Cross-addiction

A person can meet criteria for abuse or dependence for one drug and not others, although there is concern about what has been referred to as cross-addiction. Cross-addiction means that a person who is dependent upon one substance may be dependent upon another, very similar one. An example might be a person who is diagnosed as dependent upon tranquilizers and who, you may fear, is also addicted to a similar substance such as alcohol. However, the research is not entirely clear on whether cross-addiction occurs, and I have known clients who had very specific problems with one substance who did not generalize into problems with other, similar substances. A person also may meet criteria for abuse or dependence for multiple substances generally, this is referred to more simply as substance abuse or substance dependence. 

Whitwam JG, Morgan M, Hall GM, et al Pain during continuous nitrous oxide administration. Br J Anaesth 48 423 29, 1976 WileyJL, Bale AS, Balster RL Evaluation of toluene dependence and cross-sensitization to diazepam. Life Sci 72 3023—3033, 2003 Wise RA, Bozarth MA A psychomotor stimulant theory of addiction. Psychol Rev 94 469-492, 1987... 

Finally, intravenous drug administration and the sharing of needles and syringes is common among opiate addicts this creates a serious risk of cross-infection. Many studies have shown a high incidence of HIV and hepatitis B and C among heroin addicts. This risk is somewhat reduced in medically controlled narcotic prescription... 

A comprehensive study by Wert and Raulin (1986) examined both American and cross-cultural studies, and pointed out methodological problems in the body of research on cannabis. It was concluded that cannabis use may produce subtle impairment, but there is no evidence that cannabis produces gross structural cerebral changes or functional impairment. Many cannabis users remain intelligent, functional, and productive members of society (Grinspoon 1999 Davidson 1999). Tolerance, Dependence, and Addiction... 

In fact, small amounts of morphine, 6-acetylmorphine, codeine, and thebaine, all opiate compounds, have been found in mammalian brain877 878 and have presumably arisen by the same pathway observed in plants (Fig. 25-10). However, there is no cross reactivity between morphine and alcohol in addicted mice,879 and acetaldehyde is probably not the addictive agent. Acetaldehyde is very reactive and may be responsible for much of the damage caused by ethanol.880 At a blood ethanol concentration of 20 mm a person is legally intoxicated, and large amounts of acetaldehyde may be formed and react with many amines, nucleotides, proteins, etc. Ethanol blocks glutamatergic NMDA receptors and... 

In this chapter we have attempted to emphasize the psychopharmacological mechanisms of the actions of dmgs of abuse and have used these mechanisms to describe dmg dependence as well. We have attempted to define the terms frequently used in describing drug abuse and dependence, including abuse, addiction, dependence, reinforcement, tolerance, cross-tolerance and cross-dependence, withdrawal, relapse, and rebound. 

Meperidine has replaced morphine to a large extent in medical practice because of the physician s reluctance to use an opiate and the belief that meperidine manifests less undesirable side effects than does morphine. However, both of these assumptions are ill founded. Addiction to meperidine is much less amenable to treatment than is addiction to morphine. Meperidine, similar to morphine and codeine, causes spasm of the upper gastrointestinal tract and typical attacks of biliary colic in biliary tract disease. Meperidine, in doses giving an equal analgesic effect, induces as much respiratory depression as does morphine. Similar to morphine, it also crosses the placental barrier and must therefore be used cautiously in the latter stages of labor. 

At the turn of the century, the German chemical company Bayer was capitalizing on a previously unnoticed chemical improvement on morphine. In 1898, Bayer began aggressively marketing heroin as a cough cure for the rampant disease of the time, tuberculosis. Heroin, a derivative of morphine, crosses directly into the brain, where it is converted immediately back to morphine. Unbelievably, it was said to be non-addictive. 

When drugs interfere with patients functioning rather than help them cope with daily activities in the face of severe pain, the line between physical dependence and addiction may have been crossed. According to the Center for Substance Abuse Treatment (CSAT), addiction is characterized by the repeated, compulsive use of a substance despite adverse social, psychological, and/or physical consequences. ... 

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