“Polysubstance dependence” is listed as a substance disorder in the Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM-IV-TR) published in 2000, the latest revision of the manual used by mental health professionals to diagnose and treat mental health illnesses. Polysubstance dependence is diagnosed when a person meets the criteria for dependence on a group of substances-at least three different types used within a 12-month period. In such a diagnosis, a person may, for example, use cocaine, benzodiazepines, and marijuana, with no preference for any single one of these drugs above the others; the conscious intention is solely to be using and to be high. There is a similar phenomenon in the world of addiction but one which is harder to assess by users themselves. It is that of poly-addiction or the switching of one addiction for another. The switching of addictions frequently occurs when one addiction is given up or when an addiction is being recovered from in therapy or within the supportive community of a 12-Step program. When someone gives up smoking cigarettes and begins to gain weight from overeating, this is an example of switching addictions or poly-addiction, although it may be unconscious to the addict himself.
From Substance to Process
Another very common occurrence of poly-addiction or switching of addictions that people are only beginning to become aware of is unfortunately all too common in the recovery communities of treatment centers and 12-Step programs for Alcoholics Anonymous and Narcotics Anonymous. When people are in recovery together for substance addictions and they begin to build community together, sex, love, and relationship addictions many times take the place of substance abuse behaviors. Because people are often unaware of the dangers of sex and relationship addiction, these behaviors are not seen as a part of what is considered in the recovery lexicon to be “dry drunk” behavior, or a type of acting out on addiction without the use of previously preferred substances.
Addressing the Source
It is unfortunately true that those people who suffer from any singular addiction to a painful enough degree, often simply and matter-of-factly suffer from the problem of addiction, not just a problem of alcohol, or heroin, et al. The problem of addiction, of course, is a problem of something deeper still, and it is this root problem which the recovering addict must determine and reconcile. The repeated switching of addictions is an unconscious way to avoid coming to terms with the pain which is at the root of one’s addiction, and this switching will likely continue until the addict is prepared to do the work of this reconciliation-whether it is dealing with a traumatic childhood, the loss of a perceived identity, or reconciliation of unconscious feelings of shame.
A Human Problem
It is not only addicts who suffer from problems of attachment; everyone does. In fact, attachment (along with ignorance and aversion) may be the root of all suffering. Pema Chödrön, the prominent American Buddhist teacher writes about attachment, “We get hooked in that moment of tightening when we reach for relief. To get unhooked we begin by recognizing that moment of unease and learn to relax in that moment.” Instead of recognizing our unease and learning to relax, we frequently choose, albeit unconsciously, to rewire ourselves to reach for something other than the object to which we found ourselves so painfully attached before-a substance, a food, or a process like gambling or shopping or sex-by reaching for a different thing-another substance or a different process. In this endless switching of attachments, we find only temporal relief, and we are endlessly restless, unhappy. We sense something is amiss. Our relationships fail; our careers, no matter how successful, fail to satisfy; our lives feel surface and ungrounded. It is the aim of addiction to provide a distraction, a respite from whatever past and unconscious psychological pain life launches at us which might thwart the organism we are from our opportunity to move on, multiply, do the hardy work of soldiering through until we’ve had our chance to reach the age of maturity and bring successful offspring to their age of maturity. This may sound soulless, but insofar as the facts add up, it’s what we know. Still, it doesn’t have to be all there is. We can go on to be greater than the sum of our parts; to live on past whatever traumas or ill-fatededness living in such a world as this implies. To do so, we have to be unmyopic, keen of vision and thinking, and we have to know that when we finally agree to recover from the problem of attachment, it must be the whole problem, down to the very root.