Among the most significant obstacles to recovery from alcohol abuse is dealing with cravings, which are response patterns programmed into people that appear due to environment, mood changes, stress, and various other triggers. Although sometimes desires may appear to come out of nowhere, they are most often provoked by some environmental situation, memory, or emotion regarding past alcohol abuse.
Many environmental conditions can act as triggers for cravings. The acronym HALT (Hungry, Angry, Lonely, Tired) is often used to remind individuals in Alcoholics Anonymous and other support groups and rehab centers of the types of conditions likely to instigate cravings and trigger an alcohol relapse.
However, it’s not just adverse emotional states that can act as triggers for cravings. Favorable conditions, such as feeling happy, excited, and successful, also often prompt urges.
In a nutshell, cravings are vivid recollections that are emotionally driven by the pleasant reinforcing effects that continue to contribute to drinking alcohol. They represent potent reinforcements to engage in the use of alcohol for many individuals who are in recovery. Cravings are often very visceral, allowing a person to experience the reinforcing effects that they used to get from alcohol and forget all of the negative consequences that occurred due to such use.
In some instances, cravings may become so powerful that people feel like they cannot resist them, although this is seldom really the case. Cravings often incite an internal debate with oneself over whether one should give in to them this one time or continue to maintain abstinence.
Cravings, Cues, Triggers, and Relapse
Triggers and cues are different terms for the same situations that can lead to the development of alcohol cravings in an individual. They can be very personal and subjective, or they can be general and found among many people. The effects of triggers and cues produce physical and mental changes that are ultimately interpreted by the person experiencing them as cravings.
These changes can include the following:
- The onset of psychological changes consists of stimulated peripheral and central system activity, feelings of excitement and anticipation, and memories associated with past pleasant experiences with alcohol.
- The onset of physical changes consisting of accelerated heart rate, elevated blood pressure, and increases in the activity of the sweat glands. In a sense, triggers produce very similar changes to those that occur when anticipating a reward.
To prevent relapse, addiction treatment specialists make use of two major intervention strategies. The recovering individual would be wise to choose alternatives from both approaches instead of focusing on only one for maximum success in coping with cravings promptly and effectively.
Medically-assisted interventions attempt to address cravings by affecting the physical process associated with the urge and then eliminating its intensity. Numerous drugs have been used to manage cravings for alcohol.
Some of the most popular and effective medications are outlined below.
- ReVia and Vivitrol (naltrexone)
- Campral (acamprosate)
- Certain anticonvulsant medications, such as Topamax (topiramate)
- Gablofen (baclofen)
Also, the use of the medication Antabuse (disulfiram) may reduce cravings if an individual using the medication consumes alcohol as this can cause them to become violently ill and experience nausea and vomiting.
Behavioral Interventions for Alcohol Abuse
Medications such as these mainly address the physical changes caused by alcohol-associated with cravings and mitigate them. They do not help individuals deal with the environmental triggers and cues that can cause desires to develop. Instead, behavioral intervention techniques can be employed to address triggers, help individuals resist urges, and eventually reduce the severity and incidence of cravings.
Behavioral interventions are intended to help individuals recognize triggers, alter feelings associated with triggers, and learn to decrease the intensity of those urges they may experience.
Among the more effective behavioral interventions include the following:
- Helping an individual understand and identify the types of triggers that may result in cravings among almost every person in recovery
- Assisting the person to recognize and appreciate their own unique and subjective motivations that contribute to their personal cravings for alcohol
- Psychoeducation, which instills the idea that cravings are actually a regular occurrence in recovery and do not necessarily indicate signs of failure
- Continued education on the craving-neutralizing effects of techniques such as medication, distraction, and the passage of time
- The development of personalized coping strategies to deal with cravings as they occur often involving focus on the adverse aspects of alcohol use as opposed to the positive feelings that alcohol provides them
- Enlisting support from others to help them during vulnerable times
Therapists and addiction treatment centers can use several different techniques to help them cope with cravings and minimize relapse risk. For example, they can teach individuals progressive muscle relaxation and diaphragmatic breathing that can be learned rapidly and can become practical tools to cope with cravings. Persons can then focus on the more complex aspects of cravings, such as learning about their nature, identifying triggers, and using distraction techniques.
Other essential strategies that can help a person deal with cravings include the following:
- Recognize that cravings are limited by time—they do not last forever, and in fact, usually no longer than 20 minutes or so
- Distraction in the form of exercise, medication, and socialization is among the most successful approaches to dealing with cravings
- Renewed involvement in activities with a higher purpose, such as going back to school or training for a new job, can reduce cravings
- Learn stress management techniques, such as relaxed breathing and mindful meditation, to address one’s reaction to stress, one of the most common generalized triggers that produce cravings for drugs and alcohol
- Engage in a healthy lifestyle, such as exercising regularly, staying hydrated, maintaining a nutritious diet, and building productive social relationships, to reduce the effects of triggers and environmental cues
Alcohol Relapse Signs
Individuals recovering from an alcohol use disorder need to recognize the general signs that a relapse may be imminent. These include the following:
- Glamorizing past alcohol use
- Believing that one or two drinks would be okay
- Beginning to engage in behaviors that promoted prior alcohol use, such as going to bars, hanging out with former drinking buddies, etc.
- Becoming overconfident in recovery (pink cloud syndrome) or thinking that one has overcome the past alcohol use disorder
- Skipping therapy sessions or not actively listening to the concerns of others, such as peers in recovery, family, or friends
Getting Help for Alcoholism
Sometimes individuals find they have difficulty managing alcohol cravings independently and could benefit from a professional addiction treatment program. Or, those who have already received treatment may need more or a different approach to manage cravings and prevent relapse.
Just Believe Recovery is a specialized rehab facility that treats all aspects of substance abuse and mental health using a comprehensive, evidence-based approach. Therapeutic interventions and activities we offer include the following:
- Group support
- Family therapy
- Relapse prevention
- Addiction education
- Health and wellness education
- Art and music therapy
- Aftercare planning
- Alumni events and activities