What Does Drug Cross- Dependence Mean?

Question by sarah: what does drug cross- dependence mean?

Best answer:

Answer by Mathieu
It depends- there are several possible definitions:

1) Cross-dependence (also known as cross-addiction) means that a person is “addicted to everything.” Sometimes in an AA or NA meeting, for example, a person will say “I am (name) and I’m cross-addicted.”

2) Cross-dependency is also a theory in addictionology (not the same as addiction psychiatry or psychology) that a person who addicted to one drug (alcohol for example) can become addicted to any drug if they use it. Another view some take is that (to continue with the example) an alcoholic will not necessarily become addicted to amphetamine but by using another drug of abuse it will eventually lead the person back to their primary addiction, alcohol in this case.

These theories are not accepted by American Psychiatric Association or other major medical and psychiatric organizations.

3) It may also refer to the fact that certain drugs have the same or similar properties and they can be substituted for each other. For example alcohol, benzodiazepines (Valium, Xanax, Ativan), barbiturates (phenobarbital, Nembutal, Seconal), and other drugs like Ambien, chloral hydrate, and Miltown all act one the same neurotransmitter, GABA. Often when a person is physically dependent on one of these drugs (GABAnergic drugs) they will be placed on a different drug so they can be more easily be withdrawn. People physically dependency on alcohol are typically given Valium, Librium, or Ativan for detox. People physically dependent on benzodiazepines, barbiturates, or other pills are typically put on Valium, Librium, or phenobarbital.

Another example would be using the opioid methadone to substitute for heroin. Both have similar pharmacological actions and substitution can be made.

Note on vocabulary:

Firstly keep in mind that there is significant confusion on the proper use of terms both in and out of the medical field. So it is common to find incorrect use of terms.

CORRECT use of vocabulary:

Cross-dependence and cross-addiction are synonymous however cross-addiction is more commonly used.

Psychical dependency is NOT the same as addiction however physical dependency does commonly occur in people addicted to drugs that cause physical dependency. Physical dependency also occurs in many people using drugs like opioids or benzodiazepines legally, as prescribed, and for a legitimate reason. In such cases physical dependency is not considered a problem.

Many recreational drugs (amphetamines, hallucinogens, marijuana) do not cause physical dependency and some drugs with no recreational value (corticosteroids, beta-blockers, nasal sprays like oxymetazoline) can cause physical dependency.

Psychological dependency means addiction and dependency means addiction. Thus using the term dependency refers only to the disease state of addiction and the behaviour, it does not have anything to do with any physical aspects.

Misuse typically means improper use of prescription drugs.

The official MEDICAL terms from the

American Psychiatric Association
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)
and
World Health Organization’s
International Statistical Classification of Diseases and Related Health Problems (ICD-10)

DSM-IV
Substance abuse
ICD-10
Harmful use (formerly non-dependent use)

These terms refer to drug use that is problematic and is causing harm. However this is not addiction.

DSM-IV
Substance dependence
ICD-10
Dependence syndrome

These terms mean addiction, a term no longer used medically.

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