There’s a phenomenon that occurs often in the process of addiction recovery. A person, in their efforts to get sober, finds that another behavior makes it easier to resist the substance or behavior they were previously addicted to. As their addiction wanes, the new behavior becomes more of a necessary part of their life, until they’ve formed a physical and mental dependency to it. This is called a substitute addiction.
Even if you’ve never compulsively used addictive substances yourself, you’ve probably observed a substitute addiction. If you have sober loved ones in your life, or if you’ve ever driven by when a 12-step meeting was letting out, you’ll notice something: Most people who have struggled with addiction (especially alcoholism) use tobacco heavily. In fact, some studies suggest that around half of recovering alcoholics also use nicotine. But smoking cigarettes is not regarded as a healthy behavior, so why is it acceptable for people in rehab to pick up one vice to replace another? While they may seem simple from a high level, substitute addictions are complex. In this piece, we’ll discuss what substitute addictions are, why they’re so common for people in treatment and the risks they present to long-term health and sobriety.
What Are Substitute Addictions?
Substitute addiction, also called “cross-addiction” or “replacement addiction,” is a simple concept: It occurs when, in recovery, a person replaces one compulsive behavior with another. In most cases, the new behavior is one thought to come with less risk. Going back to the common example of using tobacco to help with sobriety for other substances, the belief is that while smoking comes with its own set of risks, those risks are ultimately less than the risks of the behavior smoking replaced. This is the main theory behind substitute addictions, and it also helps explain why they can sometimes be considered a beneficial influence on a person’s life.
Where they come from makes sense. In rehab, people are taught to find new outlets and coping mechanisms for negative thoughts and emotions instead of using drugs and alcohol. Many people who struggle with addiction have naturally compulsive personalities — they’re more prone to becoming unable to stop a behavior that gives them positive feedback.
What Are the Problems With Substitute Addictions?
The behavioral risk comparison involved with substitute addictions means that it makes sense to view smoking as safer than, say, using heroin. But that doesn’t mean trading one addiction for a marginally healthier one should always be viewed as a net positive. This is where the issue of substitute addiction starts to become more complicated.
One of the goals of clinical addiction treatment is to help addicts release compulsive behavior in general because of the implications it can have on the rest of a patient’s life. For example, one study surveyed people in recovery for a substance use disorder (SUD) and separated people who smoked cigarettes from the group that didn’t.
After a few years, the groups were surveyed again, and the results suggested that people who smoked cigarettes were more likely to relapse than those who didn’t. This should make us consider the hidden risks of substitute addictions — there are likely cases similar to this where replacing a compulsive behavior with another one increases the odds of reverting back to the original behavior.
There are also the visible risks of replacing one addiction with another — namely, the dangers of the “replacement drugs.” Smoking cigarettes doesn’t carry the same acute risk to a person’s health as using other substances, but in the long run, tobacco is the leading preventable cause of cancer-related death. In the context of the comparison with using heroin or drinking heavily, cigarette use is safer, but it’s still a concern in the context of long-term health.
Another consideration here is the way we understand addiction in general. People who are compelled to use a substance or perform an activity will go to great lengths to do so. This increases the occurrence of risky behavior and generally becoming a hazard to friends and family members.
Some Common Substitute Addictions
It’s important to note that any addiction can be substituted with any other. With that in mind, here are some of the most common replacement addictions.
1. Other Drugs and Prescription Medications
Sometimes, drugs and medications used to help a person stop one addiction can be the start of another. For example, marijuana is used more and more as a tool to help treat pain, which gives it potential as a resource in recovery from opiate addiction. But compulsive marijuana use comes with its own hazards and health risks.
Benzos are often used to ease the side effects — namely anxiety and depression — of withdrawal from alcohol but, in the process, may cause a new addiction. This is a case where the replacement substance may be more hazardous than the one it replaced.
Binge eating disorders act on a type of compulsion that walks the line between behavior and substance. Many people find that when they get off drugs, they are able to enjoy food again, which is a positive. Sometimes, this can be taken to the opposite extreme, though, and they find themselves living with constant cravings for high-fat, high-carbohydrate foods. Being controlled by urges to eat isn’t a positive experience, and binge eating also tends to lead to other unhealthy outcomes.
3. Exercising, Working and Other Behaviors
There are a whole host of other behaviors that provide positive emotional feedback that can become an outlet — and a compulsion — for someone looking for an alternative coping method during recovery. Some, like exercise and work, are thought of as positive. Others, like gambling and sex, are considered to be less productive. Separating these two into categories of good and bad oversimplifies a complex issue, however. One of the major factors that people should be aware of about substitute addictions is that it’s never a good thing to rely on one behavior to control your ability to feel pleasure in life. That’s why it’s important to acknowledge the pitfalls, even in “healthy” substitutes, and make sure that we’re doing everything in moderation.
Addressing Compulsive Behaviors at FHE Health
Substitute addictions are so common that many people experiencing them may be unaware they’re doing so in the first place. If you or a loved one is concerned about a potential compulsive behavior, contact FHE Health today and learn more about substitute addictions and recovery as a whole.