Swapping one addiction for another

This is the kind of swap researchers have studied most. More than a third of people in treatment have problems with both alcohol and another drug.

Behaviours can light up the same reward system that substances do. Research on these swaps is still limited, but many people in recovery describe them.

Addictive patterns often show up together. In one study of young people, most had experienced more than one in their lives.

The researchers said their results run against a long-held clinical belief. Getting better from one addiction did not usually lead to picking up another.

About 13 in 100 people who recovered did develop a new substance use disorder in that study. That is fewer than many expect, but it is not zero.

This study looked only at substances, not at behaviours like gambling or work.

Addiction changes the brain systems for reward, stress and self-control. Those systems don’t reset overnight when one habit stops.

When the brain’s stress system is turned up, the strongest pull is toward relief. A new habit can start as a way to get through those feelings.

Without a plan for that time, it is easy to drift toward whatever gives a quick lift.

Addiction often happens alongside another mental health condition. Care that looks at both together is considered best for lasting recovery.

A review of 13 studies found that drinking during drug recovery was linked to more use of the main drug and a higher chance of relapse.

Smoking is very common among people in addiction treatment. In 2019, 35.8% of U.S. adults with an alcohol or drug use disorder smoked, compared with 16.8% of adults without one.

Some people notice they turn to food for comfort when they stop drinking or using. Eating for comfort now and then is human. If it feels driven or brings shame, it is worth talking about.

Work can look like a “good” swap, because it is often praised. But working compulsively can still harm health, sleep and relationships.

Moving your body is a great support in recovery. It becomes a worry if you feel unable to rest, keep going when injured, or feel panicky when you miss a session.

Gambling is grouped with substance use disorders because the two are so similar.

The World Health Organization recognises gaming disorder, though it affects only a small share of people who play.

New love can bring a powerful rush. Some people find themselves relying on a partner, or on dating, to escape hard feelings the way a substance once did.

A review of 13 studies looked at adults in drug treatment. Drinking was linked to more use of the main drug and more relapse. For example, people who did not drink during cocaine treatment tended to do better over time.

The same review found little sign that people drank as a direct substitute for their main drug. Drinking seemed more likely to raise the risk of going back to the main drug than to replace it.

A review of 19 trials found that quit-smoking programs during addiction treatment were linked to a 25% higher chance of long-term freedom from alcohol and drugs.

Quitting smoking has also been linked with better mental health, including less depression, anxiety and stress.

Examples

• Comfort → a warm shower, a pet, a call with someone kind
• Connection → a group, a class, a faith community
• Excitement → a new skill, a sport, a creative project
• Relief from stress → a walk, slow breathing, time outdoors

If one activity becomes the only thing that feels good, that is a sign to add more. Aim for a mix: people, movement, nature, creativity and rest.

Positive relationships are a known protective factor against addiction.

Skills like delaying, urge surfing and checking if you are hungry, angry, lonely or tired work for any habit.

You could say

• “I’m so proud of how far you’ve come. I’ve noticed you’ve been gaming most nights, and I wanted to check in.”
• “How are you really doing since you stopped drinking?”
• “Is there anything you miss about how things were?”

In a large U.S. survey, mutual-help groups were the most common support people used to resolve an alcohol or drug problem.

Ideas to do together

• Cook a meal together
• Join a free class or sports team
• Try a recovery or mutual-help meeting
• Volunteer somewhere you both care about