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Addiction Cravings: Symptoms, Treatment and Relapse Prevention

Experiencing cravings is a normal part of the addiction recovery process. According to the National Institute on Drug Abuse (NIDA), more than 85% of people in recovery relapse in the first year. A common reason for relapse is due to cravings, which are often response cues formerly associated with drug-taking experiences.1

If you or someone you care about is misusing substances or has already started the recovery process, it’s helpful to learn more about cravings and how to more effectively manage them. Keep reading to answer the following questions:

  • What is craving?
  • How long do cravings last?
  • What are triggers for drug cravings?
  • What are common alcohol and drug cravings?
  • What is relapse prevention?
  • How can you manage drug cravings?
  • What medications are used for cravings?

What Are Alcohol and Drug Cravings?

Drug or alcohol cravings are intense desires to use drugs or alcohol, which trigger an urge or intent to use alcohol or drugs. Cravings can be so strong that it’s difficult for a person to focus on or think about anything else but satisfying the urge to use the substance.2, 3, 23

Cravings are a symptom of substance use disorders as outlined by the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for substance use disorders (SUDs).3 The APA explains that cravings can occur at any time, but they’re more likely to occur if you are in an environment where you used to use or obtain the substance.3

Cravings can be difficult to withstand for people who have a substance use disorder, partly due to the way many addictive substances work in the reward center of the brain.3 Dopamine is one of the neurotransmitters in the brain associated with reward, motivation and reinforcement, and repeating pleasurable activities.4 It is naturally released in response to pleasurable activities, like eating or sexual activity.4

When a person takes drugs or alcohol, the brain’s reward circuit is activated, resulting in abnormally large amounts of dopamine. This release helps to reinforce the desire to use the substance.

Over time, this release when using a substance will cement the connection between the substance and external cues or triggers related to using. Cues can be things like the environment you used to use drugs in, people you used substances with, drug paraphernalia, or certain physical sensations.4

When a person stops using a substance and goes into a withdrawal phase, they can experience craving symptoms. After the body has adapted to the presence of the drug or alcohol, it may be difficult for a person to experience feelings of pleasure from anything else.4

Many people may relapse because the desire to experience pleasure again, and get relief from uncomfortable withdrawal symptoms, is so great.

How Long Do Cravings Last?

The amount of time a person can experience drug cravings varies depending on several factors. Someone who has a substance use disorder may experience cravings while using substances, during withdrawal, and after withdrawal and treatment. The APA points out that cravings can occur at any time, and NIDA says that people can experience cravings even if they haven’t used the substance in years.1, 2, 4

Treatment for substance use disorders typically includes an element of relapse prevention where a person learns to identify and manage cravings and cues that precede cravings. For some misused substances, medications may be used to assist in reducing, minimizing, or eliminating cravings.

What Triggers Drug Cravings?

Exposure to places, people, or things that are associated with using the substance, or that remind you of using the substance, can trigger cravings.1

Cues that trigger cravings and may threaten sobriety are often common in everyday situations such
as: 1, 4, 8, 9

  • Going to the neighborhood where you bought or used drugs or alcohol.
  • Seeing people selling drugs or alcohol.
  • Going to a bar.
  • Associating with people or friends who drink or use drugs.
  • Having just one sip of alcohol.
  • Smelling the substance.
  • Psychological stress.
  • Relationship problems.
  • Work problems.
  • Chronic pain or pain associated with medical issues.
  • Co-occurring psychiatric disorders.
  • Encountering objects associated with past drug use.
  • Seeing drug or alcohol use in the media.

Common Drug and Alcohol Cravings

Being familiar with cravings and the cues that precede, or trigger cravings, can empower you to take action to prevent relapse.

Craving drugs or alcohol can include:10

  • Physical urges to use the substance.
  • Strong intrusive thoughts about the substance.
  • A desire to use the substance so badly that you can’t do or think about anything else.
  • Significant distress when you think about the substance.

Cravings for Specific Drugs

Cravings can occur if you are dependent on a substance and stop using it and can peak in intensity at certain points during the day or week.10

Specific drug cravings can vary by onset and duration. Cravings can occur with many substances, including:

Cravings and Relapse Prevention

Addiction is a chronic, long-term condition that requires lifelong management.11 While you likely will never eliminate cravings, you can take steps to recognize what triggers cravings and learn strategies to manage them and prevent relapse.

Relapse prevention strategies can involve using skills that you learned during treatment or those that you continue developing as a part of a continuing care plan. Continuing care may include mutual help groups, like Alcoholics Anonymous or SMART Recovery programs, therapy or other services.11

Receiving proper treatment, which may include medication that helps reduce or eliminate cravings, as well as ongoing support and aftercare, can be a beneficial way to deal with cravings and remain clean and sober.

Receive 24/7 text support at your convenience with American Addiction Centers. Our team is well prepared to advise on all things treatment and help you find the care you need. We’ve helped thousands recover from addiction and we can help you too.

Addiction Treatment for Drug and Alcohol Cravings

One size doesn’t fit all when it comes to addiction treatment. Individualized treatment is important for optimizing your chances of long-term recovery.9 It takes into account many of the concerns that can impact addiction and recovery, including your medical, psychological, social, vocational, and legal problems as well as other factors, such as your ethnicity, gender, age, and culture.8

Common treatments and supports for addiction include:7

  • Detox. For many people, this can be the first step in the recovery process. It consists of a set of interventions designed to help you stop using the substance, stay safe and comfortable while your body undergoes withdrawal, and prepare you for further treatment.
  • Inpatient or residential rehab. You live onsite at a facility for the duration of treatment. You receive 24/7 care and support and participate in different treatments.
  • Outpatient treatment. You live at home but travel to a treatment facility one or more times per week. Outpatient care can occur on varying levels of intensity.
  • Dual diagnosis treatment. Addressing co-occurring psychiatric conditions, like depression or anxiety, is important because they can impact cravings and your overall recovery success.
  • Support groups. Receiving mutual support from others who know what it’s like to be in your shoes can help you remain sober.

Recovery is an ongoing process that doesn’t end once you complete formal treatment. Continuing care for drug and alcohol disorders can help you avoid relapse, maintain abstinence, and support long-term recovery.10 Continuing care may involve many different methods, such as:7, 12, 13

  • Participating in self-help groups, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).
  • Engaging in individual or group therapy.
  • Living in supportive housing, such as a sober living home.
  • Engaging in self-care, such as exercise and mind-body relaxation techniques.

American Addiction Centers maintains a strong partnership with a large group of insurance companies at our addiction treatment facilities. Start the journey to recovery and find out instantly if your insurance provider may be able to cover all or part of the cost of rehab and associated therapies.

Medications for Cravings

People being treated for a substance use disorder can benefit from recognizing cravings and the cues that precede them. Behavioral therapy is commonly used to help identify cravings, cues, and triggers.

For some substance use disorders, medication can be used to help reduce cravings, which may help you remain abstinent. There are currently no FDA-approved medications to treat addiction to cannabis or stimulants like cocaine or methamphetamine.15 However, there are medications used to treat alcohol use disorder and opioid use disorder that can help reduce or prevent cravings. These medications include:14, 15, 16, 17

  • Two of the three medications that are FDA-approved to reduce cravings for those with alcohol use disorder are:
    • Acamprosate may have some anti-craving properties and is typically used to help a person who is already abstaining from alcohol remain abstinent.24
    • Naltrexone may help reduce cravings over time by blocking the pleasurable effects of alcohol.
    • Disulfiram does not help to reduce cravings, but if you do relapse it induces unpleasant symptoms that may make you less likely to continue drinking.
  • The three medications FDA-approved for opioid use disorder are each effective at decreasing cravings for opioids:25
    • Buprenorphine or methadone can reduce cravings for opioids during withdrawal management, post-detox during rehab treatment, and as part of an aftercare plan.
    • Naltrexone blocks the effects of opioids and can be used following withdrawal from opioids as part of a long-term care plan for managing opioid use disorder.

Support and Therapy for Cravings

Managing cravings usually requires a multifaceted approach to help prevent relapse. Behavioral therapies, support groups, and other forms of treatment can help a person overcome cravings, reduce the risk of relapse, and help to deal with relapse if it should occur.

A few common therapies and forms of support that can help manage cravings include:5, 9, 18, 19, 20, 21, 22

  • Cognitive behavioral therapy (CBT). This can take place in groups or on an individual basis. CBT teaches you ways to manage cravings and develop healthier stress management and coping skills so you can avoid relapse.
  • Contingency management (CM). This is a form of treatment based on positive reinforcement. You receive rewards or tangible goods in exchange for positive behaviors so that you are motivated to remain abstinent.
  • Mutual support groups. These groups can include 12-step groups like AA or NA, or non-12-step groups like SMART Recovery. By receiving support from others who are also in recovery and learning strategies to deal with cravings, you may be able to maintain your resolve to avoid substances and overcome cravings.
  • Mindfulness-based relapse prevention (MBRP). Learning mindfulness skills can help you ride the wave of cravings and help you maintain a non-judgmental, accepting attitude throughout your recovery journey.
  • Distraction strategies or therapies, such as music therapy or art therapy. Receiving music or art therapy in a group with others can serve as a helpful way to temporarily relieve cravings and manage addiction.
  • Stress management techniques like yoga. Stress can play a role in cravings and relapse, so managing your stress can be a helpful way to remain sober. Different methods work for everyone, but one study showed that yoga can be helpful for cravings and overcoming triggers to relapse.

Although dealing with cravings isn’t easy, it is possible to recognize the cues that precede cravings and overcome relapse triggers. Addiction treatment can help you develop the skills you’ll need to remain sober and manage cravings.

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