From substances to food: an examination of addiction shift in individuals undergoing residential treatment for substance use

Background: Addiction shift (also known as Cross, Transfer, or Substitute addiction) is a common theme that emerges in the literature on recovery from substance use disorders. Some research has suggested that those who recover from one substance use disorder are at increased risk of developing another. Despite existing research in this area, little is known about how individuals may be at risk of developing an addiction to food as they recover from a substance use disorder. Methods: The current study sought to examine addiction shift, specifically from substances to food in 44 participants undergoing residential treatment for substance use disorders. It was hypothesized that drug and/or alcohol use cravings would go down from pre (at intake to residential treatment) to post (at discharge from residential treatment), while food addiction and/or food craving would increase. Results: Significant changes were observed from pre to post for mean body mass index, and scores from measures assessing alcohol cravings, impulsive behaviors, distress tolerance, depression, and anxiety. No significant differences from pre to post were observed for scores measuring food addiction or food cravings. Conclusions: Changes in pre to post measures indicated that drug and/or alcohol use cravings decreased. Contrary to original hypotheses, food addiction and food craving was relatively low at baseline and did not change from pre to post. Exploratory post-hoc analyses of psychological factors suggested that impulsivity, distress tolerance, depression, and anxiety went down from pre to post. Short follow-up timeframe and competition theory are likely important factors in these findings.