everything can become the Substance
That gambling can be an abusable escape, too, and work, shopping, and shoplifting, and sex, and abstention, and masturbation, and food, and exercise, and meditation/prayer
Context
The disease generalized past any one chemical: the litany catalogues the compulsion's portability, how the same enslaving relation attaches to gambling, work, sex, food, even abstention and prayer. The Substance was never the point — the cage is the mechanism, and it will take any lever, which is why recovery can't be a matter of just removing the one drug.