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Mental Health & Alcoholism

Coping with Alcohol Cravings

coping with alcohol cravingsCoping with cravings is the key to tackling alcoholism. If you can manage to not give in to your cravings, or you can adapt so that you don’t get so many cravings in the first place, then there is no more addiction is there?

How you view your own cravings will determine how much power they have over you. If you believe that a craving won’t naturally go away once it has started, or if you think that the only way to deal with a craving is to drink, then of course you will be fairly powerless over them. This is the cognitive component of your addiction.

Making yourself aware of what things in your life tend to give you cravings, and therefore how you might avoid those situations, becomes a vital skill. For those ‘triggers’ that you can’t avoid, you can learn how to deal with them differently.

Lets say there are four types of cravings:

  • a reaction to withdrawal symptoms
  • escaping from unpleasant feelings (boredom, depression, anxiety etc.)
  • a response to a learnt association (people, places etc)
  • enhancing a positive mood

Each type requires a different approach to deal with it. And each person’s approach will be unique to them.

There are six recognised methods for dealing with cravings when they occur:

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Running from Feelings

“Many of us spend our whole lives running from feelings with the mistaken belief that you cannot bear the pain. But you have already borne the pain. What you have not done is feel all that you are beyond that pain.”

Kahlil Gibran

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Emotional Intelligence (EQ)

emotional intelligenceEmotional Intelligence is now a fairly popular term, it refers to your ability to understand and deal with your feelings in an adaptive and mature way. When we let our emotions dominate our behaviour without any awareness, it can become a huge problem.

Alcoholism and addiction are fundamentally rooted in an inability to effectively deal with your emotions, a lack of understanding about where they have come from, and what to do with them.

As such, people turn to alcohol or drugs to anaesthetize their emotions, to hide from them. But of course, merely dulling them or hiding from them does not make them go away. In fact, it often makes them worse.

So one of the key elements in beating addiction is to develop your emotional intelligence. By becoming more aware of your feelings, what has caused them, and the best way to deal with them, you can hopefully reduce your dependency on drink or drugs.

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Are Alcoholism and Addiction Genetic?

Is there a genetic component to addiction? It would seem so - the genes for excessive alcohol consumption have been identified.

But how any genetic predisposition can be distinguished from the more behavioural, learnt element is virtually impossible - and when it comes to individual people trying to break out of their addiction, the distinction tells us nothing much of any use.

“Your father was an alcoholic, so unfortunately you inherited that genetic trait.”

“Oh great news, so how does that help me to stop drinking?”

is addiction genetic?If substances have been used from an early age, then this often becomes the preferred way of coping with difficult feelings. Obviously, we learn most of these skills from our parents, our siblings or our friends as we grow up. So if these people were not themselves dealing with their emotions very effectively, then that is likely to be what we learnt also.

Thus addiction is passed from generation to generation via learning, not just biology.

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How long will therapy take?

The process of changing your habits towards alcohol is not something that happens overnight. You are learning new skills to replace your old behaviours, and this will take some time. How long it takes of course varies from person to person.

Firstly you have to decide how you will know when you have changed? What will be the signs that you have been successful? These are questions that most people find difficult to answer. Ok, so you don’t drink so much any more, you feel a bit more clear-headed and happier - but have you made the changes in your life that you really wanted at the start?

So, to answer the main question another way - you might well see reductions in your level of consumption within a week or two, but that may not mean you have made enough changes to sustain that improvement.

Usually when people decide to seek help for their alcohol problems, it is not just the actual level of their drinking that bothers them, it’s their emotional problems, their ability to cope with the stress in their lives, the number of crises they create. So reducing consumption is only one part of the overall changes someone might be hoping for.

So perhaps the initial question is a little too vague to be answered accurately. Being more specific in your expectations will lead to more informative answers. So maybe ask some questions like these instead:

“How long will it take me to learn other ways to relax?”
“How soon can I expect to communicate better with my family?”
“When will I be able to get through a whole day without even thinking about a drink?”
“Will I feel that I’m a good person again soon?”

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Binge Drinking

There is no commonly agreed definition of what binge drinking is, in terms of an actual amount of alcohol defined by the medical profession. But we all know what it means: drinking much more than you would normally drink in any one occasion.

binge drinkingThis is not limited to alcoholics of course. However, binge drinkers don’t drink every day, and so they may not consider that they have an alcohol problem.

The effects of binge drinking on the individual, on those around them and on society generally are widespread. The health implications are serious, including alcohol poisoning and accidental death.

The social functioning and work performance of binge drinking individuals suffers markedly. Hangover related absenteeism and poor job performance was estimated to cost the US economy $148 billion in 1998.

Violence, accidents and crime rates soar on weekend nights as a result of heavy drinking – 80% of hospital emergency admissions at night are intoxicated by alcohol. Of course the biggest cause of accidents and death related to alcohol consumption is the motor car.

This problem is no longer restricted to men. Younger women particularly are now drinking until they are very drunk, at least as much as young men. The incidence of unwanted or unsafe sexual activity reported by young women increases dramatically when they and those around them have been drinking excessively. After binge drinking, one in seven 16 – 24 year olds have had unprotected sex, one in five have had sex they regretted later and one in ten have been unable to remember if they had sex the previous night (Health Education Authority (HEA/BMRB 1998b) Sexual health matters: Research survey).

Are you drinking too much?

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How much alcohol can I drink safely?

The UK authorities suggest that the tolerable maximum weekly consumption of alcohol for men is 21 units (168g), and for women 14 units (112g). One unit of alcohol is defined as a half-pint of beer, a measure of spirits or a glass of wine. But how is anyone supposed to know how much these volumes are if they’re not in a bar?

safe alcohol levels?These are often referred to as ‘safe drinking levels’, but of course no level of alcohol consumption is totally risk-free. The levels are officially described as “…the amounts below which it is unlikely that someone will develop significant illness or an early death”. Pretty vague, I’m sure you’ll agree. But it just illustrates that there is no real way to tell exactly how much you can safely drink. The more you drink, the worse the effects, that’s all you need to know.

There is some evidence to suggest that, in older people at least, there may be some health benefits from drinking in moderation - primarily from reductions in heart disease. But this should not be used as an excuse for drinking more.

More recently the government has advised that these weekly consumption guidelines should be spread out across the week into daily limits, to avoid the idea that it’s fine to not drink all week, then drink your entire alcohol ‘allowance’ at the weekend. So it now becomes 3-4 units per day for men, and 2-3 units per day for women.

Of course, these guidelines apply to healthy adults only, so the ‘safe’ levels for teenagers or adults with health problems is obviously much lower.

Are you drinking too much?

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Addiction and Depression

addiction and depressionMany people who are depressed turn towards alcohol to make them feel better, at least temporarily. Conversely, many people who use alcohol in a dependent way tend to become depressed. The classic chicken and egg situation.

Alcohol has an incredible efficiency at making life seem rosy, that’s why it is so popular of course. But it is a double edged sword, because it’s also the most powerful depressant around.

Depression, whether associated with addiction or not, can be broken down into cognitive (thoughts), emotional and behavioural components.

The Cognitive component of depression is primarily concerned with a person’s negative thinking, their inaccurate beliefs about themselves or the world. Depressive thoughts can be grouped in terms of four aspects of a persons life: (more…)

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But my friends won’t like me any more…

Not everyone who has addiction problems decides (or needs) to be abstinent. But for those that do, a problem often expressed is - what about all my friends?

Of course, over years of drinking or using, people build up social circles and friendships which are often based partially on drinking or using. So what are people supposed to do with those friendships? How can an alcoholic continue to socialise with their friends when those people are still drinking? Especially when that person probably needs a lot of social support during the change process.

Letting go of old friends is something that most people just don’t want to do, and even if they don’t remove them from their lives, many addicts are worried that their friends won’t like them so much any more - they won’t think they are quite so much fun. Making new friends is just not that simple.

Unfortunately this is not a problem with an easy solution. Unless you want to give AA or NA meetings a try?

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Neuro-Electric Therapy

Neuro-Electric Therapy is a new method for easing the withdrawal from heroin or other opiates. The addict is required to apply electrodes behind the ear, which are then electrically stimulated daily for six to ten days using a control pack which the addict carries with them.

The electrical currents are said to stimulate nerve pathways (much like acupuncture), thus reducing any cravings for opiates and lessening the painful withdrawal symptoms. However the researchers are keen to point out that this treatment is not an alternative to counselling or rehabilitation, merely an effective method for dealing with the physicalities.

A trial of neuro electric therapy in Scotland has produced very promising results. This is expected to lead to much bigger trials of the treatment in the near future.

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Abstinence or Control?

This is a decision which many alcoholics struggle with, and some try both approaches at different times. It is of course tempting for anyone who drinks alcohol problematically, to think that they can just regain control and drink more sensibly. And of course this is possible, but it is also very difficult. But then achieving total abstinence is not exactly easy either.

Realistically, there is no way of knowing if you are able to change your addiction into healthier patterns of use, or if you must become abstinent, the only way to know this is to find out. Many people go around this cycle many times - achieving a certain time of abstinence, then trying to drink socially or sensibly again, only for this to spiral out of control back into alcoholism. But there are those who do successfully manage their addiction and achieve healthier patterns of drinking.

The 12-step (AA or NA) philosophy is unequivocal on the matter - “abstinence is the only way”, but more modern approaches are adapting to the fact that there are other options. Similarly, if you are trying to achieve abstinence and you slip, or relapse, then the 12-step crowd would have you believe that you’ve failed, and that you need to start again from the beginning (back to step 1). But of course this just increases a person’s sense of shame and failure, which can itself make even more drinking or using a possibility.

It would seem far healthier to look at relapses as an opportunity to learn from mistakes, and try to do things differently next time.

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Addiction and Mental Health

mental health problems?For most people with alcohol problems, they often have a number of unresolved difficulties with life generally.

Excessive drinking is often a symptom of other problems. Some of these may be minor of course, like an aversion to being bored, or a lack of confidence socially, or just a limited variety of ways to relax.

Some people have more deep-rooted problems behind their addictions - like anxiety, depression, lack of self-esteem etc. These can all be addressed with cognitive counselling techniques however.

Then there are many people with more serious mental health problems who end up having difficulties with alcohol. ‘Self-Medicating’ they call it in the medical profession. Basically, if life is unbearable and beyond your ability to cope with it, then people will try anything to feel better, even if it’s only for a few hours. And never mind what happens later.

Say what you like about alcohol, but one thing’s for sure - it can certainly take your mind off things if you’re feeling distressed. So if you’ve been trying to live with bipolar disorder or schizophrenia for years and nothing the medical profession has suggested has really helped that much, it’s no surprise when people turn to the bottle.

However, once that ‘self-medication’ turns into dependency, then the situation can spiral out of control. And this is where it becomes more difficult to help people solve their addiction issues. It’s not impossible of course, it just takes more work and perhaps a little more motivation.

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The Higher Power Problem

The 12-step (AA, NA) philosophy includes a tricky concept for some, the idea of a “Higher Power”.

If people have developed a problem such that they cannot control their own use of alcohol or drugs, so that they are in effect disempowered by their addiction, what effect might it have to suggest to them that they should believe in the ability of a “Higher Power” to help them overcome their problems?

Is it not more useful to suggest, and encourage them to believe in their own power again? From this they can work at ways to develop that inner power, so that they have the ability to take back control of their own actions and lives.

Many alcoholics are already deeply ashamed of their actions, their self-esteem is in shreds. Rebuilding that confidence in the Self is vital. Not to the point of arrogance or self-centredness obviously, because those extremes are themselves often at the root of many addiction problems. Achieving a balanced personality is the goal.

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Addiction as Learnt Behaviour

Beating addiction is not a process of being told what to do differently, or learning the tricks that you were possibly lacking, those secrets which people without an addiction surely must have. No, it doesn’t work like that.

Overcoming addiction is more to do with learning about yourself, learning how you tick, what beliefs you hold, some of which you might not even be aware of, which contribute to your problems.

Most of our behaviours are very automatic, we do things without thinking too deeply about the consequences, most of the time. We are animals, just like the rest of nature, and we respond in the same way they do. Like Pavlov’s famous dogs - if you show us something that we’ve seen before, we often respond to it in a pre-programmed or learnt way. If you smell some lovely fresh food being cooked, you’ll start to produce saliva. You will also probably think certain thoughts as a result, again often automatically (though they might not FEEL automatic). Some of these thoughts are so subtle and you have them so often, you might not even notice them.

With addiction the initial event can be anything - being bored, feeling lonely, angry, disappointed, frustrated, tired. From that thought you might think something like “I can’t stand feelings like this, I must change this feeling”. Again, this thought might not be a loud one in your head, its just a way of dealing with the world and your feelings that has become automatic.

So, in a situation like this, you’ll find something to get rid of this unpleasant feeling you’ve got - “I know what will change my mood, a drink…” or some cocaine, or whatever your problem is with (whereas someone without addiction problems might choose to accept that feeling for a while, or find a less destructive way to change the feeling).

So, to change your addictive habits, you firstly need to understand fully how they work, what you are doing to sustain them. Then you can slowly relearn some healthier ways to deal with life, with your unpleasant feelings.

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