Recovery and Substitute Addictions

Abstract

Substitute addictions – addictions that replace terminated substance use disorders (sud s) – involving addictive behaviours such as a new substance, food/eating, gambling, shopping, or sex, have implications for recovery but remain poorly understood. While extant studies suggest a multifaceted aetiology, research is needed to illuminate the nature, dynamics/mechanisms, motives and risk factors of substitute addictions. This multiple-methods study (1) reviewed the available literature on substitute addiction in people with sud s using a scoping review method; (2) explored the experience of substitute addiction from a first-person perspective using a case study; (3) investigated the prevalence of substitute addiction and associated factors among service users during and after residential substance use treatment using a quantitative longitudinal cohort design (n=137, 66% follow-up rate); (4) explored recovery support group members’ (n=23) perceptions and experiences of substitute addictions using in-depth interviews; and (5) explored service providers’ (n=22) perceptions of substitute addiction through focus group discussions. Findings were integrated across datasets to offer recommendations for prevention, practice and research.

Service Providers’ Perceptions of Substitute Addictions in the Western Cape, South Africa

“…While a key challenge remains the lack of a universal definition, it is notable that all service providers aligned with a recent, comprehensive definition of substitute addictions constructed from a scoping review of the literature that defined substitution as “the immediate or gradual functional replacement of an addiction or set of addictions that have been terminated” (Sinclair et al, 2021b, p. 692). Given the array of terms for substitution and lack of standardized terminology, it is also noteworthy that service providers preferred the term “cross addiction”, arguably the most widely used and known term (Sinclair et al, 2022). However, it has been cautioned that addiction should not be applied too loosely and that the substitute should display characteristics of addiction (Sinclair et al, 2021b), such as incurring negative consequences, loss of control, preoccupation and achieving an appetitive effect (Sussman, 2017; Sussman & Sussman, 2011).…”