How Long Will I Feel the Compulsion to Use After Rehab?

Posted on December 2nd, 2013

Learning to cope with drug cravings is an integral part of getting clean, but the internal pressure to use can often feel like it’s too much to cope with and may drive you back to your chosen substance. The most powerful pangs will undoubtedly come in the first few days of abstinence, but the compulsion to use doesn’t disappear when the last physical traces of a drug leave your system. In fact, longer-term cravings take root in psychological associations; a little like Pavlov’s dog’s salivation at the sound of a ringing bell.

Physical Withdrawal

The initial cravings come from the physical dependence on the substance. Different drugs overwhelm the brain in different ways, and with repeated exposure, the individual’s brain adapts to allow for continued functioning while under the influence. For drugs that work on dopamine, the body will produce less of its own dopamine and will retract some of the “receptors,” which allow the neurotransmitter to create its effects. When the substance is abruptly stopped, there is an imbalance in the brain that leads to intense cravings. The brain clamors for the substance because that’s how it’s learned to operate. These cravings will be pretty powerful, but begin to fade the longer the brain is left to its own devices.

Psychological Withdrawal

The bigger issue when it comes to craving is the psychological side of withdrawal. Pavlov’s famous experiment with his dog is a perfect example of how this works. Whenever the dog ate food, Pavlov rang a bell. Soon, a psychological association was established in the dog, so the sound of the bell led to the conditioned response of salivation (in expectation of the associated meal). For drug users, these associations work in the same way but without the obvious mechanism of the bell. Passing a street corner where you used to score drugs, seeing a drug-using friend or even receiving a paycheck can serve as a “trigger” for this association, re-awakening the outdated link between the specific stimulus and drug use. These cravings, unfortunately, may last weeks or even months after you’ve last taken a substance.

What to Do About It

The trick for dealing with cravings is to learn your own personal triggers, or more specifically, to focus on the most pressing ones at the current time. You may have several triggers, but if one or two in particular give you the most trouble, these should be the priority. The simplest method of dealing with cravings is distraction, in which the craving to use drugs is effectively ignored by doing something else instead, such as going out for a run. This takes your mind off the problem and makes dealing with the situations easier. For others, it can be particularly helpful to talk through the cravings you’re experiencing with close friends or family members (who themselves are abstinent and supportive of your efforts). Additionally, you may choose to purposefully remind yourself of the negative consequences of use when you encounter a craving. Rather than focusing on the high associated with cocaine, you could think about all the trouble it caused in your life, the relationships you destroyed and the opportunities you squandered as a result.

Don’t Be Afraid to Ask for Help

Cravings are normal. The important thing to remember is that they aren’t a sign of weakness or a definite sign you will relapse. They are something to be acknowledged and to be tackled in the way that works best for you. They will become less and less powerful as time goes by. It’s impossible to put a definitive timescale on how long they will last, but every day you resist them it will become easier and easier. If you ever feel overwhelmed, though, it’s integral to get help so you don’t have to go through the entire process again.

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