Cross Addiction – Is There Such a Thing?
Hello Dr. Peele,
I was hoping you could shed some light on a the topic of cross addiction for me. I have just recently found out what cross addiction is, the idea that if you are addicted to one mood altering substance, you are automatically addicted to all mood altering substances, but it didn’t sound quite right to me. I came across one website that said that cross addiction is basically a myth, but have not been able to find any other data to support that theory. Can you please give me your expert opinion on this matter?
Cross addiction is an old idea — tried and untrue — which is being given new life by modern neuroscience.
First, let me say, it is true both that people who get addicted to one thing are more likely to get addicted to another (so that someone might tend towards both an opiate and an alcohol problem, or not, or overeating and love addiction, or not), AND it is also true that people tend to have addictive preferences (i.e., they prefer one type of experience over another, the “or not” part above).
So, now that people often speak in terms of the pre-frontal cortex as being the site of the executive function that allows people to control their urges and cravings, popularizers like Dr. Volkow and Dr. Drew tend to say, “If you’ve lost/never had the ability to control your impulses, well then you’re going to be readily addicted to everything.”
Dr. Drew, in particular, has a whole “hypofrontality” meme, where the frontal lobes are supposedly comatose. Which brings up a funny story. He recently interviewed two harm reduction (not necessarily abstinence) treatment buddies of mine, Drs. Adi Jaffe and Marc Kern. The discussion devolved to Dr. Jaffe’s own story, in which he had been a meth freak. He then described on the podcast how he, with trepidation, sipped some champagne after quitting meth. No problems. Refer to podcast here: http://drdrew.com/050-dr-adi-jaffe-and-dr-marc-kern/
Dr. Drew rushed all over that, since he had been saying that if you were hyopfrontal, you were addictable to anything (cross addicted). So he actually came up with the explanation that Jaffe, as a Jew, had a special biological trait that prevented alcoholism. However, I believe Dr. Jaffe also indicated that he smoked marijuana as well — or at least he knew former addicts who did.
I personally know of a number of former meth freaks (and narcotics addicts) who now drink moderately — none of whom is Jewish. So, to summarize, meth is meth, heroin is heroin, and alcohol (let’s say white wine) is white wine, and pot is pot, and — not exactly never, but quite possibly often — the twain shan’t meet, if you get my meaning. In other words, you may overcome addiction with any one substance, and some people do use again moderately, and some people never face cross-addiction in the first place, and can certainly safely use something else even having an addiction previously to a different substance.