Cross-addiction (swapping one substance for another) is the leading cause of relapse in recovering individuals. Recovering people must be constantly alert to the possibility of triggering a relapse of their disease through the intake of drugs or alcohol. Just as a diabetic needs to be cautious about the intake of sugar, a person recovering from alcoholism must be vigilant to avoid the use of anything habit-forming, including other types of habit-forming drugs. A person recovering from addiction to prescription drugs or other substances must be very cautious regarding use of any habit-forming substances as well, including alcohol. There are also numerous prescribed and over-the-counter drugs/substances that should be avoided (cough medicine, mouthwash with alcohol, antihistamines such as Benadryl).

Cross-Addiction is best explained this way: once a person has been addicted to a substance, they have lost the ability to have a casual relationship with any other addictive substances. In other words, a person who is addicted to one substance is really addicted to ALL substances, even if they have never used them. Abstinence from all mood-altering, mind-altering substances (and addictive behaviors such as gambling) is the best way to prevent a relapse into addiction.

doctorWhat if I have to seek medical help and/or have surgery?

A person who has struggled with an addiction to any substance will likely become addicted to any other addictive substance if they use it.  At some point in their recovery, it is likely that the recovering person will probably find themselves exposed to certain medications (including prescribed and over-the-counter). It is extremely important that the addicted person be vigilant and take extreme caution when visiting any medical professional that can prescribe. It is important to let the doctor know that there is a history of addiction and give instruction that there should be NO ADDICTIVE MEDICATIONS prescribed at all. Even with this instruction, it is important to still exercise caution when given a prescription for any medication. Many doctors may be unaware of mood-altering, mind-altering properties of certain medications, especially with new medications coming onto the market on a frequent basis. Learning what drugs are safe versus what drugs can trigger addiction is extremely important. Many sleep aids, analgesics, and other drugs are marketed as “non-narcotic” to physicians and the general public, but this does not mean that they won’t trigger addiction. Many of them do. Anything that causes sedation, dizziness, or euphoria has the potential to trigger addiction. Don’t expect your doctor to know this. Look it up yourself. If there does come a time when mood-altering, mind-altering drugs are prescribed (for after a surgery or some other emergency medical situation), such medications should only be taken as prescribed by the primary physician in conjunction with an addiction specialist (addictionologist, counselor that specializes in addiction/works at a treatment facility, etc) and only for a limited period of time. This should be carefully considered and understood as a “last-resort” measure and one that should be given much thought and attention prior to the introduction of the substance(s) in the system and following the discontinuation of the use. It is highly recommended that the person increase their 12-step attendance, consult with their sponsor regularly (by phone or in person throughout), and inform trusted members of their support-system of this vulnerable time and the need for greater accountability. Oftentimes, recovering people will even go so far as to have any addictive take-home medications given after a surgery locked up in a safe and dosed-out/strictly monitored by a trusted family member.

Denial about the use of other addictive substances

An individual may think the use of addictive substances other than their drug of choice is permissible without risk of relapse. In reality, any addictive drug or compound, including alcohol, will “trigger” specific receptor areas in the brain (or “reactivate the disease”) and eventually lead the person with a history of an addiction disorder back to active addiction either through the use of their original drug of choice or a new drug of choice, OR through a new addictive behavior such as gambling, food addiction, sex addiction, compulsive shopping, etc.


  1. Hi
    Very interesting but there is one lacking subject about cross-addiction. It is how a drug addict can go to NA or an alcoholic following the 12 step program can be switching to sport addiction and be in complete denial with no help from his sponsor.
    I know precisely that case. My husband has been in NA and AA for 28 years before switching to rock climbing. That sport became so important that he had to do it every single day, lost his job and his family. A few months later got back to alcohol and prescribed drugs. He was saved by his sponsor and got back to AA. He is still hooked to rock climbing but is in complete denial that it is an addiction and his sponsor does not see it either. Both his daughters now adults have been very hurt by his attitude towards them and one of them does not want to speak to him. Rock Climbing, dopamine or whatever it is really changes his way of thinking and he says everything and its contrary all the time. I am not certain but I have the feeling this addiction to sport will lead to another relapse.
    I have searched the internet but did not find much about cross-addiction with sports.

  2. Patricia,

    I’m not sure why I am just now seeing this comment you made, but I hate that it went un-answered for so long. My apologies! Yes, this is not the first I’ve heard of this sort of thing happening. I know several who have been active in 12-step programs and remained abstinent from substances but then took up exercise of some sort (running, biking, etc) and then this exercise took over. Dopamine is released with exercise – so it feels good. Anything that feels good can become addictive. This is why we have sex addiction, gambling, video game addiction, internet addiction, etc. These are addictions, just not to drugs or alcohol. And, often they lead back to substance use – just as you described. Often a person who is exercising obsessively will eventually get hurt and go to the doctor where they are likely to be prescribed something for pain…and if they take this medication, they are introducing an addictive chemical back into their system and this is likely to trigger a reaction of “more.” So, you are absolutely right – exercise addiction – whether rock climbing, running, surfing, etc – is real and can be considered “cross-addiction.”

    Thanks for the comment.


  3. I have been addicted to opioids for 12 years I got pregnant and my Dr was giving them to me. So I got sent to a pain center and they sent me to a methadone clinic. Synthetic heroine…is what I’m coming off of now. I was on 200 mgs for four years. I am winging off but at an extremely fast right due to money issues. I a w as at 170 mgs on Friday and I’m down to 110 tomorrow. I’m feeling the effects and I haven’t even begun to go through what I watched my husband go through because he was going as well. Im scared but I’m sick of letting something control me like that

  4. Jen,

    Stick with it! It is tough but worth it in the long run if you can live a life free of substances. You will be challenged, but just be sure to reach out for support and keep your eye on your goals and the rewards that will come with no longer having to use.


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