Addiction and Recovery: The Cross Addiction Worksheet

Many recovering people who begin the process of becoming clean and sober, harbor the notion that they can continue to hang on to some remnants of an old drinking/using lifestyle. They often initially believe that specific drugs are The Problem. Initially alcoholics/addicts may not consider use of other drugs (including alcohol) as problematic. When the idea of being addicted to all mood altering drugs does come up, the idea is often dismissed as not being applicable. Denial and an absence of insight makes other historical drug use or even recent drugs used to "help with getting over" a drug problem, seem unimportant. When addicts compare the impact of the most recent drug of choice on their lives with other drug episodes, the other drugs probably pale in comparison.

These comparisons often fail to take into account the impact of "progression of the disease". Progression is the increasingly harmful course that addiction takes over time. Progression typically involves tolerance. Progression of the disease is not only marked by an increase in the use of the chemical, but is marked by a pile-up of negative consequences. These negative consequences tend to get bigger and more frequent. Progression of the disease is summed up succinctly by an old proverb that goes like this: "A man takes a drink. The drink takes a drink. The drink takes the man."

Many who make the decision to get clean and sober, hang onto the hope that they can continue to use "other drugs" without negative consequence. The idea of living drug free if often unfathomable in the beginning. Yet, to continue to hang on to those obsolete, counter-therapeutic and non-recovery thoughts, is to leave yourself more vulnerable to relapse. To assist in challenging the memories and distorted beliefs that you may still have about your relationship to drugs, use The Cross Addiction Worksheet. It has six items or questions that asks you to recall your other drug use/abuse and to look for connections between your relationship with those other drugs and continuing vulnerability to relapse. Only three of the worksheet items are shown here.

Cross Addiction Worksheet

1. Start at the beginning of your alcohol and other drug use. Develop a time line where you write down your first use of alcohol and/or other drugs, how much you used of what, how often, and any recollections of problems or negative consequences from that use (even if you did not make the connection between the drinking/using and the consequences at the time).
Example:
"1971 10th grade Started smoking pot; smoked pot weekends only; best friend stopped hanging out with me because he didn't smoke pot and didn't like it that I was smoking pot. Mom found stash. Grounded for one month."
"1972 11th grade - Smoking pot daily; drinking alcohol on weekends, getting drunk. Started skipping school and got caught several times, getting suspended each time. Grounded. Car taken away by parents. Car was run into at a party. Car insurance went up. When drinking, was trying to impress a girl and made fool of myself."

Follow this time line to present day, taking into account any DUIs/DWIs, Public Intoxication Charges, other arrests, school suspensions, loss of relationships, dropping out of school and other activities, theft, use of pharmaceutical drugs, friends' parents not letting them hang out with you because you are a "bad influence", overdoses, close calls with wrecks, being in dangerous places with dangerous people at dangerous times, starting projects that you don't finish, loss of ambition/goals, etc.

2. Name your most recent drug(s) of choice. Identify the roles that the chemical has recently played in your life. Did you drink or use other drugs to be more outgoing, to not feel feelings, to reduce stress, to help you sleep at night, to forget problems or events? Write down a list of "things" that you used the chemical for. Look back at your use of other drugs (including alcohol) and identify other drugs that you used for the same purposes.

3. Addiction exists in a social and cultural context. Alcoholics/addicts tend to pick people for their "friendship networks" that are using alcohol and other drugs the way that they are. Make a list of people that you have used alcohol and other drugs with. Name the drugs that you did with these friends/acquaintances. Identify which of the people on this list have been a part of your most recent group of drinking/using friends? What drugs are they likely to have? Who on this list have you decided to not be around in recovery? Which ones were involved in your using other drugs at other times in your life. Which people on the list present a link to your old drugs of choice, or to other drugs? Who, on your lists do you need to avoid?

Remember that addiction is a brain disease that is manifested in compulsive consumption of mood/mind altering drugs. It is chronic. It lasts a lifetime. It cannot be cured. Once you have addiction, you cannot return to "social use". It is a compelling fantasy that keeps a recovering person vulnerable to relapse.