How to Reduce the Risk of Relapse: Signs of an Oncoming Drug or Alcohol Craving

Cravings are common in recovery from drugs and alcohol. Knowing the oncoming signals and how to resist them is thus critical to avoiding relapse. Arm yourself with these helpful tips:

One way to avoid relapse into drug or alcohol use is to know the signals of an oncoming craving. The earlier the urge is recognized, the easier it is to resist.

It’s important to understand, though: all-out cravings (as opposed to twinges of temptation) are powerful opponents, capable of making things seriously agonizing before—assuming they are successfully resisted—they give up the fight. “Resist” may not even be the best word, since it implies combating an opponent strength for strength, and opponents that arise from our own brains tend to grow even stronger when we use those same brains to argue directly. It might be better to think of “defusing” a craving by turning our attention to things that make us stronger.

Regardless, most cravings can be stopped before they reach the “irresistible” stage. First, though, it’s important to understand the facts behind relapse dangers.

Risk Periods and Relapse Triggers

The riskiest period for relapse is the first 90 days after completing treatment. The second riskiest is the nine months following those 90 days. During that first year, a person has major adjustments to make, turbulent emotions to deal with, and thought habits that are quicker to remember the “relief” of substance use than the misery that followed. The more things that remind you addiction was once “natural,” and the less experience you have living life any other way, the more vulnerable you are.

Even after your first full year of sobriety, you may be at high risk for being ambushed by cravings—and giving in to them—if you answer “yes” to any of the following:

• Do you catch yourself missing your friends who were fellow users, or reminiscing about the “good old days” of getting high?
• Do you feel sorry for yourself because people “don’t appreciate all I’ve been through”?
• Do you ever think, “I’ve been sober long enough that I probably could handle one drink now?”
• Are job or relationship demands, or other challenging circumstances, placing high stress on you?
• Have you been feeling irritable or defensive for several days in a row, with or without obvious provocation?
• Are you increasingly reluctant to be fully honest with yourself, your support group or your loved ones?
• Are you having negative thoughts about non-drug coping approaches, and focusing on how you wish they’d work?

All of these constitute potential relapse triggers.

SIGNALS OF AN ONCOMING DRUG OR ALCOHOL CRAVING 

As with most illnesses, addiction/relapse is likelier to catch you unaware if you’re “too busy” or “too tired” to heed signals of impending trouble. So one key aspect of avoiding relapse is staying mindfully alert to your emotional and physical perceptions. (Mindfulness can also reduce the intensity of cravings, making it easier not to give in.)

Especially if you’re dealing with any of the high-risk areas mentioned above, a drug or alcohol craving may be trying to get at you if you notice any or several of the following signals:

• Spontaneous and persistent thoughts about addictive substances, or about circumstances under which you used them (this can be triggered by even very brief exposure to substance-related images)
• Bursts of depression, anxiety or anger (especially if you have a co-occurring mental disorder)
• Feeling that everyday sobriety practices—or healthy activities you normally enjoy—have gotten boring or unreasonably difficult
• Unexplained perspiration
• Intense hunger or thirst
• A sensation of anticipatory pleasure

HOW TO BEAT A CRAVING

It’s best to forearm yourself by planning, from the time you complete detox, what you will do if you feel a craving coming on. As already noted, head-on resistance may empower the craving more than you.

The most effective responses involve either getting away from whatever stimulus is reinforcing the craving, or reducing the attractiveness of the drug itself (sometimes by providing a more attractive alternative). Professional therapists employ a variety of technical approaches to make reduced stimuli and reduced drug/alcohol attraction a way of life, but there are techniques anyone can use to defuse immediate cravings. Most of these involve re-focusing attention. Choose an activity that takes at least half an hour (to give the craving time to pass) and that occupies your hands and/or keeps you moving (so you physically can’t reach for a “fix”).

• Find some company. Talk to a friend about something unrelated to addiction, invite someone to a movie, take the dog for a walk.
• Do something physically active or mentally challenging: a few laps around the block, a crossword puzzle, an art project.
• Especially if your craving involves “good old days” thoughts about addiction, make a list (preferably written out in longhand) of things you love about having a sober life. Or make a list of blessings in your life, things you like about yourself, ways you’ve grown up through recovery, or people who love and support you.
• Eat something healthy, or drink a tall glass of water. Many “I need to consume something” cravings can be satisfied by an alternate “something.”
• And, of course, have a sobriety partner or sponsor to call for help if cravings get severe.

It helps to prepare a list of alternate activities, in multiple categories: variety will keep life in the will to do something besides follow your cravings.

Of course, it helps to prevent all the cravings you can. If you keep up the following habits, relapse temptations will bother you less often:

• Make up your mind that attempting to return to “social drinking” is not an option.
• Stay active in a sobriety support group.
• Practice mindfulness regularly. Schedule prayer and/or meditation sessions (they can be as brief or as long as suits you) at least once a day.
• Keep a journal of your challenges, blessings and concerns. Focus all your entries on positive or at least hopeful aspects of life.
• Know your passions and your dreams. Keep a list of goals that mean a lot to you, and do something toward them every day. When you check off one goal, add a new one to keep momentum going.
• Keep feelings of deprivation out of your life. Get plenty of sleep, eat a healthy diet with occasional small indulgences (and without skipping meals), stay well hydrated, spend time with those you care about, spend time just doing nothing. If you need to temporarily skip any of the above for a legitimate reason (not for dubious “I should” activities), focus on that reason and what you will gain from doing things this way.

Finally, remember that when successfully resisted, cravings lose power and frequency over time. When you’re newly sober, it may feel that those agonizing urges will never leave you in peace, but be assured they will. Every time you do something else until the craving passes, your brain becomes more resistant to the next craving—and, soon enough, you’ll hardly remember cravings were ever a problem.

 

Sources

Dharmadhikari, A.S., and V.K. Sinha. “Psychological Management of Craving.” Journal of Addiction Research & Therapy, June 17, 2015. Accessed September 25, 2017.

Jaffe, Adi. “Craving: When the Brain Remembers Drug Use.” Psychology Today website, February 21, 2010. Accessed September 25, 2017.

Manejwala, Omar. Craving: Why We Can’t Seem to Get Enough. Hazelden Betty Ford Foundation, 2013, pp. 1–27. Accessed September 25, 2017.

Quit.com. “What to Do When Cigarette Cravings Hit.” Accessed September 25, 2017.

ScienceDaily.com. “Subconscious Signals Can Trigger Drug Craving.” February 6, 2008. Accessed September 25, 2017.