CRAVINGS 2021 update-1

www.takingtheescalator.com CRAVINGS : Basic Principles 1. Giving into cravings only makes them stronger for the next time. When you give in to the craving, you renew the pleasurable memory associated with the substance, making the urge to use even stronger next time. (For example – try to eat just one cookie. Once that first cookie is gone, the craving to eat another can often be irresistible in intensity. Therefore, it is often much easier just not to eat that first cookie rather than to try to just have one) 2. Complete abstinence is the surest, quickest way to reduce craving as cravings tend to reduce over time when the substance being craved is no longer being used. Therefore, controlled use and use in moderation can be quite challenging (and for some, impossible) For some substances there are medications that help reduce and control cravings. No matter what path is chosen (abstinence or harm reduction) learning to manage cravings is highly important, so an array of practical coping skills and positive supports is essential 3. Determination and willpower, although helpful, they alone are poor long-term defenses against craving. Lifestyle change used effectively in combination with determination and willpower is often the best defense. It is helpful to be motivated mentally and determined not to give in when it comes to coping with cravings but making life changes to limit the amount of cravings being triggered by our senses is one of the best solutions for limiting the frequency and intensity of cravings. In other words, although it is helpful to be determined and to have strong willpower, it is also important to look at ways we can change our lives to avoid situations which remind of substance use. 4. *Relapse, (a regression back toward use after a period of upward change) happens, but you have the choice between a setback and a relapse : ➢ You get right back on track back after a setback immediately. In other words, if you mess up, get right back up and keep going- Don’t hide it – Seek out more support. The idea is that when a setback happens, it does not have to be the end but rather it is important time to make adjustments and keep moving forward. ➢ Avoid the “relapse” or “fall” mentality- For example: “Oh well, I relapsed so I might as well just give up and go on a binge” or “I blew it now, I guess this quit attempt is over now, time to go back to using again! ” “What’s the use of trying anymore since I messed up” This type of th inking is akin to a person on a diet quitting the diet altogether after one night of overeating instead of just waking up and continuing the diet the next day. 5. Craving is a natural after-effect of any habitual pleasurable behavior so cravings are to be expected and to some degree may be unavoidable. However, you have the choice to conquer them rather than be their slave. 6. Research indicates that the intensity of the average craving can decreases in a matter of minutes, (Mayo Clinic, 2011). A craving will usually naturally subside with time if you can just ride it out. Cravings, although frequent and intense at times are temporary. Therefore, the primary focus when experiencing craving should be to just get away from the source of the craving and use appropriate skills to refocus our minds. Based on these principles, those who are successfully able to learn to cope with cravings often have a variety of coping skills at their disposal. Next is a list of effective tools for coping with cravings:

www.takingtheescalator.com COPING WITH CRAVINGS – SKILLS LIST 1. MANAGE YOUR ENVIRONMENT – If something, someplace, or someone sets off cravings or urges to use, simply stay away, leave, avoid contact, develop alternate plans and substitute activities. Think about what is causing the urge and get away. This is the most important piece to the puzzle when it comes to coping with cravings because it is the most proactive strategy. Planning ahead to avoid aspects of your environment that can trigger cravings is perhaps the most effective thing that you can do in order to decrease the frequency of experiencing cravings. 2. SEE IT THROUGH TO THE END- When thinking about using do not neglect to consider how you feel at the end, when whatever it is that you have used is all gone. Think about the disappointment you will feel. Think about how you will wish you had done something else instead of using. Think about all of the lies and/or excuses you will have to make to cover up. Think about the trust you’ve worked so hard to regain and how hard you have worked staying clean up to this point. Remember: consequential thinking ; Take time to remember the hangovers, feeling sick, wasted $, arguing with family, etc. Always remember that giving in to the craving now will only make it harder in the long run. Sometimes giving in can be like knocking down a house of cards that you painstakingly took the time to build, card by card. You may have previously experienced that awful “morning after” feeling that comes when you wake up the next day after a bad night. If you can just learn to remember that feeling and become determined not to feel that way again you can achieve a lot when it comes to increasing your motivation not to give in to your cravings. 3. DISTRACTION TECHNIQUES: ➢ Change the Channel – Mentally, that is- just push the cravings right out of your mind by thinking of something else. Get up and do something else. Try hard to think about something that requires your focus and distracts you from your craving, even if only for a little while. Your mind will likely keep changing back but keep changing the mental channel until you ride out the craving ➢ Use the Phone – Get on the phone quickly with a supportive person who can help you ride out the craving. Try to find a helper beforehand that you can call that you know will say just the right things to help you avoid giving in to cravings ➢ Alternate Activities – Free time is deadly with cravings. Get out and do something safe. ➢ Reverse Tomorrow Trap – Remember when you were using, and you kept that up by promising yourself “I’ll quit tomorrow” day after day? Well, in this case, now that you are not using , just do the opposite by telling yourself that you will wait until tomorrow to use instead of using and giving in right now today. (The idea of course is to wake up tomorrow and do the same thing by continuously pushing off the idea of giving in to your cravings, very similar to the “One Day at a Time” concept that is so effective in the 12 Step model (Alcoholics Anonymous)

www.takingtheescalator.com The best and most practical way to utilize this coping with cravings skills list is as follows: 1. Everyone should automatically be working on the first item: Managing your environment . It cannot be understated the value of effectively managing who, what and where you associate yourself with when trying to positively change your behavior and manage cravings. Before you face cravings you really should be thinking about what adjustments you can make in your life to prepare yourself and to minimize exposure to any reminders that can trigger cravings in your mind 2. Next go through the skills list and decide which will be your primary skill for coping with cravings. It may be good to discuss this with others and then practice and prepare to use the skill as needed. Pick a skill that plays to your strengths. For example, if you are a person with strong faith, then prayer may likely be a good craving coping skill for you. Or, for example if you are a person who enjoys exercise and have the time to readily be able to do so, the n picking “Get Moving” would be a good choice. Try to anticipate a skill that you will most want to use when the time comes that you experience a craving. 3. Finally go through the list and pick a secondary skill to use if the primary skill is unavailable or is not working. This secondary skill may need to be quite different than the primary skill to serve as a “safety net” when the first one just isn’t helping you push past the craving like it’s supposed to. For example, if you picked something active like Alternate Activities as your primary skill for coping with cravings then perhaps a good secondary skill may be something more mental and emotional such as Care for Your Feelings Discuss your plan for managing cravings:

www.takingtheescalator.com COPING WITH CRAVINGS: Proactive Exercise – Due to the importance of this issue of coping with cravings, in order to fully understand these skills, the following is an exercise based on some varying scenarios involving cravings. It is important to understand the concept of being able to match craving coping skills with the situation and personal attributes of the person undergoing the cravings. The goal is to understand better what tools likely work best in certain situations. Directions : In each of the following cases below, select the most appropriate tool to use for coping with cravings: What would be your first choice? What is your second choice as a back up to the first one? 1. James is a spiritual person. He says he has faith, but he hasn’t done much spiritually lately because he had been using a lot of ecstasy and acid, which had been clouding his thinking. James has been clean for a week now and he wants to stop using but he’s been having trouble staying stopped. It’s Saturday night and he knows that his neighbor is having a party next door a nd that he’s always invited. He really is craving to go there and get high. 2. Larry doesn’t necessarily want to stop getting high, but he knows that he has to. He is in big trouble with his family because of smoking weed and getting caught at work. His parents asked him to attend an outpatient program where he gets tested every week. It’s Thursday and Larry just got paid. His parents don’t know it, but Larry likes to have a few beers now and then. Larry would love to guzzle down some beers with his best friend who is probably waiting for him to call. Larry remembers the last time he drank he ended up smoking his brains out because his friends always have some weed on them. Now it sounds even more tempting to Larry. 3. Joyce is doing well. She’s been clean for 2 months and she will soon be graduating her intensive outpatient program. She actually has made a couple friends that aren’t into getting high or drunk. The only problem is that today is her first day going back to her dorm at college and she knows that her old friends are going to have drugs on them. Actually, she is thinking about just going ahead and getting high. “Maybe I’ll just tell let myself use and then tell my counselor later that I relapsed ”, she thinks to herself. 4. Terri just got out of rehab for doing heroin. She’s been able to stay clean for a few weeks and she feels it’s been actually pretty easy. She just avoids her “dope friends” and just hangs out with her other friends and watches them smoke pot. She hasn’t smoked herself because she’s on probation; however, tonight she’s feeling the urge. It’s the anniversary of her uncle’s death and she hasn’t spoken to anyone about it. The bong is coming her way…. 5. Tom hated Narcotics Anonymous at first because he still had reservations about using. Recently though, Tom has started to like it. He’s been sharing at meetings and getting to know some other recovering addicts. It’s almost been 90 days and Tom feels like celebrating. Unfortunately, tonight Tom is thinking about celebrating with a few lines of c oke. After all, that’s how he has always celebrated in the past. What craving tools did you decide were best in each scenario? Has this exercise helped you think about what craving tools are best for you, based on your personal needs and strengths? By this point the idea is that there is a greater understanding of: • The nature of cravings and what is involved the process of overcoming them • What is involved with avoiding situations that trigger cravings • Overview of the skills needed to overcome and endure cravings when they arise. • Selection of specific skills that best work for you to overcome cravings in your personal change plan