Cravings are one of the biggest challenges of recovery. A craving is the feeling that you absolutely must use or you will go crazy. Even if you know rationally that using would be bad, that you don’t need to use, and you really shouldn’t use, you still obsess over using again. What makes you stubbornly refuse to submit to your own best judgement?
When you’re first trying to quit, cravings make perfect sense. You are used to having a certain level of a substance in your system, and when that level drops, your body senses there’s something wrong and you want more. When you detox, it is especially bad because the absence of the drug may cause some nasty symptoms. You know the symptoms would stop if you could only use one more time. You crave a substance because you need it to get back to normal.
What about after detox, when the drug is out of your system completely? At that point, your brain chemistry is still unbalanced. You may have too little GABA in your system or too few dopamine receptors. Your brain may be overrun with glutamate. Many people experience post-acute-withdrawal syndrome, or PAWS, for many months after detox. They may feel emotionally numb or feel like they will never experience pleasure again. When you’re in this kind of state, you are likely to crave the positive feelings you remember from using.
Even people who have been in recovery for a while experience cravings. For these people, and for people just starting recovery too, cravings are typically caused by triggers. Triggers can be anything associated with your addiction. People, places, smells, situations, and stress are all common triggers.
Our brains mostly work by association and habit. Once a behaviour has become habitual, you only need a cue, or a trigger, to begin. If you see the cue but don’t complete the habitual behaviour, you feel like something is wrong. You feel uncomfortable. You experience the need to complete the behaviour as a craving.
Brain scans of people who have struggled with addiction for a long time show that the connection between their prefrontal cortex and the brain’s reward centre becomes weak. That means, the longer you are addicted, the less your better judgement controls your behaviour related to addiction. You are basically on autopilot. Reasserting control becomes difficult because you are struggling against a cognitive process that doesn’t need or want your input.
The good news is that cravings will eventually become weaker and less frequent. With persistent effort, motivation, and support, you can regain control.
Smarmore Castle Private Clinic in County Louth, near Dublin was founded in 1988 as a residential rehabilitation hospital treating people suffering from drug and alcohol purposes. Smarmore Castle believes in helping patients lead a life of abstinence through 12 Step programmes, detox and medical treatment, psychotherapy, and complementary therapies. For more information, please call 041-214-5111. For those who live out of the country, the international number is 00353-41-214-5111.
Last updated & clinically assessed 30 March, 2022