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The Big Switch: Why Many of Us Replace One High With Another

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Evelyn, a 27-year-old publicist in New York City, had been sober for nine months when she first started working through the night. It began the night she left the office around midnight but came home and continued working until five in the morning, when she wondered if she should get a few hours sleep or just keep going. She ultimately decided to plow through. ÒWork has been an underlying issue for me since forever,Ó she says, Òbut when I got sober it really escalated. You put the lid on one addiction, and it blows off on the other.Ó

According to Dr. Lance Dodes, assistant clinical professor of psychiatry at Harvard Medical School and the author of Breaking Addiction, many recovering addicts simply transfer from one obsession to another. ÒItÕs been well known for a very long time that A.A. meetings used to be filled with smoke because people shifted their focus from drinking to cigarettes,Ó he says. ÒAlcoholism isnÕt about alcohol any more than compulsive gambling is about playing rouletteÑor winning money. Addiction is a solution to an emotional need. If you deprive someone of one solution to their emotional problems, itÕs not surprising that theyÕll find another one instead.Ó

Dr. Harold Urschel, chief medical strategist of Interhealth Addiction Disease Management Company and the author of Healing the Addicted Brain, says that untreated psychiatric disorders may also drive recovering addicts to new compulsions. ÒYou may get sober but all of a sudden, you realize you have an anxiety disorder or depression,Ó he says. ÒYou may go get on porn sites because it helps reduce your anxiety or go gambling because when you hit the jackpot, it feels really good and helps lift your depression.Ó

Bill, a sober 33-year-old engineer in a long-term relationship, describes his own struggles with sex and gambling in less clinical terms. ÒThereÕs something that I havenÕt gotten to yet that is the reason why IÕm so desperate to act out in any way I can,Ó he says. Whatever that unresolved issue is, it has driven him to dozens of affairs, abuse of pornography and multiple trips to Atlantic City that have left him thousands of dollars in debt. After an all-night gambling binge at the casinos, he often drives straight to work, sleepless and broke.

Of course, some minor indulgences can help the newly sober stay that way; one of the most commonly read A.A.-approved books, Living Sober, even suggests that newcomers eat something sweet to replace the sugar in alcohol. So whereÕs the line between a comforting bad habit and a new addictionÑespecially if the behavior is keeping you from drinking or using?

According to Dodes, it depends on the motivations behind the behavior. ÒIf you were to buy a candy bar because you decided you deserve a reward today, thatÕs not an addiction,Ó he explains. ÒIf you have to have a candy bar because itÕs solving an internal problem where you feel intolerably helpless, thatÕs a compulsive behavior.Ó In other words: if you feel out of control, you probably are.

Another indicator could be negative consequences. Says Evelyn of her workaholism, ÓI self-sabotage the way I did with drinking because I neglect those really important parts of self-careÑlike sleeping and bathing and listening to my body. I was just fully focused on what I was doing. I worked until everything crashed.Ó The negative consequences in EvelynÕs behavior eventually caught up with her: she received bad feedback at her office for sloppiness due to lack of sleep and also has a difficult time keeping plans, developing relationships, or even being able to enjoy her life.

And addiction transfers can happen at any point, as evidenced by John, a 44-year-old photographer who began to struggle with sex addiction after over 17 years of sobriety. ÒThis disease looks for any way in,Ó he says. ÒIf you close a door, itÕs going to go in the window. Close a window, itÕll go in the basement. It looks for any opportunity to get at you.Ó

Kate, 26, who recently completed treatment for an eating disorder that worsened when she got sober, agrees with that assessment. ÒIÕm through with drugs, but now IÕm running down the list of addictions one by one,Ó she says. ÒAt the moment IÕm obsessed with shopping. I steal my parentÕs credit cards and go on weeklong sprees. I have dozens of shoes and bags and jewelry that I donÕt look at twice once theyÕre in my closet. I know this isnÕt healthy sober behavior but I donÕt think I can stop shopping until my momÕs credit card is finally declined.Ó

The biggest concern is that the stress of battling a new issue can lead recovering addicts to relapseÑas a 24-year-old recovering alcoholic named Alison experienced when she entered treatment for her eating disorder. ÒAs I focused on my weight and the food issues, I stopped calling my A.A. sponsor and going to meetings,Ó she says. ÒI really thought that I could drink as long as my food intake was stable.Ó When she began drinking again after four years of sobriety, both conditions worsened; she ended up checking herself into an inpatient facility in California.

So how can addiction-prone people avoid endlessly cycling through the list of available substances and activities? Do they have to join all the 12-step programs, attending a different kind of meeting every day of the week?

Not according to Dr. Urschel, who says that the key to avoiding addiction transfer is treating the disease comprehensively. ÒThe 12-step model is a very important component of treatment, but is not sufficient to treat the illness any more than a support group to help you not eat sugar would be sufficient to treat diabetes,Ó he says. In addition to a 12-step group, he suggests a psychiatric assessment in case there are any coexisting disorders like depression, or bipolar or panic disorder, as well as anti-addiction medications like Vivitrol, family therapy, good nutrition and exercise.

Evelyn has sought therapy for her outside issues, and says her workaholism gets a Òlot of airtime.Ó But she has been able to apply some of the principles she learned in A.A., such as self-acceptance and staying in the moment, to work on her other addictions. She also relies on the support she receives from fellow members of her meetings and participates in an email journal with other recovering women. ÒI had this false expectation that everything was going to be fixed because I stopped drinking,Ó she says. ÒI found that wasnÕt the caseÑI have to really apply the tools IÕve learned from my alcohol recovery to these issues as well.Ó

Alison, too, has been able to use the tools she learned after putting down the booze to help deal with her other issues. ÒItÕs difficult to focus on more than one addiction at once, but getting sober gave me the room to tackle my other problems,Ó she says. ÒIf IÕm sober and not binging or purging or restricting, then I can deal with my next problem. And hopefully the next one and the next one after that.Ó

Emily McCombs is the Managing Editor of the soon-to-launch Before that, she was the managing editor of defunct menÕs site, where she created, wrote, and starred in the weekly web series ÒA WomanÕs Perspective.Ó Her writing has appeared in BUST Magazine, Elle, Marie Claire, and She is in need of at least five different recovery programs, but has been sober from drugs and alcohol for two years.

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