When you enter treatment for drug addiction, one of the first challenges you will encounter is wanting to use. The Mayo Clinic defines addiction as an uncontrollable physical dependence on a particular substance, and these cravings are completely normal; however, that doesn’t make it easier to experience them.
Thankfully, we now understand why cravings happen, how to combat them in the short and long-term, and how to make them easier to handle in the future.
What causes drug cravings?
Addiction is so much more than just “a drug habit;” it physically changes the neurons and circuitry in your brain. Drug use interferes with the following parts of your brain:
- The motivation center– Drug use becomes more important than healthy choices.
- The reward center – Drug highs become connected to external cues (people, places, and situations) so that these factors trigger the urge to use.
- The control center– Because using is associated with high motivation and reward levels, your brain “forgets” the negative consequences you have experienced as a result of addiction. This makes it harder to learn from your past mistakes and control impulses.
Furthermore, the longer you’ve been using, the higher your tolerance for the drug is. Once you build a tolerance, drug use becomes more about avoiding withdrawal than seeking a high. Cravings result from your body’s desire to escape withdrawal symptoms.
In short, cravings result from changes that drug use has made to your brain. They’re not a sign of failure or that you want to use. Cravings are a normal part of recovery that you can treat and learn to combat.
How to combat cravings in the short-term
There are several ways to deal with drug cravings during detoxification and treatment, including:
- Vivitrol, a medication incorporating Naltrexone, blocks the effects of opiates on the brain and has been proven to reduce cravings for narcotics like heroin and alcohol. It is injected once a month and has no addictive properties.
- Entacapone, a medication used primarily for Parkinson’s Disease but that also works with dopamine receptors in the brain, was found to decrease cravings for marijuana in 52.7% of patients, according to a study published in Current Pharmaceutical Design.
- Baclofen, a muscle relaxant, has been proven to decrease cravings for cocaine when addicts are exposed to use-related triggers. The same study showed that the brain patterns that normally accompanied cravings were also minimized by use of Baclofen.
- Rivastigmine, a medication used to treat Parkinson’s and Alzheimer’s disease by improving mental functions, was shown in a study to reduce cravings for methamphetamines. The same study also showed that Naltrexone drastically reduced meth cravings.
- Both Risperdal, an anti-psychotic medication used to treat schizophrenia and bipolar disorder, and Ritalin, a medication used to treat ADHD, have been shown to reduce cravings for MDMA (ecstasy) addicts.
However, while medications can be a good short-term solution, recovery is a continuing process. A lot of addicts don’t want to stop using drugs only to become reliant on medication to reduce cravings. There are also a good number of ways to handle cravings through non-medicinal means, methods that can be maintained long-term.
Long-term ways to cope with drug cravings
There are several ways to reduce your cravings or to better handle them when they arise. Some include:
Mindfulness is incredibly effective at reducing drug cravings, according to a 2015 study. Techniques included “check-ins” with how your body feels, practicing meditative awareness while eating, paying attention to breathing, doing yoga postures, and traditional sitting meditation over eight sessions. According to the study, mindfulness training lowered addicts’ cravings by 20% in the short-term and has even more promise over an extended period of time.
Distracting yourself with something healthy (reading, watching a movie, exercising, cleaning, or knitting) can direct your attention away from drugs while also promoting your general welfare. Preparing and eating a meal also works, but there is always the danger of bingeing or emotional eating. If this works for you, practicing mindfulness during meals is a good way to keep you from overeating.
Urge surging or the practice of focusing on the craving until it passes can work when done properly. This is another kind of mindfulness, one that allows you to get in tune with your cravings so that you can recognize how they manifest and roughly how long it takes them to dissipate.
Everyone has their own way of urge surging, but here’s a basic guide on how to do it:
- First, you should allow yourself to take note of your body, notice where you feel the craving, and what the feeling is like.
- Next, pick one area of your body that feels the craving and describe to yourself what you feel there (i.e. tension, heat, etc.).
- Once you’ve described the first area as best as you can, move to the next and the next until the craving passes.
Reach out to others
Talking to your support system (family, friends, a sponsor, a therapist, etc.) when a craving hits can also be helpful. This way, you’re not alone with your craving, you can continue to practice honesty in your relationships, and you may also be able to figure out what’s triggering your craving by talking it out.
Challenge your thoughts
Challenging your thoughts when a craving arises is a good way to release frustration while also rationalizing yourself away from the urge to use.
Ask yourself questions like:
- “What’s the evidence that _____?” (where the blank represents flawed thinking such as “I’ll die if I don’t use”).
- “What’s so bad about ______?” (where the blank represents things like “experiencing a craving”).
- “Who said that______?” (where the blank represents statements like “This should be easier”).
Identify your triggers
Identifying your triggers (and even writing them down) can give you a concrete idea of what to avoid so as to prevent cravings. For instance, if your former dealer lives in a certain part of town, make a promise to yourself to avoid that area, or if it’s unavoidable (i.e. you work nearby or your children go to school around the corner), to go only with someone you trust. If you used drugs with a certain group of people, cut your ties and instead associate with people who aren’t going to expose you to a triggering situation. If certain things remind you of using (such as drug paraphernalia, items of clothing, a specific type of music, etc.), get rid of them and replace them with things that make you feel good, like a different wardrobe or a new playlist.
Remind yourself of the consequences
Writing down the negative consequences of using and keeping them handy at all times gives you something physical to use when you experience a drug craving.For example, a series of notecards can fit easily into your wallet or purse, and you can read through them to remind yourself of the things you once experienced and don’t want to go through again.
The thing to take away is that cravings are a normal part of the recovery process. Because of the effects drug use has had on your brain, your body is used to getting a regular supply of drugs. Your body takes a while to “catch up” to your decision to get sober, which results in cravings.
But understanding that every recovering addict experiences cravings and knowing what to do about them can make all the difference. As long as you educate yourself about coping mechanisms for cravings and are willing to try different techniques as you discover them, you’ll eventually find a system that works for you, reducing the difficulties of recovery so you can focus on the positives of your new, healthy life.
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