Drug Rehab Center

 By Geoff Thompson – MA, CCC
Program Director, Sunshine Coast Health Center

Many fellows who leave Sunshine Coast Health Center often feel that early recovery is like a minefield of situations, events, emotions, places, people and things that trigger their desire to use drugs. This month’s online program will give you five strategies and techniques to help you navigate safely through the triggers and cravings.

‘Triggers’ create ‘cravings’, so we often use the terms interchangeably. A trigger is anything that you, consciously or unconsciously, link with drug use. Common triggers are payday, Friday after work, sitting in a bar, getting into an argument, and boredom. And triggers are specific to each person; one person may be triggered by payday, while another is not.

Clients often believe they have received good treatment at Sunshine Coast because “I haven’t craved drugs for three weeks!” They lucked out. Triggers and cravings are a normal part of early recovery, and everyone in recovery experiences them. Chances are that eventually most if not all clients will have a craving.  Since cravings are a natural part of recovery, individuals with addictions might as well learn to deal with them. It’ll make life a lot easier.

The great news is that triggers and cravings will go away. Recovering individuals are NOT doomed to a life where cravings will continually create havoc. Remember that. Individuals who follow their recovery program will find that cravings go away. So noone has to live the rest of their lives with a dagger hanging over their head. But also remember that one of the jobs of someone in early recovery is to trudge the happy road of destiny until the desire to use is gone.

Tip #1 – Be aware of your triggers

Most people in recovery probably know their own triggers. At the same time, these same people are also likely unaware of many other triggers. The reason many people are unaware of their triggers is because the mind automatically links certain ‘things’ with drug use, whether or not it’s done intentionally.

Remember Pavlov and his dogs? Pavlov noticed that when dogs ate, they salivated (which helps the dog digest food). He rang a bell and then gave the dog food. After he did this repeatedly, he then just rang the bell and did not give the dog any food. He noticed a remarkable thing: the dog salivated at the sound of the bell (not because of the food). The dog’s mind had unconsciously linked the bell with the food. Interestingly, even single-cell creatures link a stimulus with a reward, so this is a property of all animal life.

Think of a trigger as Pavlov’s bell. When someone has been drinking and drugging for a long time, the mind has linked certain stimuli with getting high.

Of course, the great news is that Pavlov also demonstrated how to extinguish the trigger. He repeatedly rang the bell but did not give the dog any food. The first few times, the dog continued to salivate at the sound of the bell, but as Pavlov kept ringing the bell (with no food), the dog’s mind eventually ceased to link the bell with food and stopped salivating.

So, if individuals want to extinguish the triggers, the bottom line is don’t use after being triggered. Eventually, the mind will stop linking the trigger with drug use. The point here is that individuals in recovery are not doomed to struggle through cravings forever. They go away…as long as individuals don’t use.

Tip #2 – Bring it on!

Everyone in early recovery has triggers and cravings. That’s an important fact, because it means that triggers and cravings are natural and expected. Unfortunately, many recovering people think that triggers and cravings are ‘bad’. When individuals think this way, then they are frightened of them. And…here’s the kicker…when individuals are frightened of triggers and cravings—they are their own worst enemy.

Research has shown that the fear of cravings will actually make them stronger and very likely will help bring them on. This is worth emphasizing. It is the fear of the cravings and not the cravings themselves that make dealing with them so difficult.

So, a tool for anyone’s relapse prevention toolbox is to develop a new attitude toward cravings. If individuals want to make their lives a lot easier, tell themselves that they’re a lot tougher than a craving.

One of the best techniques is to wake up each morning and say out loud: “I want to be triggered today with the worst cravings in the history of recovery. We’ll just see who’s tougher—the craving or me! Bring it on!” Strange as it may sound, this technique works really well. (For those interested, in psychology this is called “paradoxical intention,” and it is used to help people overcome all sorts of struggles.) In fact, the act of someone demanding to be triggered will likely mean that that same individual won’t be…or that the trigger will not be very powerful. The reason for this is that the FEAR that makes cravings powerful; if the individual is not afraid of the cravings, then the craving isn’t as powerful.

Tip #3 – Maintain physical health

Triggers and cravings are a natural part of the recovery process. There is nothing ‘bad’ about them; in fact, they are a sign that the individual is getting better.

Another proven way of dealing with cravings is maintaining physical health. Eating healthy meals, exercising, sleeping well, visiting physicians and dentists, etc, are known to ease the power of cravings.

Dr. Roy Morton, medical director of Royal Columbia Hospital in New Westminster and an expert in recovery, says that he can always tell who is craving drugs because they eat green apples. Dr. Morton has a good sense of humor, but his message is important. And Dr. Morton would also emphasize the importance not only of eating right, but also of exercising and sleeping well.

Remember HALT: Hungry, Angry, Lonely, Tired.

Tip #4 — Talk

Another tool for dealing with cravings is to talk. Individuals can talk to themselves or they can talk to others. Here is one of the most powerful things that anyone can tell themselves when the cravings hit: “This is temporary.” Perhaps, the most studied cravings are nicotine cravings. The average ‘nic-fit’ lasts seven minutes. Smokers in early recovery who don’t understand that the craving will soon pass usually become desperate, feeling as if they need to smoke or else. But the reality is that if they could make it through seven minutes, the craving would pass. Another thing you can remind yourself of is that cravings are a sign of health; you are getting better.

Talk to others. One of the most important psychological benefits of talking about cravings is that doing so closes the back door to drug use. If an individual does not talk about cravings, there is a real danger that, since no one knows they’ve been triggered, they might pay attention to using. 

Some of the alumni at Sunshine Coast report being worried that if they tell their family about the cravings, the family might worry. But it is well known that in recovery, it’s important to talk about cravings.

Individuals who talk to themselves or tell people about tehir cravings allows for a gain in perspective. In active addiction, individuals simply react…most of them didn’t even realize they had a choice. Pulling back from the cravings ,and looking at them for what they are, allows people in recovery time to ‘play the tape out to the end’, remember what using will lead to.

Tip # Five—Don’t test yourself

It is one of the more odd things in recovery that some people think it a good idea to test themselves. Some typical examples: One person kept a case of beer in the fridge because he reasoned that he only craved a drink when there was no beer; having beer in the fridge would eliminate the cravings. Another person went to Vancouver’s Downtown Eastside just to see how ‘strong’ his recovery was.

When we look at these examples as objective outsiders, it is clear that the ‘test’ involved a lot more than merely dealing with cravings or discovering how good his recovery was. In fact, both relapsed. It was, not to put too fine a point on it, a setup.

Cunning, baffling, powerful. Slick often tries to fool us. The person with the beer in the fridge actually wanted to drink but was too guilty to simply admit it. So, he invented the silly idea as a way to circumvent what he was really feeling. And the fellow in the Downtown Eastside simply wanted to get loaded. Like the alcoholic, he could not be honest and admit he wanted to get loaded, so he invented an excuse to go the Downtown Eastside, hoping (knowing) that someone would offer him drugs.

Although triggers and cravings are natural and expected, it isn’t a good idea to get triggered unnecessarily. Individuals in recovery will get enough cravings without going out of their way to create them. It’s not that they will necessarily have a slip, but it’s always good for an individual to load up the odds in their favor.

Tags: addiction, cravings, Dr. Roy Morton, early recovery, HALT, Pavlov, recovery process, Royal Columbia Hospital, triggers, Vancouver Downtown Eastside

This entry was posted on Thursday, February 19th, 2009 at 1:35 am and is filed under Addiction Recovery (Life After Treatment), Exploring Addiction, Geoff Thompson. You can follow any responses to this entry through the RSS 2.0 feed. You can skip to the end and leave a response. Pinging is currently not allowed.