorance or denial. To
manage the disease of chemical dependency, one must remain totally abstinent from all
mood-altering substances for the rest of their life. To understand why this is
necessary, one only need examine the definition of the disease of chemical dependency.
Because
the disease is primary, by definition, the disease has symptoms, one of which is
impaired control of one’s use of drugs and alcohol. As such one can no better control
their use of one drug better than their use of another drug—their impairment exists
across the whole spectrum of mood altering substances.
Because
the disease is chronic, it never goes away and so to switch from one mood altering
substance to another is merely being active in one’s disease with a different mood
altering substance than their original drug(s) of choice.
Because
the disease is progressive, one’s use of a secondary substance other than
their original drug(s) of choice will escalate over a short period of time as you are
witnessing with your daughter and her dependence on a substance other than her drug(s) of
choice will eventually develop.
Because
the disease is prone to relapse, switching from one mood-altering substance to
another is merely a relapse, no matter how one might try to explain it differently.
Because
the disease is potentially fatal, your daughter is at risk as long as she is active
in her disease by using any mood altering substance.
So what
to do about your daughter’s relapse? If she is to continue to live in your house, set
some bottom lines as to what you and your husband consider to be appropriate and
inappropriate behavior. Just remember, the disease of chemical dependency is cunning and
baffling. If something doesn’t sound right, it probably isn’t. Continue to seek
clarification of any questions that you might have by contacting a qualified health care
provider.
Recover
from chemical dependency and its toxic impact on family members. Raise your children to
choose to be alcohol and other drugs free. Learn how to in Dr. Frisch’s, Psy.D.
Recovery book series—From Insanity to Serenity.
Pathfinder’s Checklist
1.) Don’t blame yourselves or be easily deceived—this is relapse pure and simple
and relapse is part of the disease of chemical dependency.
2.) Share the information that I have provided to you about cross-addiction with your
daughter.
3.) Encourage your daughter to contact the rehab program that she attended.
4.) Your husband and you should clarify to yourselves and your daughter what your bottom
line behaviors are that you expect from your daughter if she is to continue living in your
house, i.e. no drinking, no drugging, pay rent, attend aftercare group at her rehab
center, attend 12-Step meetings.
5.) Identify consequences to your daughter if she violates the agreed upon bottom lines
that you and your husband have established.
6.) Follow-up on violations of agreed upon bottom lines with consistent application of
agreed upon consequences.
7.) Attend Al-Anon meetings to help you to better detach from your daughter’s
choices.
G.B.U.
Steve
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