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Chapter 5

Managing Cravings

Craving is the desire for a drug or alcohol. An urge is an internal sensation, a subtle pressure pushing you to get ready to act on a craving. Craving is associated with wanting and an urge with doing. The urge is the feeling that comes after you begin experiencing a craving. You experience a craving or a desire to get high and then a desire to feel relief from this discomfort. The urge is the actual internal feeling of pressure to act on the craving. In between your sensation of craving and the urge to use is a moment of time (Beck, Wright, Newman, & Liese, 1993).

An urge is the intention to carry out a specific behavior. The urge can be started by unpleasant feelings such as anger, frustration or anxiety or by the expectation of an unpleasant, stressful event. If you act on your urge, you will use. Using will reduce craving and you will have a momentary reduction of frustration, anger, and anxiety (Beck, Wright, Newman, & Liese, 1993). But, you will also be back on the trail to an addiction lifestyle. That’s not what you want.

Between cravings and the urge to use is your opportunity for action. There is a time interval or delay between the craving and acting on it to obtain drugs or alcohol. This delay gives you a window of time to use control or willpower. Willpower is active. It is using self-help techniques. It is not simply passive endurance of discomfort.

Extending the time period between the craving and the use of drugs and alcohol creates a natural decrease of the craving episode. It lowers the chance that you will decide to act on the craving. The longer you

don’t act on the craving, the less intense the craving is. Urges to use are about anticipated outcomes. Urges to use anticipate a positive reward for using and feeling high and a negative experience for not doing it, such as experiencing craving (Beck, Wright, Newman, & Liese, 1993). Some people confuse an urge with a need. They say they need a drink as though they would not be able to function and would die without it. Such a belief is dysfunctional and not reality based. Dysfunctional beliefs play a huge role in the generation of urges. Dysfunctional beliefs fail to perform the function that is normally expected of a realistic belief, that is, to guide you in acting or responding in a way that supports your goals (Beck, Wright, Newman, & Liese, 1993).

Beliefs Help To Form The Expectation, Which Then

Molds The Urge To Use

Beliefs help form expectations of what we can and cannot do. Research confirms many addicted individuals hold dysfunctional beliefs that

Active

Defined by following a course of decisive action, not contempla- tion or speculation� Creates or involving

Make Your Last Relapse The Last

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keep them at risk of continued use (Beck, Wright, Newman, & Liese, 1993):

1. General exaggerated sensitivity to unpleasant feelings 2. Low motivation to control behavior

3. Low impulse control 4. Excitement seeking

and low tolerance for boredom

5. Low tolerance for frustration

6. A sense of hopelessness for ever achieving pleasure in a way that does not include alcohol or drugs

Dysfunctional beliefs play a huge role in urges and decisions to use. Recognizing and breaking down your false beliefs will help you manage your cravings. Dysfunctional beliefs fuel cravings. They are often used by individuals to justify continued use of drugs and alcohol. People use dysfunctional beliefs to ignore, minimize, and deny problems arising from their drug use. They often blame problems on something or someone other than the true source of the problems, their use of drugs or alcohol.

Dysfunctional beliefs of people who are addicted are frequently centered on the individual’s sense of hopelessness about being able to stop drinking and using. These beliefs develop over time. The individual’s original belief, I should drink or use to relax and be part

of the group, becomes I need to drink or use to be accepted. The belief is gradually expanded to include using as a response to a single negative emotion such as feeling angry. This belief is then expanded

to include using as a response to all negative emotions. I have to take a

snort when I am lonely, unhappy, angry, worried or even a little distressed.

Eventually the person is using whether they are alone, around somebody, happy or sad – it doesn’t matter. Dysfunctional beliefs gradually lead to increased use and an increased number of reasons to use (Beck, Wright, Newman, & Liese, 1993).

The depression or sadness that is always experienced after using most drugs including cocaine, heroin, or alcohol results in more craving to counteract this low feeling. The dysfunctional beliefs expand to include, I need to use just to feel better. When drugs or alcohol are taken to relieve all stress, all anxiety, all sadness, and all the natural occurring tension in our lives, it reinforces the person’s belief that they can’t tolerate unpleasant feelings or function without alcohol or drugs (Beck, Wright, Newman, & Liese, 1993).

The most commonly held erroneous belief by people who are addicted is that they have little or no control over their urges and behaviors.

The most commonly held erroneous belief by