Cravings are one of the 11 symptoms of addiction. Cravings are an intense desire for a drug or alcohol; often due to a dependence (both physical and psychological). Cravings are an important aspect to treat, but it should be noted that cravings are just the tip of the iceberg when it comes to addiction treatment; afterall, cravings are just one of the 11 symptoms.
However, cravings will happen in recovery and for this reason, we must know how to keep them at bay. Without knowing how to properly cope with cravings, relapse may be inevitable. There are a variety of ways to help cope with cravings; some are through medications and others are through therapy techniques and coping skills learned from a relapse prevention program.
Cravings can be hard to describe as the need or burning desire to use so high that it almost feels as though life itself is dependent on taking the substance. You might have heard people say, “I am craving some chocolate right now,” but this is not the same craving. People will go to extreme lengths, bypassing any morals, to achieve an end to their craving.
How Long Do Cravings Last?
Cravings will last depending on the person, their drug of choice, and how dependent they are to the drug. Some might last 20 minutes while others might feel them for up to 2 hours. Ultimately these cravings will subside. For this reason, many of the management strategies for cravings involve distraction.
We often use medications to help with cravings. For example, imagining studies show an increase in dopamine when participants are shown cues such as drug paraphernalia. When looking at cocaine specifically, the brain will ‘light up’ with neuro-activity when exposed to these cues. Through the use of medications that impact dopamine, we can modulate the cravings to a certain extent. The fluctuations of dopamine are harsher during active addiction, and for this reason cravings are much more intense. As a result, the longer a person abstains from their drug of choice, the lesser their cravings appear and the lesser the intensity.
For opioid, alcohol and nicotine addictions, we have strong medications that decrease cravings and we can use those meds along with coping skills approaches to treat your cravings.
Medication-Assisted Treatment (MAT) for Opioid Cravings
A common finding from scientific research studies that looked into buprenorphine was its effectiveness at decreasing cravings. The partial-opioid quality of buprenorphine seems to fulfill this burning desire of the brain such that cravings tend to be very little. If you have strong cravings during buprenorphine maintenance, talk with your medical professional about increasing your maintenance dose. We will often recommend a maintenance dose up to a maximum of 16mg everyday till cravings are well handled. There is some information that dosages of buprenorphine greater than 16mg each day offer decreasing returns for craving reduction, so you might get a targeted 16mg dosage.
Abstaining medications such as injectable naltrexone also seem to minimize cravings, however this may be through a various mechanism. The naltrexone medication does not technically ‘satisfy’ the opioid center in the brain as does buprenorphine. Instead, there is something psychological happening. When a person is ‘shut out’ from using opioids and does not truly have gain access to, cravings tend to diminish. The inverse of this is likewise accurate. Cravings to consume can be so strong that the individual just caves and relapses if an alcoholic buys a pub and invests a lot of time around alcohol. We pay attention to about substance access in early healing.
Alcoholism Approaches using MAT
The most studied medication revealed to minimize cravings to consume alcohol is naltrexone. Although this medication was at first established to prevent opioid usage, it has actually revealed through various research study studies its efficacy for alcohol addiction. The mechanism for this is not entirely comprehended. Since alcohol triggers a couple of various neurological paths in the brain, we understand clinically that the opioid and pain pathway is likewise included. Through blocking activity in the opioid receptor through naltrexone, feedback loops that trigger cravings to drink decreased.
Other medications that have been shown to be helpful in reducing alcohol addiction cravings include glutamate modulators. These include such meds as gabapentin and topiramate. Interestingly, these are also anti-seizure medications. Through helping the nervous system efficiently relax, the private reports less cravings to consume. Of note, these medications are thought about off-label techniques to deal with alcoholism, whereas naltrexone is FDA approved to treat alcohol addiction.
MAT for Nicotine Cravings
Medication can be used to help avoid relapse on tobacco. Nicotine replacement products such as patches or gum can be utilized to help treat withdrawal symptoms and to relieve strong cravings to smoke. Other medications such as bupropion and varenicline have very good data supporting their usage in tobacco cessation. In fact, the statistical numbers for these medication approaches show success rates in between 63 and 71%.
Talk to your doctor about the medication choices if you are making a pursuit to quit tobacco. The strong efficacy of these approaches reveals that they are very helpful tools and ought to be utilized strategically to help enhance your efforts.
Coping Skills for Cravings
There are several coping skills to find out to enhance your recovery. Skills used to handle cravings are divided into 3 various classifications:
- Distraction strategies
- Talking skills (Either talking with others or ‘self talk’).
- Urge surfing
Distraction Techniques.
It is necessary to remember that cravings can be exceptionally effective, but do not last forever. Many people will report that cravings last 20 minutes or less. This is especially important when we’re talking about distraction as a useful technique. By inhabiting your brain with a focused activity, the mental energy dedicated to the craving is taken away. Good examples of distraction consist of:.
- Eating a treat
- Listening to music
- Reading a blog article
- Choosing a walk or other brief exercise
Talking Skills
We break talking into 2 categories: Talking with others and Self-Talk. Each includes moving the unconscious process of craving to something a lot more mindful. This is comparable to bringing the skeleton out in the open and into the light (cravings and addiction enjoy the darkness …).
Interaction prevents you from being ‘blind-sided’ by the cravings and prospective substance abuse. Even if you are talking to yourself, you can self-validate that the cravings are typical and will not last permanently. Here is a quick script of how this can go:.
You: I’m actually struggling here! If I can do this any longer, I don’t even know. These cravings just burn at me …
Listener: I get it. What do you need? Is there anything I can do to help you out? You aren’t fighting alone any longer!
You: Thanks for just sitting with me. That helps more than you ‘d think!
Urge Surfing
This coping skill is the most abstract of the three, in that it welcomes some mindfulness techniques. It is a little various than distraction skills based on how it feels. You begin feeling agitated and after that gradually feel grounded and more physically focused. The conscious components include remaining very present with how you feel, avoiding judgments about your thoughts and feelings, and essentially staying ‘still.’.
This concept of being ‘still’ is also abstract, in that you can urge surf while remaining physically active, such as riding your bike. It instead implies that you are very much accepting the craving sign without a drive to change it. Interestingly, the more you release the craving and accept what it is, the less power it will have over you and the sooner it will leave.
The imagery used for urge surfing often can include water such as a real wave crashing into a stream or the shore flowing past. You might imagine the power of the stream and feel the approval that you can’t really put pressure to stop the powerful energy. You rather trust that the craving will be washed out of sight with time. This method stresses persistence and the peace that the craving will decrease by itself.
Final Thoughts
Helping people to comprehend cravings as a normal part of the healing procedure is needed to completely recover from dependency. We can utilize some medication approaches to help, and this depends on which form of dependency you experience. Learning efficient coping abilities is always important and can be utilized for cravings for any and all types of addiction.
