Cravings. For drugs. Or alcohol. Perhaps, both! A real struggle for many. Also, a reason for multiple relapses.
You have done the noble task of getting the help you need. As hard as it was, you went through detox and a 30-day rehab. Maybe, even a 90-day treatment! You deserve a pat on the back for making this bold move!
So, you walk out of rehab. Confident. Full of hope. You have a resolve to stay clean, and you mean it this time! After all, you’ve been through treatment six previous times, and this is your seventh! You are sure that this will be your final treatment.
Even though you are going back to the same environment, you believe things will work out this time. After all, this treatment was different from all the others. New coping mechanisms accompany you from what turned out to be an excellent treatment facility. But you have a concern, though. You worry about a struggle you know only too well. Cravings!
First of all, I think it is impressive that you have been able to dust yourself up and get back on the sobriety wagon after several relapses. As you know, addiction is a chronic brain disease. So, one or more relapses are common in this journey of recovery.
While some people can get back to seeking and obtaining help, some others, unfortunately, continue to wallow in this disease. Succumbing to triggers to get back to using addictive substances as a result of cravings is one of the reasons people relapse.
These are physical compulsions or urges to use addictive substances. They are experienced by people who currently abuse drugs and alcohol or have a history of being addicted to these substances.
The prominent symptom of cravings is the overpowering desire to use the drug. This drive causes individuals to focus on acquiring the drug. It also leads to a psychological want for the positive effects of the substance.
The National Institute on Drug Abuse defines addiction as a chronic, relapsing, brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.
The chronic nature of addiction means that it is long-lasting and cannot be cured. Relapsing infers that even after improving or getting better, the individual may suffer a setback or get worse again. Addiction is a brain disease because structural and functional changes occur in the brain due to drug use.
Drugs affect brain chemistry through a complex system. The effects of dopamine lie at the center of this process. There are several receptors in the brain, known as dopamine receptors. Drugs have been shown to damage these dopamine receptors in the brain. As a result, they increase dopamine concentrations in various regions of the brain.
Dopamine helps with motivation as well as reinforcement of rewarding behaviors. The disruption in dopamine from using drugs can, therefore, corrupt the messages sent to different parts of the brain. Due to this, there can be an alteration in decision making, learning, behaviors, and the reward system.
Drug addiction is a chronic and recurrent condition with a high rate of relapse. The struggle with drugs is made worse when an individual is unable to manage triggers and cravings.
Cravings are normal and can last for long periods, often causing people to relapse. Cravings may be experienced during the acute withdrawal period and may also occur weeks, months, or even years after use. In general, though, they tend to decrease in strength and frequency over time. Cravings may last for minutes to even hours but usually will go away eventually, until the next episode.
Cravings do not indicate that there is a problem. It does not mean that you are unable to manage your desires or that you are weak. A previously published article describes cravings as coming in waves – they build up, reach a peak, and then subside.
Relapse triggers are things, people, places, or situations that an individual who struggles with drugs or alcohol associates with the reward of getting high. These triggers may lead to intense cravings.
Triggers may be random and tend to vary amongst individuals. Another writer categorizes triggers into four broad categories: emotional triggers, social triggers, pattern triggers, and withdrawals.
The use of addictive substances often has emotional bearings. These emotional triggers may present as self-medication for depression, anxiety, and other mental disorders. It may also manifest in positive emotions such as happiness during celebrations. Some individuals relate their drug use to these feelings, which may be negative or positive.
The use of addictive substances may have been carried out with specific individuals or groups of people. This association serves as a social trigger, and this can cause people to have cravings. Such social associations may act as a trigger, creating a strong desire to use addictive substances which could potentially lead to a relapse.
Certain things or places may create a desire to use drugs or alcohol. Significant milestones and other life events, time of year, and even specific times of the day may act as pattern triggers.
Discontinuation of an addictive substance often leads to uncomfortable physiological and psychological symptoms specific to the drug in question. These symptoms may act as triggers to recommence drugs or alcohol. Withdrawal triggers usually occur within days or weeks following abstinence.
Cravings may also occur without any known triggers!
While some people may have a few triggers, some others may have numerous triggers. Though some triggers may be random, there is usually an association with previous use of an addictive substance. To help identify your triggers, you may want to ask yourself four basic questions:
Asking the above questions may highlight multiple triggers which can be along the lines of the examples below:
The key to limiting relapse is to manage relapse triggers and cravings. To better respond to them, however, you need to be able to identify, understand, and avoid them. Our first point should come as no surprise.
The first step to stopping your cravings is learning to identify and avoid them. Being aware of your emotional triggers, social triggers, pattern triggers, and, also, withdrawals will go a long way in your ability to avoid these triggers.
Planning ahead of time to avoid triggers is essential. This may be as simple as driving home on a different route to avoid the restaurant or bar which you associate with your drug or alcohol use. Unavoidable happy hours may, perhaps, be enjoyed by having a non-alcoholic beverage. You can keep things in check at holiday parties by attending with a friend or family member who holds you accountable.
Some people, places, things, situations, and feelings which serve as triggers may, however, be unavoidable. In cases like this, it becomes necessary to come up with strategies to deal with cravings that may arise from these triggers.
Mindfulness is a mental state achieved by focusing your awareness on the present moment, while calmly acknowledging and accepting your feelings, thoughts, and bodily sensations. It refers to the ability to be fully present, aware of where you are and what you are doing, and not overly reactive or overwhelmed by what is going on around you.
Mindfulness is a therapeutic technique that we all have. It is available to us in every moment if we take the time to appreciate it. A 2015 study showed that mindfulness could decrease cravings in people who use addictive substances by as much as 20% in the short-term and probably even more over an extended period.
Learn to practice mindfulness!
Distractions are an excellent way to overcome cravings. Moreso, when you cannot avoid the triggers. Examples of such distractions may be reaching out to someone for social support, going for a run, engaging in work, playing video games, listening to music, watching a movie, taking a relaxing bath, cleaning, and mowing the lawn.
It may be helpful to make a list of distractions that help with your cravings. This means you can quickly refer to your list and pick on something to distract yourself when the cravings are present. Lists are helpful as this can make a call to action much faster. The short duration it may take to think up and decide on a distraction may be all that is needed to succumb to the cravings and relapse on your drug of choice.
The urge that comes with cravings can be a huge struggle. It may be more beneficial to surf the urge, rather than trying to stop it altogether. Urge surfing is a mindfulness technique that helps with accepting a craving for what it is rather than resisting and struggling with it.
One way to do this is to stop and acknowledge a craving when it comes on. This means, accepting that the cravings are there and riding them out, rather than trying to push them away. They will eventually pass. They always do. Many urges disappear in about 10-20 minutes if you can remove yourself from the trigger for the cravings.
Calling and speaking with a friend, family member, sponsor, or therapist may help you cope with your cravings. Support groups like Alcoholics Anonymous (AA) and several others, encourage having a sponsor whom you can talk to one on one when the cravings are present. Attending support group meetings can also be very helpful as it connects you with other people who have the same struggles. This can go a long way in helping with your conflicting desire to use drugs and your commitment to stay sober.
Drug helplines are available, and these numbers can be obtained online for your area. These helplines have trained counselors and volunteers who understand the process of addiction and recovery and who may have been through it as well.
Also, churches and other religious bodies usually have people with a capacity for compassion. This may be helpful even you are not religious.
It may be that you had used drugs and alcohol in the past to drown emotional and physical turmoil. You, however, need to look at things differently and work through the various issues you may have. Professional counseling will help you deal with the inevitable stressors of life.
Expressing your feelings sounds simple, but the benefits of this can be huge. There are many ways to do this, all of which can help with the cravings. Simple forms of expressing yourself, such as painting, dancing, singing, drumming, writing, and journaling, are helpful. Your ability to immerse yourself in your feelings, rather than trying to escape drug urges, can be a truly transformative experience.
CBT is a form of therapy that aids in developing a positive skillset in recovery. It helps people understand the relationship between thoughts, emotions, and behaviors. It provides techniques to help with cravings when they arise. Redirection, visualization, and distraction are some of the methods that can be used to cope with cravings.
Redirecting your attention to something else may be a way to cope with cravings. Some people can distract themselves with some thought or activity until the craving passes. Imagining yourself in a relaxing and soothing environment may help you relax during a craving. Such visualization techniques are quite helpful.
CBT techniques help with negative thinking and cognitive distortions. During drug craving, a common cognitive distortion an individual may experience is catastrophizing. This may lead people to experience thoughts like: “There is no way I can do this if I don’t use this drug. I have to use a little to make it through this.” CBT techniques can help with such negative thoughts and help you think through your craving more rationally.
This form of therapy can help people deal with their stressors, identify and change their behaviors. Also, their way of thinking that may lead to negative consequences. It helps obtain motivation to change and cultivate ideas to avoid using drugs and alcohol.
Hobbies and new interests may provide an excellent way of creating a distraction during drug cravings. Boredom and loneliness may precipitate cravings as the mind attempts to fill a void or space in someone who no longer uses drugs and alcohol. A hobby helps to provide an alternative to engage people and avoid the use of addictive substances.
In some cases, people may have lost their jobs due to drug use. This creates a lot of free time and a lack of structure which could make relapse more likely. The ability to occupy your time with a job not only takes away boredom but also gives you a sense of self and fulfillment, which helps with your recovery process.
You can resist the urge to use drugs by talking yourself out of it. The negative effects of using should be a constant reminder of the need to stay away from drugs and alcohol. A written down list of the reasons for quitting has been found helpful by several people, and you may benefit from such a list as well. Reading through such a list can remind you of the things you previously experienced, which you would rather not go through again.
Also, challenging your thoughts when cravings arise is an excellent way to help rationalize yourself away from the urge to use drugs or alcohol.
Good self-care such as regularly exercising has been shown to help improve physical health and emotional well-being. This can help make you more resilient and better able to deal with cravings when they arise.
Exercise also has the added benefit of boosting the release of endorphins, sometimes referred to as the “feel-good hormones.” Most forms of exercise will help you get through your cravings. Aerobic activities tend to help more with the release of endorphins. Examples are walking, running, cycling, swimming, tennis, and basketball.
Medication-Assisted Treatment (MAT) is an evidence-based treatment approach that involves the use of medications with counseling and behavioral therapies to treat substance use disorders. The goal is to provide a “whole-patient” approach to treatment. MAT is often called the gold standard of addiction treatment.
Three medications are approved by the U.S. Food and Drug Administration (FDA) for the treatment of opioid addiction. These drugs are methadone, buprenorphine, and naltrexone. Federally regulated clinics are the only sites for methadone administration.
The most common medications used to treat alcohol use disorder are disulfiram (Antabuse), acamprosate, naltrexone tablets, and Vivitrol. These medications do not cure the disease but help with maintaining sobriety.
Nicotine replacement is one of the most common treatments for tobacco addiction. It comes as patches, lozenges, inhalers, spray, and gum. Also, there are two prescription medications approved by the FDA to help with tobacco addiction. These are bupropion, sold as Zyban, and varenicline, marketed as Chantix. Both drugs work by blocking cravings as a result of interactions with brain receptors, thereby altering neurotransmitter levels.
Positive results have been obtained using Transcutaneous Electrical Acupoint Stimulation for the treatment of opioid withdrawals. Some studies have shown reductions in cravings by TEAS treatment.
The Bridge Device has an indication from the U.S. Food and Drug Administration (FDA) for use in helping reduce the symptoms of opioid withdrawal. It is the first non-pharmacological, non-implantable medical device available for opioid withdrawal. Housed in a small device that fits discreetly behind the ear, it claims to reduce the symptoms of opioid withdrawals by sending gentle electrical impulses to the brain.
Please note that though I have heard about and read up on The Bridge Device, I cannot speak of the efficacy of this device from personal experience as an Addiction Specialist. For more information about this device, I would encourage people to talk to their treatment providers and perhaps check out the website of this device. In the future, if I do gain some experience as to the efficacy of this product, I will be happy to share my observations.
The above 12 ways are by no means exhaustive. The triggers, cravings, and coping mechanisms differ from person to person. What works for you may not work for others and vice versa. It remains exceedingly essential for you to look inwards and find out what works for you and how you can utilize your coping mechanisms to deal with your addiction. Moreso, when done with professional help.
Some other helpful ways to cope with cravings include staying busy with healthy behaviors, eating healthy, and surrounding yourself with positive influences. Also, getting enough sleep, encouraging yourself, and being optimistic. Focusing on the positive aspects of your life, practicing kindness and patience with yourself and others, turning to your faith and setting future goals are also helpful.
Cravings are physical compulsions or urges to use addictive substances. They are normal and can last for long periods. Cravings do not indicate that there is a problem. They tend to come in waves and will usually build up, reach a peak, and then subside.
Relapse triggers can lead to cravings. These triggers are things, people, places, or situations that an individual who struggles with drugs or alcohol associates with the reward of getting high. Examples of triggers are anniversaries, life milestones, bars, vacations, accidents, and medical conditions. Cravings can also occur without any known triggers.
There are many ways to stop cravings. Some examples are identifying and avoiding your triggers, mindfulness, urge surfing, Cognitive-Behavioral Therapy, exercising, and Transcutaneous Electrical Acupoint Stimulation.
It is important to remember that managing your addiction without professional help has a rather low rate of success. Addiction is a chronic brain disease that can be managed with proper treatment. A good recovery program provides an avenue for you to learn skills to abstain from drugs and alcohol. It also helps you manage the triggers and cravings, which may eventually lead to relapse if not correctly treated. In some cases, medications may also be prescribed to help with your recovery.
What has helped you with your triggers and cravings? Please leave your comments. Also, share this article with others who are struggling with drugs and alcohol.
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The entire content of AddictionBlueprint, including content on drugs and alcohol, medications, therapies, facilities, spotlights, recommendations, and other features is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. This does not constitute a physician-patient relationship. Please seek the advice of your physician or other qualified health providers regarding your addiction, mental and medical issues.
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