For people living with alcohol use disorder (AUD), ending the cycle of dependence and quitting drinking alcohol for good is a more complex process than simply stopping.
If you or a loved one has ever tried to stop drinking on your own, it is incredibly likely that even if with the clearest, most resolute intentions, what followed was a struggle against physical withdrawal symptoms, societal pressures, and one of the most powerful opponents of addiction recovery: cravings.
For people in the process of healing from a substance abuse disorder, it can be hard to talk about cravings. The people around us may understand cravings as simply something like a normal ‘want’ or desire. It can be hard to get people who have never experienced cravings on this level to empathize with what can be a deeply distracting, overwhelming, nearly obsessive thought pattern that’s pushing us to undo all of our long, hard, recovery work. It doesn’t help that they often come on the strongest when we’re already stressed out and looking for ways to cope.
It’s not as simple as not acting on cravings. Addressing cravings, learning to cope with them, and modifying behavior before they happen are all fundamental parts of a successful recovery journey from AUD. In some cases, medication assisted treatment (MAT) can support clients in handling urges to start drinking again.
Alcohol Abuse in the Brain: What Causes Cravings
Long-term alcohol abuse inundates our brains with unnatural concentrations of dopamine and glutamate, rewiring the neural pathways in our brains associated with rewards, emotions, and stress. This simultaneously dysregulates our functioning when our brains are on alcohol in ways that challenge our lives, while also creating pathways in our nervous systems that light up in extreme ways when we are reminded of alcohol after our last drink.
A craving for alcohol is therefore a direct product of a neurotransmitter imbalance, but for the most part, these cravings are brought on by implicit reminders of drinking, or ‘cues’. Consider what’s going on in the present moment when we experience the urge to drink: it is generally most intensely triggered by three factors:
- Alcohol itself
- Environmental/situational drinking reminders (external cues)
- Unmanaged stress
Alcohol cravings themselves are understood to be one of the lead factors that differentiate between individuals who successfully recover from alcoholism and individuals who relapse and get recaptured by alcohol addiction. Teaching coping and planning skills that manage the urge to drink in healthy ways is a determining facet of any successful AUD treatment plan.
9 Steps to Stop Cravings
Recovery from alcohol addiction is a long-term journey. Experiencing occasional desires to drink and learning how to handle those urges is key to avoiding relapse and making this process work for you long-term. Here’s our comprehensive guide on what to do both before and after a craving for alcohol occurs.
Commitment
If you’re here, you’re probably feeling ready to put the work in to stop alcohol cravings and prevent relapse, but let’s start at the very beginning. Remind yourself why you want to quit drinking.
Are you doing this because you want to reclaim your physical and/or mental health? Do you want to rebuild cherished connections with friends and family members? Did your job, finances, and relationships suffer due to your alcohol dependence? Remind yourself exactly why you don’t want to relapse in clear terms. Realizing the consequences of ‘just one more drink’ and internalizing what it could put at risk is a grounding part of the journey to cope with and stop alcohol cravings.
Know Your Triggers
If you want to relieve cravings, you need to know what is causing them in the first place.
Being around alcohol itself is, of course, a trigger for alcohol cravings, but it doesn’t stop there. Common triggers for alcohol cravings are:
- Places: Bars and nightclubs, restaurants, the homes of particular friends
- People: Individuals with whom you used to drink alcohol, or who glamorize heavy drinking themselves
- Situations: Vacations, events, concerts, festivals – there are a lot of situations that involve drinking, which in turn can cause alcohol cravings.
- Visual cues: Cravings can occur simply from seeing an alcohol ad, or watching a character in a film or television show have a drink.
- Emotions: Many people begin drinking heavily as a way to self-medicate stress, anxiety, or other negative feelings, bringing on alcohol cravings whenever they’re feeling anxious. Alcoholics Anonymous encourages checking in with these feelings with a useful acronym: HALT (standing for Hungry, Angry, Lonely, Tired).
It’s important to take note of what’s going on around you whenever you feel alcohol cravings come on. Not every trigger is going to be avoidable; for example, some people have situational cravings that occur after meals. Do not stop eating. Knowing what is causing your alcohol cravings can help you triage which situations you can stay away from, which ones require habit replacement, and which ones you have confident coping skills for.
Your decision to stop drinking is your own, and you don’t need to explain it to anyone. However, if you’re suffering due to a lot of external triggers in your life, but the people around you aren’t aware of it, consider how they could help you. Talking about alcoholism is hard, but anyone who cares about you will be on board to help.
Our homes can be full of environmental cues, so speak to the people you live with about your efforts to stop drinking if you haven’t already. Explain your triggers, and keep in mind that it is reasonable to ask that alcohol and drinking be kept out of shared spaces.
If someone else in your close circle is sober, you may want to suggest buddying up and looking out for each other at social events. You could do this either by going together or by checking in with one another. If you want to skip a high-risk situation entirely, you and your sober partner can support each other by planning other activities, and engaging in a shared interest together.
Audit Your Routines
When you are embarking on a sober life after a long period of alcohol abuse, you’re making a profound and fundamental change to the way you relate to yourself, your own health, and the people around you. Realistically, your new life isn’t going to be the same as the old one minus the ethanol, so don’t expect sobriety to perfectly fit into the routines and habits that you had before.
That said, it’s very easy to let your guards down before you’re ready and slide back into the same routines you had pre-recovery – inviting triggers and subsequent alcohol cravings. To avoid this, you’ll want to take stock of the situations, people, places, and behaviors that used to trigger your drinking, and assess which of these you can healthily remove yourself from.
Look at the big picture. For example, it’s not only the existence of Friday night work drinks that triggers a person who craves heavy drinking at the end of the week. This person also needs to think about how their routines and behaviors are stressing them out in the days before, bringing them to this point.
This doesn’t mean you have to up and move to a cabin in the mountains to get away from triggers but be prepared for your routines to change pretty noticeably in recovery.
Reframe
You’re probably still going to feel cravings from time to time, especially in the first six months after you quit drinking. AUD is understood as a treatable, chronic disorder with no set time limit for when its symptoms fully resolve. Stress comes and goes, and you live in a culture that unfortunately normalizes drinking alcohol to unhealthy degrees.
An alcohol craving is not something to feel guilty about or a death knell for relapse. It is just a sign that you’re in recovery. What matters is how you handle the craving when it comes.
Urge Surfing
Strong cravings are very intense, consuming experiences, and it’s not always possible to distract yourself. The good news is that they are also short-lived.
Sometimes the best thing to do is to become aware of the urge to drink when it occurs, and let yourself feel your own cravings without acting on them. When an alcohol craving comes on, withdraw yourself from any immediate access to alcohol, and then ride it out.
Pay attention to both where your thoughts go and what your body feels like. An alcohol craving may manifest as something like an itch, or you may feel a hot flash or a headache. All of these symptoms become more manageable and less scary when they’re demystified. Cravings happen, but they also stop.
Mindfulness
There are very good reasons why mindfulness is such a ubiquitous idea in the recovery community. The emotional and physical sensations associated with cravings of any kind can quickly knock us off our feet if we aren’t good at witnessing them when they happen. Mindfulness offers an easy, accessible way to build up and sustain your connection with yourself, your body, and what you’re feeling at any given moment.
When you’re being mindful, you’re drawing your attention inwards to your experience in the present, witnessing and validating what you feel without passing judgment on what it means. This skill is a muscle that you can build up in an easy, accessible way through mindfulness meditation
Mindfulness is a mindset that supports a lot of behaviors associated with successful recovery, including:
- Knowing our triggers
- Engaging fully with healthy activities and hobbies
- Reframing our lived experiences of cravings when they occur non-judgmentally
- Pursuing urge surfing
It also helps us get the most out of all the good parts of recovery. Alcohol abuse numbs us to much of life’s happy experiences, but as it leaves the system, the fog starts to roll back. Mindfulness is a practice that promotes all the positive feelings in our brains and bodies that come with recovery simply by bringing our awareness to them.
Explore Your Hobbies
Drinking alcohol stimulates the systems in our brain that deal with dopamine and pleasure, so with it gone, you need to find new healthy paths to activate those processes. This is a necessity in building a sustainable recovery and keeping alcohol cravings at bay, but it’s also one of the most rewarding parts of the journey.
Sobriety is a great time to tap into your inner child and let yourself feel excitement and enthusiasm. Reflect on the activities you used to love, the things that used to excite you, or hobbies that always inspired you but you never really put aside time to try out.
It can feel like there’s not much time to engage with activities you love nowadays, but when you cut heavy drinking (and long hangover recovery periods) from your life, you’ll find that your schedule really opens up.
Medication for Alcohol Cravings
Cravings themselves stem from a chemical imbalance left behind in an individual’s nervous systems by heavy alcohol use. In individuals who experience intense cravings, or who are not able to extract themselves from situations that trigger the desire to drink, medications can work in various ways to address these chemical imbalances in safe sustainable ways.
Research has shown that five medications can be helpful in reducing the desire to drink in individuals in recovery from alcoholism:
Acamprosate: works mildly to reduce cravings, but has the added benefit of reducing the volume of alcohol an individual drinks if they relapse. This reduces the acute health risks of drinking with a lowered tolerance.
Baclofen: A muscle relaxant with the moderate ability to reduce cravings.
Disulfiram: does not significantly alleviate cravings prior to relapse, but works by making individuals who do give in to the urge to drink severely ill, rewiring the brain’s rewards system with negative feedback and reducing cravings long-term.
Naltrexone: Available as a once-monthly injection, tablet, or implant, this medication was originally developed for opioid addiction treatment but has the promising ability to stop cravings in many types of substance use disorders in low doses.
Topiramate: an anticonvulsant medication that interacts with GABA and reduces the pleasure associated with alcohol consumption. Can be prescribed in low doses to relieve alcohol cravings.
Treatment for Alcohol Use Disorder
NP Addiction Clinics is a state-of-the-art residential addiction and mental health clinic serving clients in Port St. Lucie, Florida. We offer a full scope of evidence-based therapies and treatment modalities administered by leading specialists in holistic mental health, alcohol, and drug abuse.
If you’re ready to stop substance use for good, but are concerned about the risks posed by cravings, as well as external and internal triggers, we are uniquely poised to support your recovery. For more about our therapeutic program for alcohol abuse, treatment facilities, or to book an assessment, call us today at (888) 574-3506.
