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SALT LAKE CITY — Treatment providers have long recognized the dangers of "cross-addiction," or reaching sobriety in one addiction and then moving addictive behavior to a new drug of choice. One treatment provider is now recognizing that some addicts aren't waiting to "cross-addict" anymore. They are creating "hybrid addictions" by using multiple drugs of choice concurrently.
Addictive or compulsive behavior is defined by the presence of an urge that is greater than one’s will to resist. The destructive results of addiction are obvious to observers; addicts will continue to use despite sometimes monumental consequences: the alcoholic who faces job loss but continues to drink, or the sex addict in danger of losing family who continues indulgence in their demon drug of choice.
If addiction confined to one drug of choice is problematic, multiple or hybrid addictions absolutely take no prisoners.
The pairing of addictions usually involves stimulates (such as cocaine, meth, etc.) and one of the sexual addictions (like pornography). This phenomenon is like an addiction on steroids, and old treatment solutions aren’t up to the healing challenge.
Using alcohol and cocaine together has been a precursor to what treatment providers are seeing with the new hybrids that include sex addictions. One plus one does not equal two when cocaine and alcohol are used together. The drugs have a synergistic effect, creating a third drug, cocaethylene, as the substances are filtered through the liver. According to addiction specialist Simon Mott, “Cocaethylene acts as an amplifier to the effects [of alcohol and cocaine] but is also toxic to the liver and places extreme strain on the user's heart.” So while the combination brings on new “highs” the side effect can be increased, with sometimes lethal demands on the body.
However, few treatment programs are equipped to deal with multiple drugs of choice that involve sex addictions. Often providers specialize in alcohol or drug treatment, or treat process addictions like sex, food, shopping or gambling, but do not have designed treatment programs for the drug/sex hybrids.
"Most drug and alcohol treatment doesn't deeply address any issue other than the using itself,” Robert Weiss of Promises Treatment Center located in Malibu, Calif. said.
Part of the problem maybe the American Psychiatric Association’s choice to not include Hypersexual Behavioral Disorders (sex addictions) in the Diagnostic Statistical Manuel for Psychiatric Disorders, the psychiatric standard for diagnosing mental illnesses and disorders. Without classification as an official psychiatric disorder, treatment regimens aren’t being created — and insurance companies would not pay if they existed.
Most drug and alcohol treatment doesn't deeply address any issue other than the using itself.
–Robert Weiss, Promises Treatment Center
“The effects of this are both an issue of public health and personal well being, because unmitigated sexual behaviors that have gone out of control cause significant psychological, social, relational and financial distress for individuals and their families and, in their worst scenarios, can lead to sexually transmitted infections, the breaking up of families and a string of legal problems,” said Alexandra Katehakis, founder and clinical director of the Center for Healthy Sex in Los Angeles.
Weiss has developed a five-week residential treatment program to meet the need for a condition that occurs in both gay and straight men, whom he says struggle with cross additions in parallel but different ways.
"They act out in different venues and with a different gender, but have the same paired sex/drug disorder," he said.
Just quitting any addiction isn’t easy, but the hybrids are especially challenging.
“Relapse poses a particularly huge threat to stimulant addicts, particularly those with concurrent sexual addiction,” Weiss said. Addicts struggle with shame over previous sexual activity and difficulties adjusting to sober sex. "This population will already have likely tried and failed at previous [well intended residential and outpatient] treatments that avoided or simply missed fully looking at the paired and powerful sexual issues surrounding their drug use."
"I suspect we will do better than most with this very high-relapse population [stimulant addicts] as we are giving them more tools toward sobriety and doing more shame reduction around their sexual behaviors—acted out when high."
In the process of recovering from addiction Roger became a licensed addiction counselor and wrote the LDS recovery guide, “The Waterfall Concept, A blueprint for addiction recovery.” He blogs at his recovery website www.waterfallconcept.org