Curbing Cravings and Preventing Relapse
Drug and alcohol cravings are a normal part of recovery. The best way to deal with them is to learn to not only recognize them, but to use new coping skills to overcome them. If you are concerned about a possible relapse, seek addiction treatment immediately.
Craving Symptoms and Treatments for Specific Drugs
The specific characteristics of cravings and the treatment for them can vary based on the drug. Below you'll find links to pages with more information about cravings for specific drugs.
Signs and Symptoms of Cravings
Knowing the signs and symptoms of cravings can help you identify them and, importantly, cope with them. Some general signs and symptoms of substance cravings include:
- Preoccupying thoughts about the substance.
- A desire to return to old using environments or see old using friends.
- Wanting to use drugs or alcohol when in the presence of them or near something that reminds you of them.
- Buying substance-related paraphernalia.
Onset of Cravings
Onset and duration of cravings can vary depending on the substance abused. For example:
- Crystal meth cravings can begin anywhere from a few hours to a few days after the last dose but can then last for years due to alterations in brain structure and function believed to be caused by persistent, heavy use. 1, 2
- The onset of prescription opioid cravings will depend on whether the drug is short- or long-acting. Short-acting opioids can cause cravings as soon as 6-12 hours after the last dose. Cravings for long-acting opioids may not begin until about 2-4 days after the most recent dose. 1 Cravings for opioid painkillers can last for weeks to months. 1
Treatment and Medications
Different treatments are available to help curb cravings and prevent relapse. Don't be afraid to ask for help if you have strong urges to return to your drug-using habits.
Each form of cravings treatment has pros and cons. It all depends on what best suits your unique needs.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy works to improve negative thoughts to positively influence feelings and behaviors . Therapists teach you different coping skills to be used when you experience cravings or are in the presence of triggers.
Some CBT techniques include: 3
- Self-talk: Encourage yourself and remind yourself how far you've come in recovering from addiction.
- Avoid trigger situations: Sometimes the best way to battle cravings is to figure out ways to stay away from trigger environments and people, such as old using friends or old using locations.
- Relaxation: Use guided imagery, count backwards from 10 to 1, or take slow, deep breaths when experiencing cravings.
- Talk it out: Many recovered addicts find that cravings lose their power when they discuss them with a family member, friend or sponsor from a 12-step program.
- Distraction: Engage in a sober activity that will take your mind off of your substance cravings. Try a hobby or form of exercise that you enjoy, or hang out with sober loved ones.
Many people attend 12-step meetings for life to curb cravings, to receive positive encouragement and support, and to connect with others with similar experiences. Typically, members of these programs have sponsors - people they can confide in. If you are experiencing substance cravings, calling your sponsor to talk it out can be helpful in avoiding relapse.
Inpatient Rehab Programs
If you are experiencing very strong and persistent cravings, you may want to enter an inpatient treatment program in which you can reside at the facility and escape from the tempting environment.
You'll receive individual therapy, group counseling, medical treatment (if necessary) and aftercare planning .
Outpatient Rehab Programs
If you are seeking cravings treatment but can't neglect your responsibilities at home, work, or school, then an outpatient recovery center may be best. You can live at home while receiving treatment to prevent relapse and overcome cravings.
Individual Therapy and Group Counseling
- Alcohol cravings. Medications to help with alcohol cravings include naltrexone , acamprosate (Campral) and disulfiram ( Antabuse ). 4
- Marijuana cravings. There are no FDA-approved medications for the treatment of marijuana addiction and dependence. But some medications have proven effective in research trials: Ambien, buspirone and gabapentin. 5
- Heroin cravings. Medications that may help reduce heroin cravings include methadone , buprenorphine and naltrexone. 6
- Cocaine cravings. No FDA-approved medications exist for the treatment of cocaine dependence and cravings. But some medications used to treat other diseases are being researched: disulfiram, topiramate, modafinil and vigabatrin. 7
Stopping Cravings Naturally
If you are not comfortable taking medication or attending treatment, you can try to combat your cravings naturally without pharmaceutical intervention. These natural remedies include:
- Exercise. Exercise has proven effective in helping to curb alcohol and drug cravings while in recovery. If you are experiencing cravings, go for a walk or run, lift weights or play a sport that you enjoy. 8
- Meditation. Meditation and mindfulness can help to alleviate stress associated with alcohol and drug cravings and prevent relapse.
- Diet. Often, substance addiction leads to a poor diet and health problems. Improve your diet and eat healthy, balanced meals to provide your body with the appropriate nutrients.
Cravings and Relapse Risks
The warning signs and how to address them are as follows:
- The dismantling of social relationships. Call or meet with your sponsor if you're a member of a 12-step program, confide in a group of sober and supportive friends or discuss your concerns with your therapist.
- Believing that you can use alcohol or drugs without falling back into addiction. Remind yourself that recovery is a lifelong process and compulsion is a normal part of the process. Use positive self-talk or distraction strategies learned while receiving cognitive behavioral therapy.
- Romanticizing your past substance abuse. Make a list or inventory of all the things you enjoy about your healthy, sober life. This will put things into perspective.
- Sudden loss of interest in hobbies or recreational activities. Make a list of your favorite hobbies and begin scheduling times to do them. It may be difficult to get started. But over time you will likely find joy in these activities again.
- Sudden changes in behavior and attitude toward recovery. Don't ignore negative and uncomfortable emotions. Use coping self-talk or meditation to promote a peace of mind.
- Beginning to reconnect with old using friends. Avoid using environments and schedule sober activities with a group of non-using friends. Join a 12-step program or SMART Recovery to find a supportive and sober group of friends.
How Long Do Cravings Last?
There isn't one answer as to how long your alcohol or drug cravings will last. Typically, cravings will decrease over time. But they can persist for years.
- The amount used.
- How long you used.
- Whether you tapered off the substance or not.
- Your mental health.
- Your physiology.
Triggers for Cravings
A few triggers can activate cravings:
- Major life changes.
- Returning to old using environment.
- Being around the substance or paraphernalia.
If you're looking for cravings information about a specific substance, see the craving symptoms and treatment section at the top of the page for more details.
Find Recovery Programs
. Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
. University of Washington. "Methamphetamine Addiction Mechanism Discovered, Explains Why Cravings Last So Long." ScienceDaily, April 10, 2008. Available at: http://www.sciencedaily.com/releases/2008/04/080409120619.htm
. Cully, J.A., & Teten, A.L. (2008). A Therapist's Guide to Brief Cognitive Behavioral Therapy. Department of Veterans Affairs South Central MIRECC, Houston.
. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Alcohol Addiction. Retrieved January 7, 2016, from http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/pharmacotherapi-1
. National Institute on Drug Abuse. (2015). Available Treatments for Marijuana Use Disorders. Retrieved January 7, 2016, from http://www.drugabuse.gov/publications/research-reports/marijuana/available-treatments-marijuana-use-disorders
. National Institute on Drug Abuse. (2014). What are the treatments for heroin addiction? Retrieved January 7, 2016, from http://www.drugabuse.gov/publications/research-reports/heroin/what-are-treatments-heroin-addiction
. National Institute on Drug Abuse. (2010). What treatments are effective for cocaine abusers? Retrieved January 7, 2016, from http://www.drugabuse.gov/publications/research-reports/cocaine/what-treatments-are-effective-cocaine-abusers
. Smith MA and Lynch WJ. (2012). Exercise as a potential treatment for drug abuse: evidence from preclinical studies.Front. Psychiatry 2:82. doi: 10.3389/fpsyt.2011.00082