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Dr. Steve Frisch, Psy.D. is a clinical psychologist in private practice in
Chicago, Illinois and Northfield, Illinois.

You can contact Dr. Frisch, Psy.D. at
(847) 498-5611.

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.


What is Cross Addiction?


D
ear 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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