Sometimes being the take-charge individual who has to do everything on his or her own is not the way to go. This is particularly true when it comes to trying to overcome addiction on your own. Chances are you’ll face an uphill battle. But it’s actually more than just a tough road to go: it may be impossible. Here are some things to think about, possible consequences of not getting treatment for addiction.
Read more about Possible Consequences of Not Getting Treatment for Addiction
The interesting thing about drug addiction is that it does not play favorites. We may think we can identify the drug user or addict by a specific stereotype, but such an approach will often return erroneous results. Instead, it is better to look for specific signs.
Addiction has plagued civilization for thousands of years, pre-dating the legendary conqueror, Alexander the Great, and the Greek and Roman empires. As long as there have been grapes for wine and ingredients for other liquids for imbibing that brought about an altered state of consciousness – or unconsciousness – addiction has been with us. It’s only in the last few decades that any serious attention has been paid to overcoming addiction. But are we any closer to finding a cure? Is it within the realm of possibility that we can ever cure addiction? And, if we can, will we?
All Addiction Is Not the Same
When you talk about addiction and finding a cure for it, the problem is magnified by the fact that all addiction is not the same. That is, the disease of addiction affects each person in unique ways and depends upon a multitude of factors. Genetics, family history, physical and mental condition, the environment, and a host of other factors play a contributing role in who becomes addicted and who doesn’t.
There’s also the difference between substances abused. Some are literally more addictive than others. For a vulnerable individual, the first encounter with an illicit drug may result in them being hooked – locked into a never-ending drug-seeking, using, and attempting to recover from the effects of the use, and then repeating the pattern all over.
Furthermore, many addicts suffer from multiple addictions, such as alcoholism, illicit and prescription drug abuse, or co-occurring disorder, which is substance abuse and mental health disorder. Combating just one addiction won’t overcome the others.
There’s also the problem of replacement addiction. When one addiction is overcome through treatment, without continuing counseling and an effective support network, those in recovery may quickly fall into a substitute addiction.
Relapse is very common, especially during the first six months of recovery.
Given all this, it’s no wonder that searching for a “cure” for addiction is difficult. If and when a cure is discovered, it will likely be for a narrow subset or a particular addiction. Such a cure will need to go through lengthy clinical trials for efficacy, safety, and effectiveness. Follow-up studies will be required before such a cure can be marketed or made available to the general public.
None of this should deter scientists, medical professionals, addiction specialists, and researchers from continuing to search for ways to unlock the secrets of addiction. But it is a reality that they all recognize.
Smoke and Mirrors
Throughout the past three decades or so, there have been a number of so-called cures for various types of addiction. Some have failed miserably, while others apparently work for a small number of individuals, only later to be proven ineffective or impossible to sustain. Some medications developed to counteract certain effects of withdrawal have been shown to have promise longer term, working, for example, to ease anxiety or depression during the early stages of recovery and enhance the individual’s ability to practice recovery strategies.
There have been potions, extracts from exotic plants, vitamins and herbs that have been touted at one time or another as a cure for everything from gout to anxiety to alcoholism to drug abuse. Before drug regulation and strict controls on advertising claims, if someone had a good idea to promote a product, they could pretty much do what they wanted. The result was a lot of smoke and mirrors – and no real progress toward a cure for addiction.
That all changed, specifically within the last 10 to 15 years. That’s when federal agencies such as the National Institute on Drug Abuse (NIDA) (http://www.nida.nih.gov/), of the National Institutes of Health (NIH), stepped up their efforts to support and help fund research on addiction. NIDA’s stated mission is: “to lead the nation to bringing the power of science to bear on drug abuse and addiction.”
No more smoke and mirrors. Now the search for effective treatments and medications to end addiction is serious stuff.
The Search Goes On
Addiction is also, without a doubt, a big business. Pharmaceutical companies play a huge role in funding and supporting research (for their products, naturally) that brings promising drugs or therapies closer to marketability. Leading universities, medical professionals, the National Institute on Drug Abuse (NIDA), private organizations and foundations are all heavily involved and invested in looking for ways to overcome addiction.
Research into alcoholism is conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) (http://www.niaaa.nih.gov/), which is also a part of the National Institutes of Health (NIH). NIAAA’s mission is to lead in the national effort to reduce alcohol-related problems by:
• Conducting and supporting research in many scientific areas including genetics, epidemiology, neuroscience, health risks and benefits of alcohol consumption, prevention, and treatment
• Coordinating and collaborating with other federal programs and research institutes on alcohol-related problems and issues
• Collaborating with international, national, state, and local agencies, institutes, organizations, and programs engaged in alcohol-related work
• Getting the word out about research findings to the general public, policymakers, researchers, and health care providers
The NIAAA celebrates its 40th anniversary this year (2010), from its beginnings with the Hughes Act of 1970, subsequent growth and establishment as an independent institute in 1974, and highlighting its significant accomplishments, such as the first Fetal Alcohol Syndrome workshop, passage of minimum legal drinking age laws, and launch of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).
If you want to know what’s going on in the area of clinical trials, check out the lengthy list of clinical trials underway at any given point through ClinicalTrials.gov (http://www.clinicaltrials.gov/). This is a registry of federally and privately supported clinical trials conducted in the United States and around the world. The site gives information about a trial’s purpose, who may be eligible to participate, locations, and phone numbers for more details. Studies can be searched by condition, drug intervention, sponsor, and location. During a recent search, some 92,530 trials were underway in 174 countries.
Latest Research
While there’s no cure for addiction yet available, there is promise to report in a number of different areas.
Genes that Influence Brain Wave Patterns
NIAAA scientists have recently identified new genes and pathways that influence a person’s typical pattern of brain electrical activity. This is a trait that may serve as a useful surrogate marker for more genetically complex traits and diseases. One of these genes, for example, is associated with alcoholism.
The study, which was reported in the May 20, 2010 edition of The Proceedings of the National Academy of Sciences, is summarized in the NIAAA Spectrum (http://www.spectrum.niaaa.nih.gov/newsfromthefield/GenesBrainWave.aspx). The news magazine reports that one of the paper’s authors, David Goldman, M.D., chief of the NIAAA Laboratory of Neurogenetics, said, “While our main findings are for genes that influence EED wave patterns, this study represents an important step towards the use of EEG as a surrogate marker for alcoholism. It also reveals new molecular pathways involved in addiction processes.” The abstract of the original article, “Genome-wide association identifies candidate genes that influence the human electroencephalogram,” can be found on PubMed (http://www.ncbi.nlm.nih.gov/pubmed/20421487).
NIH-supported Finding on Cocaine Addiction
A recent study funded by NIDA, a component of the NIH, has discovered that a specific and very small fragment of RNA appears to protect rats against cocaine addiction – and may also protect humans. The study, which was published in the journal Nature is summarized on the NIDA news section of its website (http://www.drugabuse.gov/newsroom/10/NR7-07.html).
In essence, the study findings suggest that microRNA-212 plays a pivotal role in regulating rat intake of cocaine, and, perhaps, in the rodent’s vulnerability to addiction. What greatly interests scientists is the fact that the same microRNA-212 is found in the human dorsal striatum, a brain region linked to drug abuse and habit formation (addiction). Paul J. Kenny, senior study author and associate professor at the Scripps Research Institute in Jupiter, Florida, is even more upbeat, commenting: “The results of this study offer promise for the development of a totally new class of anti-addiction medications. Because we are beginning to map out how this specific microRNA works, we may be able to develop new compounds to manipulate the levels of microRNA-212 therapeutically with exquisite specificity, opening the possibility of new treatments for drug addiction.”
Search for Cocaine Vaccine Has Mixed Results
Another NIDA-supported study on a cocaine vaccine shows promise, but also some mixed results. The study, published in the October 2009 issue of Archives of General Psychiatry is also summarized on the NIDA website (http://www.drugabuse.gov/newsroom/09/NR10-05.html), which says it is “the first successful placebo-controlled demonstration of a vaccine against an illicit drug of abuse.” NIDA Director Dr. Nora Volkow is quoted as saying: “Provided that larger follow-up studies confirm its safety and efficacy, this vaccine would offer a valuable new approach to treating cocaine addiction, for which no FDA-approved medication is currently available.”
The study’s principal investigator, Dr. Thomas Kosten, of Baylor College of Medicine in Houston, Texas, said that immunization did not achieve complete abstinence from cocaine use in this study. He did add that, “Previous research has shown…that a reduction in use is associated with a significant improvement in cocaine abusers’ social functioning and thus is therapeutically meaningful.”
The Washington Post, reporting the story January 5, 2010, identified the vaccine as TA-CD and said that, according to Dr. Kosten, “the vaccine…shows promise but could also be dangerous; some of the addicts participating in the study of the vaccine started doing massive amounts of cocaine in hopes of overcoming its effects”.
The 2008 National Survey on Drug Use and Health (NSDUH) shows that 2.1 million Americans used cocaine in the month prior to the survey. After media reports of TA-CD hit, one researcher was deluged with calls from people desperate to get their family members off the cocaine addiction downward spiral. According to the Washington Post story, Margaret Haney, a professor of clinical neuroscience at Columbia University Medical Center who has been researching the cocaine vaccine (although not part of Kosten’s study), said: “They have a mistaken view of how a vaccine might work, thinking of it as magic, where what it’s doing, at best, is blunting the effects. They get very excited, and it’s heartbreaking.”
Anti-Smoking Vaccine on the Near Horizon
Nicotine addiction causes nearly a half million deaths annually in the United States, and many more millions worldwide. After years of research and development into finding effective treatments to help people stay off cigarettes, a promising new anti-smoking vaccine, NicVAX, by Nabi Biopharmaceuticals (http://www.nabi.com/pipeline/pipeline.php?id=3) of Rockville, Maryland, entered the first pivotal Phase III trial stage in November 2009. In March 2010, NicVAX entered the second Phase III study.
NicVAX is an injectable vaccine that is intended to help people quit smoking and keep them from relapsing. Successful completion of the trial will bring the vaccine closer to final approval by the U.S. Food and Drug Administration (FDA), which has already given the drug fast-track status. In order to reach fast-track status, a medication or treatment must first pass the regulatory hurdles showing the proposed drug or treatment is sound.
How it works: Like other vaccines, NicVAX works by boosting the immune system. Here, the goal is to generate antibodies that bind to nicotine. In smoking, normally nicotine is a small molecule that travels quickly through the lungs, bloodstream, and into the brain. NicVAX, by trapping the nicotine in an antibody, makes it too large to get into the brain, thus subverting the effects of the nicotine.
Scientists know that nicotine, once it reaches the brain, activates the release of dopamine, a chemical linked to pleasure and addiction. Once addicted to nicotine, it is very difficult to achieve and sustain abstinence. Complicating matters and triggering relapse are withdrawal symptoms, environmental cues, and stress.
A vaccine that lasts for 6-12 months gives smoker’s a chance to end the addiction/relapse cycle and quit smoking for good. In the future, NicVAX may prove helpful in preventing smoking in the first place.
Nabi Biopharmaceuticals, which has been actively researching and developing the anti-smoking vaccine, received a $4.1 million grant from NIDA in 2005, which partially offset the company’s funding requirements for the vaccine development program. In September 2009, Nabi received an additional $10 million in funding from NIDA to continue development. In March 2010, Nabi entered into a worldwide optioning and licensing agreement with GlaxoSmithKline Biologicals.
How Much Longer?
In the search for new medications and treatments that may prove effective for addiction to substances, it is easy to become excited and then disappointed at the progress or stalling of development. It takes many years to get through the rigorous FDA approval process. Safety, efficacy, and effectiveness are primary considerations. That takes years of post-marketing follow-up as well.
Perhaps it’s best to look at a cure for addiction in smaller increments. The potential anti-smoking vaccine may be one of the first to hit the market, thus helping millions of motivated smokers kick the habit for good. Following its release to the public as an anti-smoking cessation aid, further studies into its use for prevention of smoking may follow.
Another potential vaccine that may come to market in the coming years – after further testing and validation of effectiveness in helping cocaine users abstain and sustain abstinence – is the so-called cocaine vaccine.
As for other substances of abuse, as well as process addictions such as compulsive gambling, sex, work, and eating disorders, among others, the outlook for a vaccine or “cure” is quite a bit cloudier.
This is not to say that research won’t continue into many of these areas. But it will take a resounding success in the effectiveness of one “cure” before others may potentially receive funding and/or attention from researchers and developers. After all, R&D costs many millions of dollars and takes years – often without success.
Can we cure addiction? Will we cure addiction? Only time will tell. In the meantime, there are effective treatments that can help motivated individuals overcome their addiction – although they will have to be vigilant for the rest of their lives in order to maintain sobriety in recovery. As addiction treatment professionals say, overcoming addiction is the beginning of a lifetime in recovery.
In other words, if you or someone you love is currently addicted to drugs, alcohol, or compulsive behavior, don’t wait for the “magic bullet” or “cure.” Get into treatment and take charge of your destiny. Should a cure come around in the future, you’ll be that much further ahead.
If you have a loved one who needs or is getting treatment for addiction, you probably have already learned that addiction involves more than just the addict. When one person in a family is addicted, everyone is affected. That’s why they call addiction a family disease. Other family members who have ignored, denied, justified, and enabled the addict are known as codependent. But what, exactly is codependency and how do you stop it? Here are some points to consider.
Codependency Definitions
There are a number of definitions of codependency from various sources.
Some define codependency as a personality disorder, a dysfunctional relationship with the self characterized by living through or for another, attempting to control others, blaming others, a sense of victimization, of trying to fix others, as well as intense anxiety around intimacy.
Another definition of codependency is that it is habitual behaviors that are ultimately self-destructive.
Codependency is also considered by some as a psychological condition in which one person exhibits too much (and often inappropriate) caring for and about other people’s problems and issues.
Still others classify codependency as a disease, one that can be every bit as deadly as alcoholism, drug addiction, or eating disorders.
One site, WiseGEEK (http://www.wisegeek.com/what-is-codependency.htm) says codependency “describes a situation in which a person literally becomes emotionally addicted to another person’s addiction.”
The Encyclopedia Britannica (http://www.britannica.com/EBchecked/topic/889897/codependency) defines codependency as “a psychological syndrome noted in partners or relatives of persons with alcohol or drug addiction. Not a formal psychiatric diagnosis, codependency has become a useful term for discussing aspects of family dysfunction, particularly among participants in recovery groups like Alcoholics Anonymous or Al-Anon.”
According to the National Institute on Drug Abuse (NIDA) (http://archives.drugabuse.gov/txmanuals/IDCA/IDCA11.html), “codependency occurs when another individual, perhaps the addict’s spouse or family member, is controlled by the addict’s addictive behavior.” Some codependents are adult children of alcoholics or addicts. Their codependent behavior is the result of growing up in this environment of addiction. NIDA further says that “enabling behavior occurs when another person, often a codependent, helps or encourages the addict to continue using drugs, either directly or indirectly.”
Whatever the definition, codependency is a serious and debilitating condition that wreaks havoc on the lives of the codependent person and all those around him or her.
Characteristics of Codependents
How can you tell if you are codependent? What are some of the characteristics of codependents? While the following is not an all-inclusive list, and individuals who are codependent may not display all of them at one time, it is a good place to start.
People who are codependent have certain characteristics or traits involving caretaking, low self-worth, obsession, and repression.
As codependents, they may feel that they’re responsible for another person’s (especially the addict’s) actions, feelings, thoughts, well-being or lack of it, even their destiny. Frequently, when another person has a problem, the codependent feels a sense of anxiety, pity, or guilt. They may feel compelled to help the person or to somehow fix the problem – even if it is out of their ability to do so. Codependents will get angry when their attempts to fix the problem aren’t effective. They try to anticipate what other people need and constantly wonder why the same thing doesn’t happen for them. They don’t really know what they want or need, say yes instead of no, submerge their own interests and enjoyments in order to be caretakers to another, over commit, take on too much, and ignore their own well-being. Attracted to needy people, needy people are also attracted to them. It’s like a pull of gravity. If the codependent isn’t fixing a problem or handling a crisis, they often feel bored, worthless, and empty. At the heart of all this, the codependent feels angry, victimized, underappreciated, undervalued, and used. They also blame others for the spot they’re in and say that the reason they feel the way they do is because of other people.
Low self-worth is another key characteristic of the codependent. Often, the individual comes from a troubled or dysfunctional family – one which they adamantly deny was so. They also often have been victims of sexual or emotional abuse, violence, alcoholism, abandonment, or neglect. They actually feel like victims, take things personally, fear rejection, and are afraid they can never do anything right. Filled with self-blame for everything, the codependent constantly engages in self-criticism: They don’t look, act, feel, think, or behave the way they’re supposed to. Rejecting compliments or praise, codependents nevertheless secretly yearn for admiration from others. When they don’t get it, they become depressed. Ashamed of whom they are at their core, codependents have intense guilt. Since they think their own lives aren’t worth living, they valiantly attempt to help others instead. No one can possibly really love them, so they’ll settle for being needed.
Codependents may also suffer from repression and obsession. Afraid to let themselves be who they are, they may appear rigid and controlled, pushing their own thoughts and personal feelings aside due to guilt and fear. Their obsessive traits are quite obvious to anyone who pays attention. They worry over everything, constantly check up on people, aren’t able to sleep because of worry over other people’s problems. They constantly talk about other people, find something to worry about over meaningless things, and are always anxious about other people’s problems and issues.
Are you up all night, tossing and turning, unable to sleep because of drug cravings? Or does that gnawing, incessant urge to drink torture your every waking moment – no matter how hard you try to ignore it? Is there no one who can help you through this? If you answer yes to any of these questions, you’re among the many addicts who are alone and miserable – and fighting the urge to use.
There is a way out of this situation. But – and there’s always a disclaimer, isn’t there? – it won’t be easy and it will take time. Of course, there’s no guarantee the urges and cravings won’t come back, but when and if they do, you’ll be in a much better position to cope with them.
Cravings and Urges – What Are They?
You certainly know what you feel, but what are cravings and urges, really? What is the physical and/or psychological basis for them? Do they happen to every addict? How can they appear months and years after you’re clean and sober? Will they ever go away for good? These are excellent questions that frequently come up during treatment for addiction.
Cravings and urges are best described as strong memories that are linked to the effect of drugs (alcohol, cocaine, marijuana, methamphetamine, prescription drugs used for nonmedical purposes, etc.) or addictive behavior (such as compulsive gambling, spending, or sexual behavior) on the neurochemistry of the brain.
Using brain imagery techniques, researchers have been able to pinpoint intense brain activity when addicts are shown pictures of crack pipes, alcoholic drinks or other visual images of addictive substances or behavior. Research shows that these images or cues can be as brief as 33 milliseconds before they activate the brain’s “go” circuit – even before the person is even aware of it happening.
What actually happens is this: The brain remembers the intense relief or pleasure of the previous drug experience or addictive behavior. It is a kind of programmed response to past association with drug use that activates the cortical areas of the brain by just the sight, sound, smell or thought of the drug itself. You don’t have to be using the drug to experience the craving or urge. Simply seeing or hearing or smelling a trigger – a beer commercial, the sound of ice tinkling in a glass, the sweet aroma of marijuana – makes you relive the experience and produces a strong emotional reaction. This is the craving or urge that you feel.
Tied to memories of such intense pleasure and relief, cravings and urges are both very powerful and tough to ignore. As to whether all addicts have them, the consensus is that they do, although how they react to them is very much individualized.
Some addicts can have the urge and not act on it. Maybe their addiction wasn’t as deep-seated, or they didn’t have any genetic predisposition to addiction (family history of alcoholism, for example). Their addiction may have been more of an environmental and social nature than a hard-core, chronic manifestation of the disease.
Even so, there are many hard-core addicts who successfully overcome their addiction – and are able to combat cravings and
urges effectively. That is not to say that the ability to cope with cravings comes easy or that it doesn’t require conscious effort – especially in early recovery when the memories are the most vivid and insistent.
What Happens in a Craving?
You know you’re experiencing a craving when you start to feel a tingle of anticipation. You hear, see, or smell the trigger and your thoughts center on the memories of using. You can’t get it out of your head.
Cravings aren’t something that you can schedule around, since you never know when they are going to occur. You can get a craving just by watching television or going to the beach, while you are trying to work or go to sleep. All you know is that your body is telling you how much better you’d feel if only you took that drink, smoked that joint, used that drug, went to the casino – you get the picture. Actually, that’s the point: You do get the picture and now you need to know what to do about it.
Help to Deal with Cravings
Isn’t it ironic that most cravings seem to come to you when you’re by yourself, overwhelmed, stressed out, feeling blue – in other words, when you’re alone and miserable? It’s as if the area of your brain – the limbic area – knows when you are the weakest and picks that moment to strike. Chances of you succumbing to the craving are generally higher when you are in early recovery. This is the time when you are fresh out of treatment and may not yet have your offensive and defensive coping strategies firmly in place. You haven’t had enough practice yet to feel comfortable in dealing with the cravings. You feel helpless, anxious, depressed, angry that you have these urges, desperate to hold onto your sobriety.
There is help to deal with cravings. It all begins with you. Here are some tips that may prove useful – as they have for countless others.
• Recognize the feeling – It’s important that you recognize the craving for what it is. Some addicts in recovery refer to the craving as a kind of freebie, something that you get without having to pay for it – in the sense of consequences. That’s not to say that many treatment professionals would refer to it this way, but the fact of the matter is you know what that pleasure feels like, so acknowledge it, recognize it – and then you can deal with it.
• Don’t be afraid of cravings – When cravings occur, don’t allow yourself to feel fear – or guilt or shame or regret. You don’t have any say over when cravings hit, and it certainly isn’t anything that you consciously do that prompts them. Don’t give the craving power by giving into it. By not fearing it, you are less likely to act out and use.
• Understand control – The fact that you recognize the craving for what it doesn’t mean that you can control it. You can’t. Cravings will occur regardless of how you feel about them. Everyone has cravings of one sort or another. It isn’t the existence of the cravings, but what you do about it. So there are two issues of control here. You can’t control when cravings occur, but you can control what you do about them. Always remember that you are the one in control. You are the one who determines what you will do or not do.
• When you’re overwhelmed – Sometimes the cravings are just too much to bear. You feel as if you’re destined to fail, to relapse. It’s as if you’re falling into an abyss and you can see yourself slipping back into your habit. This is a particularly vulnerable time for you – and, don’t you know it – it probably occurs when you are least able to handle it. Now’s the time to activate your coping mechanisms. Get in touch with your 12-step sponsor immediately. Don’t worry that it’s the middle of the night or Easter Sunday or whenever. Your sponsor has pledged to help you through such difficult times – that’s what he’s there for. One day you may be able to help another recovering addict in the same situation, but for now, you need the help. Reach out and take it. If you don’t have a 12-step sponsor, make sure there’s someone else you can trust. This may be your therapist, counselor, parent, spouse, other loved one or trusted friend. It doesn’t matter who it is, just that you have complete trust in the person – and know that they will be there for you when you need them most.
• Learn about craving triggers – Do yourself a big favor and become educated about the triggers that produce cravings. Write down situations, circumstances, events, people, sounds, smells, even thoughts that occur just before you’re aware of the craving. These are your triggers. Rate them on a scale of 1 to 10, with 10 being the highest or most intense craving. Now, write down next to each type of craving the techniques or things that you have done that seem to minimize the cravings. Do you notice a pattern? Are the coping mechanisms you use for little cravings the same as for the more intense ones? Are there ways that you can modify the effective ones to work on all your cravings? You don’t have to be an expert at this for it to have some benefit. The point is that you are teaching yourself to see the relationship, the cause and effect, of triggers and cravings – and how what you do can help reduce, minimize or eliminate the craving. You will, in effect, be learning how to manage your cravings, and this is a big part of recovery.
• Utilize the 5-minute rule – While cravings are different for each individual, they do have one thing in common. They tend to last only for a short time. One of the most practical ways of dealing with cravings, then, is to get through this brief period. Addiction treatment professionals refer to this as the “5-minute rule” or “5-minute contract” or “anti-craving behavioral strategies.” Basically, you pledge to yourself that you will not act on the desire – the craving or urge – for 5 minutes. In the interim, distract yourself with some activity that requires your complete concentration, or do mind exercises, crossword puzzles, counting, or physical exercise – whatever works to pass the time. Keeping your brain and your body occupied will help you get through this period of craving – without acting on it.
• Get professional help – You may benefit from professional counseling to help you better manage your cravings. If you have aftercare as part of your treatment program, you have access to a counselor or therapist who can help you with behavioral techniques to manage cravings. If aftercare is not part of your treatment program or if you haven’t been through treatment, look for counselors and therapists that may be available through federal, state or community addiction treatment resources. Cognitive behavioral therapy (CBT) is one technique that has proven very effective in helping addicts to manage cravings – but this is something that you need professional help to learn. There are other behavioral techniques that may also be employed, in conjunction with CBT or separately.
• Anti-craving medication – If your cravings persist, your therapist or physician may recommend anti-craving medication. Some cravings, particularly for certain types of addictions, can occur so rapidly and feel so overwhelming that, without medication, you may not be able to get through them – even with your arsenal of coping strategies and techniques. The point of anti-craving medication is only to get you to the point where you are better able to work through the craving without acting on it. It is not to get you dependent on medication. In fact, anti-craving medication has been the subject of a great deal of recent research. Medications to combat nicotine cravings and those to counter cocaine and methamphetamine cravings are currently in development and show great promise. If your therapist or physician does prescribe anti-craving medication for you, be sure to take it exactly as prescribed. Note any disturbing side-effects and alert your doctor immediately. Your dosing may need to be reduced or another medication substituted. Use medication only as part of multi-faceted therapy, including counseling, and when appropriate, your doctor will gradually wean you off the medication.
• Alternative treatments – You may also wish to consider alternative treatments to help put you in a better mindset to deal with cravings. Some addicts in recovery have found acupuncture or acupressure to help, while others report success with therapeutic massage, hypnotherapy, meditation, or other approaches. Look at it this way: If it makes you feel better, restores your strength, peace of mind, and gets you through the craving, why not make this part of your coping mechanism toolkit?
• Get out and get physical – Many experts in the field of addiction recovery recommend physical exercise to their clients. Why? The reason is simple: When you exercise vigorously, your body produces the natural feel-good chemical that helps elevate mood, reduces anxiety, stress and depression. It’s also great for your physical well-being in that it helps improve cardiovascular systems, tones muscles, helps you sleep better, aids in digestion, even cognitive abilities. In fact, rigorous physical exercise is like a highly-competent utility player – good at any position. Besides, when you’ve engaged in a vigorous bout of physical exercise, you feel a good kind of fatigue – the kind that makes you feel good about yourself. When you feel good about yourself, you’re better able to tackle everyday issues and challenges, including cravings that may pop up uninvited.
• Remember nutrition – In line with taking good care of your body with adequate physical exercise, remember your nutritional needs as well. Eat a well-balanced diet that consists of fresh fruits and vegetables, lean meat, good oils such as olive, fatty fish (salmon, mackerel), and reduce your intake of sugar and empty calories. Keep to a regular mealtime schedule. This is important because cravings can occur if you are hungry (or when you are sleep-deprived or stressed out). It’s also important to keep your body fueled with the nutrients it needs in order to ward off illness, maintain strength and vitality.
• Celebrate victories – As you grow more confident in your ability to fight off the urge to use, give yourself the credit you deserve. It’s not easy overcoming cravings, as you well know. Give yourself a reward for your victories. When you have reached milestones (weeks, months, years, etc.) of sobriety, have a little celebration – minus alcohol or drugs, of course. By celebrating your sobriety you are reinforcing your mastery of successful coping techniques – and the fact that you’re getting stronger in recovery.
• About relapse – What happens if you relapse? Well, it happens, and to some in recovery, it happens several times before they develop sufficient coping skills. But it isn’t the end of the world. You just pick yourself up and move on. Don’t beat yourself up over it. That won’t do any good. There’s no shame in relapse – so don’t even let that thought come into your head. Recovery is not a straight-line process for everyone. There are victories and set-backs, some major, some minor. Remember that it isn’t what happens that counts, but what you do about it. Re-double your efforts. Re-examine your strategies. Get help to deal with the problems. And keep moving forward in your recovery. You will have learned from your relapse and will be stronger as a result of the knowledge. Think of it this way: You have accumulated even more wisdom about what triggers affect you the most – and what to do to counter them.
Will Cravings Ever Go Away?
Chances are, no, but they will diminish over time. The key point to keep in mind is that the more knowledge you amass about cravings, what triggers them, what works best to eliminate them or get through them without acting upon the craving, the less they will trouble you when they do occur. Over time, you will find that cues or triggers that used to cause you great distress either no longer bother you with the same intensity, or they don’t bother you at all. You are able to recognize them, distract yourself while they pass, and get on with your life.
Read more about Alone and Miserable – Fighting the Urge to Use
Coming back from the cycle of addiction is a long and tough road. Not only does it take a lot of courage and determination, but it’s physically and mentally taxing as well. When you’ve finished your treatment and are in recovery, you really need the love, support and encouragement of your loved ones to help you maintain your sobriety. So what happens if your loved ones cannot forgive your addiction? What if there’s so much weight in your baggage that they can’t look beyond the past?
Read more about What If Your Loved Ones Cannot Forgive Your Addiction