People with substance abuse problems sometimes temporarily or permanently substitute other drugs for their primary drug of addiction. While addicts and recovering addicts typically have a number of justifications for their actions — and may even believe that switching from one drug to another is a sign of improvement — drug substitution is no less dangerous than addiction to a single main substance. In fact, it can add further danger by reinforcing the behavioral patterns that underlie drug addiction and other forms of addiction.
Underlying Issues of Drug Addiction
While addicted individuals may think they only have problems with a single drug, they typically have underlying thoughts and behaviors that are common to all addicts. Common thoughts that lead to or support addiction include a belief in drugs as a gateway to greater creativity; a belief in drugs as necessary tools for relaxation or stress relief; a belief in drugs as a salve for various painful emotional states; and a belief in drugs as a way to ease the boredom of everyday life. Common behaviors that lead to or support addiction include compulsive drug use, preoccupation with drug use-related topics, continuation of drug use despite obvious harmful effects, and neglect of the various aspects of daily life (work, relationships, etc.) that interfere or conflict with drug use. Underlying both addictive thoughts and behavior is a conscious or unconscious desire to change the basic chemistry of the brain.
How Substitution Happens
Some addicts and recovering addicts believe that switching from one drug to another proves that they’re not "addicted" at all and can modify their actions whenever they choose. Addicts may also substitute one drug for another in order to stave off the effects of intentional or unintentional drug withdrawal; cycle back and forth between two or more drugs with different specific effects; or use a drug that’s more generally acceptable in their current social circumstances. Most addicts switch their preferred drugs for a combination of these reasons, according to the National Association of Addiction Treatment Providers. In addition, a great number of addicts use multiple drugs simultaneously, or combine use of a single drug with other forms of addictive behavior (gambling, compulsive sexual activity, etc.).
While addicts may believe that drug substitution frees them from the burdens of addiction, this substitution does nothing to alter the underlying thoughts and behaviors that lead to and support addiction. It also does nothing to alter the urge to alter the brain’s basic functional chemistry. For these reasons, when an addict switches drugs, he or she merely transfers these underlying problems to a superficially "different" or "new" situation that’s actually business as usual. In fact, since this new situation creates an additional layer of denial or deluded thinking, it can actually be worse than business as usual and ultimately make it more difficult for the addict to truly start the path to recovery.
In addition to substituting one drug with another, addicts may also try to replace drug use with gambling, compulsive sexual behavior, binge eating, binge shopping or other addictive behaviors. In most cases, different individuals have established degrees of preference for these activities and will bounce back and forth between them as circumstances allow. During recovery, some addicts also substitute exercise or other typically healthy activities for drug use and treat these activities in the same way they would treat a new drug or other addictive behavior. In fact, some addicts use the recovery process itself as a substitute for drug use and build up their old habits and patterns around this normally therapeutic setting.
To avoid the dangers of drug substitution, an addict or recovering addict needs extensive help from addiction specialists or other trained professionals in order to understand and recognize the underlying thought and behavioral patterns associated with addiction. Ongoing help is then needed to create new thoughts and behaviors that replace these patterns and provide a sense of fulfillment that ultimately displaces the addictive cycle. Typical required steps in this process include detailing the addict’s current drug use, creating an in-depth patient history, making sure that the addict and the addict’s family understand the dangers of substitution, and pointing out substances or behaviors that merely continue addiction in another form or setting.
If you know an addict or recovering addict who substitutes one type of drug for another, do what you can to make him or her aware of the dangers of this activity. Also, seek the assistance of a trained specialist who can help your friend or loved one establish a treatment program that adequately addresses the potentially complex issues surrounding drug substitution.