Cravings represent a core symptom of addiction. While long-term recovery from addictive disorders commonly demands reconciliation with love ones and/or an introspective process to resolve a pain from long ago, the beginning steps in the recovery process must focus on cravings. Self-control – the ability to inhibit a craving or urge of any type – is a prerequisite to the reparative process mentioned here. Invariably, addictive behaviors create distance in relationships, and usually block introspection. Long-term change, then, is an impossibility without first mastering cravings to use or drink.
On a fundamental level, addiction reflects an impulse control disorder. Over the course of an addiction, reason yields to cravings, as people continue to use despite the toxic effects that most addictive cycles result in – damage to relationships, financial loss, problems at work, legal consequences, medical scares, and so forth. Early treatment must focus on enhancing self-control.
Due to a condition known as allostasis, those in the earliest stages of abstinence are more sensitive to stress, be it relational stress, work-related, physical stress or emotions experiences. Physiologically, those in early recovery will be deficient in the neurochemicals associated with resiliency and drive, resulting in the acute sensitivity to stress discussed here. Through abstinence, the body will slowly correct the effects of allostasis and reset a more stable central nervous system. Until it does, though, those in early recovery will be susceptible to stress and, therefore, cravings.
Stress regulation is the basic function of the brain. Our brains demand the right amount of stress to optimally fire off. An absence of stress leaves the brain inert and with depressed metabolic activity. Excessive stress paralyzes the brain, and can result in cortical loss. In cases of addiction, the brain’s mechanism to regulate stress becomes impaired, with drugs and/or alcohol increasingly relied on to compensate for a loss in this regulatory function. That is, people use to check out, to numb out, to take the edge off, to take a load off, to relax, to chill, and any other number of clique reasons, all highlighting how substances of abuse interface with the brain’s built-in mechanism to regulate stress.
The brain’s ability to regulate stress becomes increasingly compromised the longer and more severely someone uses addictive substances. From a neurobiological perspective, stress is easily activated and poorly managed in early recovery, as the brain begins to reset its physiology and restore homeostasis. Stress dysregulation amplifies the level of risk to relapse, as cravings typically fire off in response to stress, the brain seeking the substances of abuse that, historically, helped it manage anxiety, confusion, sadness, pain, and so forth.
Kevin Murphy, Psy.D.
AToN Center 888-535-1516