Cross Addiction Explained: How Another Addiction Can Lead to a Gambling Problem

Cross addiction is when someone has two or more addictive behaviors at the same time. There are two ways of looking at cross addiction. One is when someone uses two different substances or behaviors at the same time, like drugs and alcohol or alcohol and gambling. The second is when someone “trades one addiction for another.”

Gambling affects the same part of the brain with hormones that drugs and alcohol do: Serotonin, Dopamine, and Noradrenaline. These three are exactly what cocaine stimulates as well. There are two main parts of the body where these three hormones respond. One is in the brain, and the other near the stomach. Some even describe feeling “butterflies in my stomach” when just thinking about gambling, and sometimes the feeling is so intense that it induces nausea. This is a result of too much adrenaline. A roller coaster can have this same effect, causing a rush of the hormones and neurotransmitters.

Switching one addiction for another is very common. This happens when the suffering individual stops one addictive behavior (for example, drinking alcohol) and picks up another (like gambling). People often trade one addiction for another during recovery due to unresolved underlying issues and the brain’s vulnerability to addictive behaviors. Addiction alters the brain’s reward system, making individuals more susceptible to seeking out new sources of relief or pleasure that mimic the effects of their original addiction. Factors such as unresolved trauma, anxiety, or depression can drive individuals to substitute one compulsive behavior for another in an attempt to cope with emotional discomfort. Additionally, the absence of effective coping mechanisms or incomplete recovery processes may leave a void that new addictive behaviors fill, perpetuating the cycle of dependency.

Take a look at this comparison of similarities and differences between problem gambling and substance abuse:

Problem Gambling: The Many Similarities with Substance Abuse

J.A. Ewing’s CAGE assessment, originally developed to screen for alcohol dependency in the early 1970s (long before gambling disorder was understood as it is today), highlights the striking similarities between gambling addiction and substance abuse. Both disorders involve compulsive behaviors that disrupt daily life and elicit emotional responses such as guilt, defensiveness, and reliance on the behavior as a coping mechanism. The four CAGE questions—addressing the need to Cut down, feelings of Annoyance from criticism, Guilt about behavior, and using the activity as an Eye-opener can feel relatable for someone suffering from problem gambling. Take a look at the CAGE Questionnaire below, and think about how it relates to gambling.

CAGE Questionnaire [1]:

1. Cut Down – Has anyone ever suggested that you should cut down on your drinking or drug use (gambling)?
2. Annoyed – Do you ever become annoyed by other people’s comments about your drinking or drug use (gambling)?
3. Guilty – Have you ever felt guilty about your drinking or drug use (gambling)?
4. Eye Opener – Do you ever need to use drugs or alcohol (gambling) in the morning to get yourself going?

For example, individuals struggling with gambling addiction may feel the need to Cut down on their gambling, experience Annoyance when others criticize their behavior, feel Guilt over financial losses or broken relationships, and use gambling as an Eye-opener to escape stress or negative emotions. These parallels underscore how gambling addiction mirrors substance abuse in its impact on the brain’s reward system and emotional regulation.

Problem Gambling: The Crucial Differences from Substance Abuse

While looking at the similarities to substance abuse makes it easy to understand how someone could develop a gambling addiction, understanding the differences is even more important, especially when it comes to treatment, the importance of certified counselors, and expertise about problem gambling resources.

• Invisible Symptoms Make Problem Gambling the Hidden Addiction
  Unlike substance addictions, gambling disorder lacks visible physical symptoms, making it easier to conceal. There are no “dice eyes”, no “roulette breath”, and no “card marks on the arms.” Problem gambling is known as the hidden addiction for this reason, which delays detection and intervention as the problem worsens over time. While the individual may seek treatment for resulting mental health impacts or relationship problems, a certified counselor will know to screen for problem gambling as a root cause.
  
  
• Financial Devastation, Relationship Difficulties, Legal Problems, and Mental Health Issues
  While many mental health issues can impact finances, gambling disorder has the potential for rapid and catastrophic financial consequences. The ability to quickly accumulate massive debts through gambling can lead to severe relationship problems, illegal activities to fund the addiction, and mental health impacts like anxiety, depression, and even suicidal ideation and attempts. A certified counselor understands how deeply the impacts of gambling addiction permeate into the lives of the gambler and his or her loved ones.
  
  
• Cognitive Distortions Keep the Gambler Going Despite Accelerating Negative Impacts
  Gambling disorder is characterized by persistent cognitive distortions that set it apart from other addictions. Unlike substance use disorders, where individuals generally recognize the harmful nature of their behavior, those with gambling disorder often maintain the false belief that continued gambling will eventually lead to success. This “chasing losses” mentality can drive individuals deeper into addiction and financial ruin.
  
  
• Neurobiological Similarities to Substance Abuse, Without the Substance
  Research has shown that gambling activates the brain’s reward system in ways similar to addictive drugs. However, the absence of a physical substance introduces unique challenges in treatment, requiring specialized therapeutic approaches that only a certified counselor can provide. With gambling addiction, money is the drug that fuels the addiction.
  
  
• Comorbid Conditions Complicate the Treatment Picture
  Gambling disorder frequently co-occurs with other mental health conditions, such as depression, anxiety, and substance use disorders. This comorbidity necessitates an integrated treatment approach that addresses both the gambling addiction and any underlying mental health issues simultaneously.
  
  
• Recognizing the Need for Financial Rehabilitation in Recovery
  Unlike many other mental health treatments, recovery from gambling disorder often necessitates extensive financial rehabilitation. This may include debt management, financial counseling, and rebuilding trust with family members affected by the gambling behavior.
  
  
• Effective Treatment Requires Specialized Therapeutic Approaches
  Effective treatment for gambling disorder requires the specific expertise of therapists certified for gambling addiction. Specialized treatment focuses on developing robust relapse prevention strategies that address the unique triggers and thought patterns associated with gambling urges.
  
  
• Managing the High Risk of Relapse
  The potential for relapse in gambling disorder is high, given the widespread availability of gambling opportunities, including online gambling, mobile betting apps and associated advertising. Gambling is deeply ingrained in social and cultural contexts, making it challenging for individuals to avoid triggers and maintain recovery. Specialized treatment must address these social factors and provide strategies for navigating high-risk situations.

Gambling addiction proves to be especially illusive and resilient due to its sprawling dimensions and progressive nature. True problem gambling experts and certified treatment providers possess specialized knowledge and extensive training about the unique characteristics of gambling disorder. Without understanding the underpinnings of what drives the suffering individual to choose gambling over financial stability, career, legal standing, and even family, a counselor has no hope of curtailing the downward spiral. Learn more about the importance of certified counselors.

Did You Know? The Florida Council on Compulsive Gambling (FCCG) only refers help seekers (problem gamblers and other affected individuals) to licensed, mental health treatment providers who are Certified in Gambling Addiction. Acceptable certifications include either Florida’s Certified Gambling Addiction Counselor credential, (CGAC), or the International Problem Gambling and Gaming Certification Organization’s (IPGGC; formerly International Gambling Counseling Certification Board, IGCCB) ICGC-II.

Cross Addiction or Not, Help is Available for Problem Gambling in Florida

If you or someone you know is having problems with gambling, call or text the 888-ADMIT-IT HelpLine in Florida, which offers immediate, free, and confidential support. The HelpLine is available 24/7 and connects callers with trained specialists who provide guidance and resources to address gambling addiction. These resources include access to Professional Counseling, Self-Help Support Groups, and Self-Help Literature such as the A Chance for Change Recovery Workbooks. Additionally, the FCCG’s Peer Connect Program allows individuals to speak with someone in recovery for encouragement and motivation. The HelpLine also offers the Online Program for Problem Gamblers (OPPG) for those unable to access or afford in-person treatment, as well as Self-Exclusion Programs to help limit gambling opportunities.

By reaching out, individuals can take the first step toward recovery with personalized support and a range of effective tools designed to rebuild their lives. Call or text the 888-ADMIT-IT HelpLine today.

1. Valley Spring Recovery Center, CAGE Questionnaire: Definition, Description, Scoring, Usage, Advantage and Limitation, https://valleyspringrecovery.com/addiction/screening/cage-questionnaire/ June, 2024.