Cross Addictions

© Phil Werdell, M.A.

The Problem of Cross Addictions

Let us begin by looking at the easier part of the problem: food addicts who are cross addicted and already abstinent and in recovery from other chemical dependent substances. Three of those most frequently encountered are nicotine, alcohol and street drugs.

Smokers and Food Addiction

A very common issue of cross-addiction that is usually not talked about in these terms is “shifting” from nicotine to food as a drug of choice. We see it all the time. Someone works hard to put down cigarettes. It might take more that one, maybe as many as a dozen attempts. As soon as there is a period of abstinence from cigarettes, though, the prior smoker starts to gain weight. Some go back to smoking to keep cigarettes as a part of their weight control regime. If they have a commitment to their health that moves them to stop smoking again, then their weight becomes a problem again.

While there was still an argument about whether or not cigarettes were addictive – much less dangerous to your health, almost no one noticed the cross addiction “shift” from nicotine to food. With the major changes in consciousness and in public health policies about smoking, there are more and more people getting the support they need to stop smoking. Health professionals working in chemical dependency treatment are more likely to be conversant with the addictive nature of nicotine. We can now see that the weight gain that sometimes follows abstinence from cigarettes may be a cross addiction.

One small fact that is seldom mentioned is that tobacco is often cured in sugar. This makes it a natural entry-level drug for sugar addiction.

Alcoholics who are also Food Addicts

There are many who come to Overeaters Anonymous (OA) from other 12 Step programs, especially Alcoholics Anonymous (AA), that have substantial time sober from alcohol and other addictive substances. In fact, they often come to OA or one of the other food–related 12 Step fellowships because they find themselves reacting to food just like they had reacted to alcohol or their drug of choice many years before. In early recovery, many AA’s are often counseled by their sponsors to not worry if they are craving sugar or gaining weight. In fact, the recovery text, Alcoholics Anonymous suggests that a newly sober drinker carry come candy in their pockets to help relieve urges to drink. Especially if their chemical dependency on alcohol or drugs had been progressing for years, it certainly looked like drugs and alcohol could killed them long before food.

Food addiction also progresses as a chemical dependency, so the dangers of addictive eating can easily increase over time. Many recovering alcoholics first try to work on their eating within AA. just as they work on other life problems using the 12 Steps, and many are successful.

Many are not. Often they will identify sugar, flour or fat as a substance that is acting in their bodies like a narcotic. They do this just because of their long time experience using and recovering from alcoholism and/or drug addiction. However, when they decide to abstain from their self-assessed food addiction, they are not able to do it. It is difficult to move from the “all or nothing” model of no alcohol to a structured eating plan. This is doubly a problem for those who have already decided to recover from nicotine addiction.

This group has special problems, some of which are addressed in Judi Hollis’s excellent publication When AA’s go to OA. It is humbling to come into a new fellowship with years of sobriety in AA and have to start recovery over from the beginning in OA. It is confusing when the AA newcomers observe a large variety of food plans and perspectives on abstinence in OA.

We think there is another problem: for many alcoholics: food is an earlier and primary addiction. What is alcohol but grain and a form of sugar? The most common addictive foods are sugar and flour. A majority of these sober alcoholic food addicts can quickly remember using and abusing food years before they picked up alcohol.

Not only does this mean that their detoxification from food is likely to be worse than their detox from alcohol, it means that they have to deal on a whole new level with mental-emotional and spiritual developmental problems that began earlier.

It is often said that emotional development stops – or is at least serious curtailed – from the age that a person begins using a substance addictively. Thus, early developmental issues such as trust vs. mistrust must be revisited as one begins to recover, and there are often very basic emotional skills which were stunted in infancy and now must be developed as an adult. When raw emotions came up in early alcohol recovery, one could still use food to cope. Now, for many, there is nothing.

It is true that when the alcoholic says they don’t drink, they do drink water, fruit juice, coffee, tea and other beverages. This is more like the food addict’s abstinence: no binge foods, but other foods are OK. However, the person addicted to food in volume does have a qualitatively different problem being abstinent. This is why many food addicts commit their entire meals daily – sometimes even meal by meal – to their sponsors.

Food abstinence is different from abstinence from other substances in that the food addict still needs to eat several times a day. It is not possible to just “not be around food” the way it is possible to avoid alcohol or smoking.

Drug Addicts who are also Food Addicts

Some alcoholics put on a “beer belly,” but there are few heroin or cocaine addicts who are overweight. So, it is often a surprise to a recovering drug addict when they cross over and start eating and putting on weight out of control. As we shall see, foods can break down in the digestive symptom into bio-chemical compounds that are similar to the opioids in narcotics. The dosage and effect of using morphine, heroin or cocaine is much stronger, but once these are out of their blood, some physically sober drug addicts can get high and chemically addicted just by using more and more food.

Not all narcotics users get hooked on food when they become drug free. In fact, a majority do not, at least at first. For those who do, though, this is a very serious problem. Not only do they then engage all the medical risks of obesity – and of bulimia and anorexia with they try to purge or restrict to control their weight, but active food addiction can be a trigger back into hard drugs.

Then there is the case of marijuana. While there is an argument yet about whether or not this drug is physically addictive, it clearly can be psychologically addictive, and for many it triggers the well known “munchies” and minimizes resistance to a variety of acting out behaviors. For the food addict whose disease is advanced, this is a serious problem. Often they cannot stay food abstinent unless they abstain from marijuana, too. For those unwilling or unable to do this, this means they are likely to eat, and addictive eating for a food addict means to die.

Food Addicts Not Yet Abstinent in Another Addiction

There is a different – and equally important – set of problems that occur when a food addict is actively using other substances or processes while being abstinent from food.

For some food addicts, this is not a large issue. For example, many food plans ask for abstinence from alcohol or caffeine. There are food addicts who can tell immediately that they are not normal drinkers of alcohol or caffeine, but they are not as important “food drugs” for them as, possibly, sugar, flour, fat or volume. So, these food addicts are quick to accept abstinence from liquor and coffee.

Other food addicts are much more attached to these other edible addictions. They are, at first, not willing to even consider putting down alcohol or caffeine. As they do consider the possibility, they are in the stage of bargaining. “I’ll just have an occasional glass of wine with diner.” “I need my cup of coffee in the morning.” If and when they do become willing to abstain, they fall off the wagon on this one food substance over and over.

For some food addicts this is a grave problem because alcohol or caffeine – another addiction – can turn into a “gateway drug” leading to serious food bingeing and long periods of relapse.