One of the most common misconceptions around alcoholism is that it’s a choice, and that a person could simply “just stop.” While there are some cases of people who quit once and never drink again, for most individuals things are much more complicated. And one of the biggest reasons is alcohol cravings.
Cravings for alcohol can be very powerful for long term drinkers, and are among the top reasons why people relapse. Fortunately, researchers are beginning to understand why cravings happen, and what to do about them. Below, we’ll share some of the best strategies for stopping alcohol cravings, and regaining control for good.
What are cravings?
We often use the word “craving” casually in our culture. But the real thing is often much stronger than simply being “in the mood” for a slice of pizza or an ice cream cone (although for people with eating disorders, food cravings can be very real). A person experiencing cravings for alcohol may be able to think of nothing else, and may even experience severe stress or anxiety if they cannot drink.
Scientists are still researching how craving works in the human brain, but it is already considered a major factor in the development and maintenance of addiction. It is generally defined as a strong compulsion to use a given substance, which is often very hard to resist.
What triggers alcohol cravings?
For people with an addiction to alcohol, drinking is deeply connected to the reward systems in their brain. Alcohol is often associated with positive experiences, and eventually with people, places, things, activities, and even times of day where drinking often happens. Any of these associations can eventually become a cue, or trigger, motivating them to pick up a drink.
For many, alcohol also plays a role in regulating emotion. When they experience stress, sadness, anxiety, irritability, or any other negative feeling, they may develop a habit of drinking to manage that feeling. As time goes on, these emotions or associations may also become strong drinking triggers.
If one of these triggers arises, and a person cannot drink, they will often experience strong alcohol cravings.
What can make this especially difficult is that cravings tend to be psychological in nature, and not necessarily tied to physical addiction. This means that if a person quits drinking, and is no longer chemically dependent on alcohol, any of these triggers may still inspire a strong urge to drink. This can be particularly hard for trauma survivors, whose drinking triggers may be connected to severe psychological distress.
For this reason, it’s very important to have strategies in place for managing alcohol cravings, especially in long-term recovery. Fortunately, some effective methods have emerged to help with this, including anti-craving medication, and mindfulness practices.
Medications that help with alcohol cravings
Over the past several decades, a number of medications have been developed that can help people cut back or quit drinking. Most of these work by limiting alcohol cravings. They include:
- Naltrexone – By blocking the pleasurable effects of alcohol, naltrexone reduces a person’s motivation to drink. Eventually, many people report a loss of alcohol cravings.
- Acamprosate – Acamprosate is intended for people who want to stop drinking entirely. People typically start acamprosate on the fifth day of abstinence, and it helps to control cravings and prevent relapse.
- Baclofen – Often used to treat back spasms, baclofen has found an additional use as a treatment for alcoholism. Some people who take it report a loss of interest in alcohol.
- Topiramate – Similarly, topiramate is generally prescribed to treat seizures and migraines. In clinical trials, however, people have also reported fewer cravings for alcohol, especially those related to anxiety. Participants have also reported less pleasure from alcohol.
- Gabapentin – Another emerging off-label medication, gabapentin is particularly effective for reducing cravings triggered by anxiety and insomnia.
In addition to medication, a mindfulness practice can be very effective in managing cravings for alcohol or any other substance. Mindfulness has its roots in ancient Buddhist practice, and is essentially a form of mental training. When used in addiction treatment, the goal of mindfulness is to become fully aware of things as they are at the present moment, and to accept them. This can be very useful in breaking mental “loops” and establishing new behavior.
What does this look like in practice? If you were having an alcohol craving, you would start by bringing your awareness to the present, and then observing the craving. You would avoid judging anything you were feeling, or trying to fight against it. You would simply let it exist, without actually following it. With time and practice, you would begin to learn that cravings eventually pass, and as a result they would become less powerful.
Essentially, mindfulness is a tool that helps you make choices about your thoughts and behavior. It teaches you to observe rather than react, strengthening your ability to “ride out” unpleasant feelings and cravings. Of course, the more often you do this the easier it becomes. Beginning a daily practice can make a big difference. This generally includes meditation, but you might also choose to set daily aspirations, or practice performing everyday activities mindfully.
Learn more about using mindfulness to overcome cravings and addiction by watching our interview with Dr. Judson Brewer.
Online programs and support
If you are interested in changing your relationship with alcohol, and are struggling with cravings, Ria Health may be able to help. Our program includes access to anti-craving medications, as well as regular meetings with recovery coaches who can help you establish a mindfulness practice. Best of all, the whole process is affordable, and accessible from your smartphone.