Sunday, July 25, 2021
Julie Myers PsyD and Alex Papp MD
Cravings for drugs or alcohol are controlled by a variety of brain chemicals, including norepinephrine, dopamine, and glutamate. Many people describe their cravings as coming out of nowhere, as if these chemicals pop into their brains and create a cravings spontaneously.
These chemicals and the manifestations of cravings are actually triggered by stimuli from external environmental cues and internal mood states, particularly anxiety, irritability, and dysphoria. Environmental cues can include familiar people, places or things, for e.g., being in a favorite place that you used to use. Environmental triggers are often easier to identify than internal mood states, particularly if the moods are subtle. For example, a mildly irritating discussion may be enough to trigger a craving, although it may be difficult to identify this discussion as the trigger.
So does this mean that you are at the mercy of the environment and your own internal mood states? Absolutely not! It means that you can minimize your cravings by employing ways to control your environment and modify your mood. You have the power to choose what people, places and things you expose yourself to that might trigger a cravings. You also have the power to recognize and change your own reactions, thereby changing your mood state.
The first step is to identify your specific triggers. Try keeping a simple log of your cravings. What environmental cue did you encounter? What were you feeling? Sit down and write it down. Think about it backwards, from the time that the craving hit, backwards until you can identify something you believe triggered that craving.
If you can identify your triggers, you have taken the first step to taking control of your cravings.
There are some prescription medications that reduce or modify cravings. Perhaps the best known is Naltrexone which works on the opioid system in the brain. Campral (acamprosate) is actually FDA-approved for alcohol abuse but is perhaps less frequently used. Topiramate, a medication with a surprising number of very different uses, can also be helpful for some people for alcohol cravings.
