06 May Avoiding Relapse: Dealing with Cravings
The treatment of addiction often requires a multi-step approach. Detoxification comes first, and depending upon all the specifics-the substance or substances, the amount used, your specific history of using drugs and/or alcohol-can be a medically supervised, hospital-based and potentially life threatening procedure. Getting “clean”-removing the substances from your body safely-is only step one. For many people, step two involves rehabilitation, which has everything to do with moving from clean to sober. Rehab is where you learn to be sober, and love it. Rehab is where you learn the skills to move from surviving to thriving. But step three is often something you need to address in an on-going way for the rest of your sober life: how to prevent relapse.
Relapse is a part of the process of getting sober and staying sober. If you spend time in the AA or NA rooms, you will likely hear stories of relapse, sometimes even after decades of time spent enjoying a sober and healthy lifestyle. Being realistic and honest in acknowledging that relapse happens doesn’t mean that you should throw up your hands and let it happen. Doing what you can to prevent relapse is an important part of the sober attitude and approach to life: take an active role in your health and do what you can now to prevent problems later.
Preventing relapse isn’t as easy as following a formula, although working a 12-step program with honesty and gusto is definitely a great plan. Preventing relapse can involve many different skills and techniques, and will mean vigilance regarding certain pitfalls or sinkholes. Cravings, and how to deal with them when they hit, are just pieces of the relapse prevention puzzle.
What are cravings? Cravings start in your brain and can become whole body experiences. Imagine cravings a certain brand of soda: it doesn’t take long before you are salivating and can practically taste that taste and feel the carbonation. Cravings are a neurochemical experience that translates into a sensory experience. Your brain pokes you and you respond with all the physical and emotional responses you know so well: longing, hunger, desperation, anxiety, obsessive thoughts…you name it, it’s part of the craving experience.
Cravings are different from the physiological need for the substance you might experience when using. The need to use to prevent withdrawal is different from cravings, as cravings are experienced when you are totally clean and sober. There is no risk of withdrawal, no chance that not using will cause a problem. Cravings are the urge, desire, and longing to use again, despite knowing what havoc that will cause.
Cravings start in your brain and that’s where you will focus your efforts to stop them. First things first: stay positive. If your sponsor or your therapist said to you “Don’t think of the color pink!” it is very likely that pink would leap into your mind despite your best efforts. Similarly, don’t move through your day reminding yourself “don’t drink” or “don’t get high.” You are subliminally reminding yourself of exactly the thing you’d like to move beyond. Eventually the thought may trigger a craving and you’ve increased your troubles. If you are struggling with thoughts of using, think positive thoughts: create a gratitude list, create an ordered list of your favorite ice cream flavors, or worst songs you ever heard, or listen to a radio station you’ve never tried before (For example, if you like country music, try classical!). Distract yourself, but not with reminders to not use; that’s a bit like nagging and no one likes a nag.
Experiencing a full-blown craving? Tell yourself a few important things about this experience: 1) it will end. Cravings, like anxiety attacks, build quickly then subside. This too shall pass. 2) If you give in and use, you will cement the neurological pathways you are trying to extinguish. Over time, the more you make it through cravings without using, the more you undo the connection. This means each time you get through a craving without using, you make it that much easier for yourself in the future. If you give in to it? You make it that much more difficult next time.
Take the “here and now” approach. If you are driving, or in a meeting, or in some other way unable to do all the self help things you know to do when you’re having a tough time (such as taking a walk, calling your sponsor, getting some fresh air, etc.), anchor yourself in the here and now. Stay in the present moment, focusing on your breath, and what you can see. If you’re driving, notice mailbox numbers or license plate numbers-anything small and inconsequential but something you can look at and pay attention to. In a meeting, notice your colleague’s jewelry or the pattern on a tie. The purpose of this exercise is to distract yourself from the craving (something that isn’t “real” but is only hypothetical) with something that is real and present tense.
Call your sponsor, your parent, your friend, your spouse. Call anyone whom you can trust to help you stay strong. You don’t have to discuss your craving, although you should acknowledge it. Talk about anything that will distract you. And wait it out-the craving will end.
Use positive “self talk” either silently or aloud. Tell yourself that you’re doing well, feeling well, and thriving in recovery. Remind yourself of your accomplishments, even if they are limited in number or scope. If you haven’t given in to this craving, you’re doing great-start there. Some addiction and recovery professionals recommend reminding yourself of your toughest times and your hardest losses that you endured while using. Be wary of this approach, though, as some people end up romanticizing and glorifying the “good old days” and inadvertently make the craving worse. As long as you can stay honest with yourself and stay clear about why you entered recovery, go ahead and remind yourself of the trouble using caused.
Cravings are only one pitfall that can lead to relapse, but they are an important one you are sure to encounter. Cravings happen, but the more you disconnect that feeling of wanting to use from actually picking up a drink or drug, the less frequently they’ll occur.
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