Understanding Secondary Behavioral Addictions

A person in treatment for a substance use disorder may struggle with feeling an emptiness or need their substance used to fill. In many cases, the brain in recovery still needs time to repair itself and adjust. However, since most drugs act on reward systems in the brain, some people find seemingly harmless replacements that can become addictions. A secondary addiction forms during or after a person’s original substance use disorder. For some people, a secondary addiction can be another substance. For others, though, the secondary addiction may appear as a behavior called behavioral addiction.

What Is a Behavioral Addiction?

When someone in recovery slips and begins using another substance, the person and those around them may recognize the signs. However, when a person in recovery engages in what seems like harmless behaviors, these can become a new addiction. Behavioral addiction is defined as an addiction to the feeling produced by behavior when repeated. In other words, engaging in the behavior triggers a reward pathway in the brain that reinforces it, just like using a substance creates a reinforcement.

Many types of behaviors can become rewarding enough to become addictive, but some of the most common behavioral addictions include:

• Gambling Addiction: For people who develop an addiction to gambling, winning or even playing and expecting to win can trigger reward systems in the brain. Like a substance, though, gambling goes from recreational to addictive when the person continues to engage in risky or harmful behavior to keep gambling (such as going into heavy debt) and cannot stop.

• Sex Addiction: If sex did not have its own reward pathways in the brain, humans would not reproduce very well. Like anything else, sex becomes an addiction when the person’s behavior to obtain or engage in sex becomes harmful or risky (such as taking the risk of catching a sexually transmitted disease or causing harm to a relationship).

• Internet Addiction: People may joke that we are all addicted to the internet, but there are actual criteria for internet addiction. Internet addiction only becomes a problem when it starts to cause harm to other areas of the person’s life. The brain can find many rewards on the internet, from social media approval to video game wins.

• Shopping Addiction: While people may refer to “retail therapy,” they do not realize they actually want to enjoy the stimulation of the brain’s reward circuits when a person buys a new thing. A little shopping may not cause harm, but some people develop an addiction to the neurological reward and cannot control their shopping.

Why Do People Develop Secondary Addictions?

Many people with substance use issues use multiple substances, from tobacco to alcohol to prescription medications to illicit street drugs. Each substance triggers the brain in its own way, but most tamper with the brain’s reward system and make it want to repeat the substance use. Research from the American Journal of Drug Abuse suggests that substance use disorders and behavioral addictions follow similar pathways in the brain. Other research has found similarities between the brains of people with alcohol misuse and gambling addiction.

Secondary behavioral addictions may develop by this pathway:

1. The person stops using the substance of misuse.
2. While in recovery, the person’s brain cannot get the reward system triggers it got used to.
3. The person wishes to remain in recovery, so they avoid substances.
4. The person finds an activity that gives pleasurable brain responses.
5. As with substance use disorders, environment and genetics play a role in the development of behavioral addiction.

How are Secondary Addictions Treated?

According to SAMHSA and others, cognitive-behavioral therapy has been the treatment of choice for behavioral addictions. Secondary addictions will receive the same treatment they would receive as a primary disorder, emphasizing relapse prevention. This usually happens on an outpatient basis in individual or group therapy. Cognitive-behavioral therapy helps people recognize and change negative or harmful thoughts, replacing them with logical and helpful ones. This helps to reduce distress and improve decision-making.

As with secondary substance addiction, people with a secondary behavioral addiction may have a dual diagnosis or another mental health condition requiring treatment. Since depression and other mental health disorders may emerge or worsen during recovery, people may need assessment and treatment for these disorders as well.

Many people with these disorders also benefit from group support, so they may seek out a program such as Gamblers Anonymous that provides a 12-Step program similar to Alcoholics Anonymous. Other support groups may also accept people with addiction disorders not related to a substance.

While in recovery from a substance use disorder, a person can be more vulnerable to misusing other substances or engaging in behaviors to achieve a similar feeling. These are called secondary addictions, and behavioral disorders such as gambling or sex are called behavioral addictions. Behavioral addictions trigger reward pathways in the brain like substances do, and people in recovery may risk becoming addicted. The best way to prevent secondary addiction is to prepare the person during initial treatment so they have the tools to avoid further addictive behavior. At Lakehouse Recovery Center, with our 100% virtual recovery platform, we support people in recovery and help them recognize and resist the potential traps of secondary addictions. If you think you may have an addiction to any type of substance or fear you may be developing a secondary one, please call us at (877) 762-3707. We can help you avoid these traps and develop solid recovery skills.