Coronavirus Chronicles — Cross-Addiction Creep

Impacted by food shortages and isolation, some people who suffer from eating disorders have been pushed out of their comfort zones and forced to adopt new displacement behaviors as vessels for their anxiety. This begins to encroach on territory we have examined before, namely, cross-addiction.

Some addictions pertain to substances, like nicotine and cocaine and (in the patients’ own estimation, anyway) certain types of food. Sugar is a notorious one, with thousands of people who are certain that its grip on them is the same disease that enslaves any heroin-hooked junkie.

Some eating disorders, like binge eating and purging, are more on the behavioral addiction side than the substance addiction side. Many eating disorders come into being because something else has been expunged: namely, an addiction to nicotine, alcohol, or some other drug.

Six of one, half a dozen of the other

Cross-addiction is also called addiction transfer, and could logically be called omni-addiction or any-addiction, because the person’s life circumstances play a larger role than the particular substance or behavior. As some experienced problem users have expressed, addiction is determined by personality and opportunity, and by the escape hatch they happened to be exposed to at the vulnerable time, a.k.a. “whatever got there first.”

Addiction is tolerant and adaptable. It is willing to cooperate and welcome in something else to fill the hole left by shedding a different addiction. This is why isolation can be so dangerous. After healing from an eating disorder, it is very easy for a person to pick up a new problem. Conversely, in straitened circumstances where another dependency is thwarted, an eating disorder can step in.

At any give time, it is estimated that substance use disorder affects around 20 million Americans while, astonishingly, almost half that many have a serious gambling problem. Journalist Adrian Bonenberger notes, “there is almost certainly some overlap.” In the days of coronavirus, that modest assessment has assumed ominous overtones. In discussing the possible consequences of the pandemic, Bonenberger points out that the closure of physical casinos, racetracks, and other gambling venues have led to “problematic video gaming” and Internet-enabled gambling addiction.

Dr. Brian Fuehrlein, a psychiatrist who works for the Veterans Administration, sees a worrying trend. Either spooked by the very real possibility of catching COVID-19, or relieved to discover a convenient excuse, many people who had been on track, heading for inpatient substance abuse treatment, have decided to stay home instead. Dr. Fuehrlein says,

A quarantine, particularly at home, may lead to bingeing on video games, alcohol, or drugs… It could also lead to a relapse for those who had been doing well previously. Second, those who may have been considering coming to treatment now may suddenly be hesitant given possible exposure to the virus in a hospital or treatment setting and have decided to delay getting help.

Of course, the same can be said for people who had been on the verge of committing to residential programs to treat eating disorders, or who had planned bariatric surgery, or who had almost decided to seek help from recovery networks. A hooked person needs treatment specifically designed for hooked people. This is why the alcohol 12-step program has been so widely adapted to other disorders.

Meanwhile, to take advantage of virtual resources, any person who is struggling with this issue is urged to call the National Eating Disorders Association Helpline at (800) 931-2237.

Your responses and feedback are welcome!

Source: “Falling Through the Cracks in Quarantine,”, 03/21/20
Image by pixishared/CC BY-SA 2.0

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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