How Alcohol Impacts Other Addictions

Many clients who come to me for help with addiction or substance use disorders focus solely on their primary struggle, whether that's cocaine addiction, marijuana addiction, prescription medicine addiction, or sex addiction. But there's frequently a hidden factor that can sabotage their recovery efforts: alcohol. Even for those who don't consider themselves alcoholics, drinking can have profound effects on other addictions in ways that many don't realize.

In my 30 years as an addiction counselor, I’ve learned to ask very early in therapy about my clients’ drinking even if they are coming to me for another issue. I’ve had hundreds of clients admit or realize in therapy that they exclusively act out their addiction once they’ve been drinking. Other clients tell me though they may act out without consuming alcohol, drinking dramatically increases the likelihood they will act out.

The Inhibition Problem

Alcohol's most immediate impact on other addictions comes from its effect on judgment and impulse control. Though we’re not all affected the same way by drinking, one universal truth is that alcohol reduces our inhibitions and helps us make poor decisions. I have yet to meet anyone that makes better decisions when they drink. This is part of what we like about drinking. The disinhibition makes it easier for us to be in social situations, approach people romantically, etc. The prefrontal cortex, the part of our brain responsible for decision-making and self-regulation, becomes impaired when we drink. For someone trying to abstain from cocaine or marijuana or another substance or manage a sex addiction, a few drinks can undo months or years of progress in a single night.

This isn't about willpower or moral failure. It's simple neuroscience. The same executive functions that help us say no to destructive behaviors are the ones alcohol suppresses first. Many people in recovery report that their relapses didn't start with their primary addiction, but with what seemed like a harmless drink or two.

Shared Brain Chemistry

All addictions, whether to substances or behaviors, operate through similar neural pathways in the brain's reward system. When we drink alcohol, we’re activating the same dopamine circuits that respond to cocaine, sexual stimulation, or any other addictive trigger. This cross-activation means that using one substance can awaken cravings for others.

Think of it like a network of connected alarms. You might only intend to trigger one, but because they're all wired together, pulling one can set off the entire system. This cross-sensitization explains why people recovering from one addiction often experience intense urges for other substances or behaviors after drinking.

The Danger of Substitution

Another common pattern is addiction substitution. Someone who successfully quits marijuana or cocaine, for example, might start drinking more heavily without recognizing the shift. They tell themselves that alcohol is legal, more socially acceptable, or less dangerous, but the underlying pattern of compulsive use and loss of control remains unchanged. This substitution doesn't solve the core issues that drive addiction. It simply moves the problem from one substance to another, and often makes recovery more difficult because the new addiction feels less urgent or dangerous.

This May Not Apply to You

Most reputable treatment programs and addiction counselors emphasize complete abstinence from all substances regardless of the substance someone enters treatment for. Though this is frequently the position I take with my clients, I don’t subscribe to the one-size-fits-all model of recovery. If the problem you come to me for help with is not impacted by alcohol, then you may be able to continue to drink. What’s crucial is that we thoroughly and honestly assess all the pieces of the puzzle and come up with a recovery plan that fits you and your specific situation.

For more information, visit my Alcohol Counseling page.

Feel free to contact me with any questions.