Triggers and relapse, a craving connection for addicts

I’ve already written about one reason why cravings make quitting difficult (find it here). However, cravings and triggers are not just abstract concepts; they are well known, important players in addiction research and I think they deserve some more attention.

What are triggers?

A trigger can be thought of as anything that brings back thoughts, feelings, and memories that have to do with addiction (like a computer reminding a sex addict of porn). In addiction research, these are often simply called cues. The word comes from learning research in which a reward (or punishment) is paired with something (the cue).

For instance, in Pavlov‘s classic experiment, a dog heard a bell ring right before it would get served its daily portion of meat. The dog quickly learned to associate the bell with food, and would begin salivating as soon as the bell would ring, even before the food was presented. In this case, the bell was the cue, and food the reward it was paired with.

The story in drug addiction is similar. I’m sure many of you can relate to the overwhelming memories and emotions that seem to come out of nowhere when you hear music you used to get high to or pass a street where you used to buy drugs (or sex). Each of those examples is a trigger that is simply bringing about a similar reaction to Pavlov’s dog’s salivation. Seeing these things, or hearing them, creates an immediate response to the reward that it was paired with, the drug!

Triggers, cravings, drugs, and relapse

As if matters needed to be made worse, triggers not only bring about responses that make you think about the drug. In fact, over and over in learning and addiction research, it’s been shown that triggers actually bring back drug seeking, and drug wanting, behavior. As soon as a cue (or trigger) is presented, both animals and humans who have been exposed to drugs for an extended period of time, will go right back to the activity that used to bring them drugs even after months of being without it. In fact, their levels of drug seeking will bounce back as if no time has passed. Sound familiar?!

Given these findings, is it any wonder that cravings bring about relapse in so many addicts who are trying to quit? If simply thinking about, or hearing, something that was always tied to drugs can bring about such a strong response, what is an addict to do?

Is there a solution for addicts??

For now, the simplest way to break the trigger-response connection is simply repeated exposure without the reward. As bizarre as this may seem, staying away from the triggers can make their ability to bring back the old drug-behavior stronger. Obviously, this isn’t something that should be undertaken lightly. I’m currently working on putting together a drug treatment system that specifically addresses these issues so that with help, users can eventually release the hold that triggers have over them.

In the meantime, be honest with those around you, and if you’re seeing a therapist, or a good case manager, tell them about your triggers so that you can hopefully start talking about them, and re-triggering them in a safe environment. As always, feel free to email me with any questions you might have.

4 responses to “Triggers and relapse, a craving connection for addicts”

  1. like fear extinguishing.

    who’s that famous guy in new york with a band who studies fear conditioning and has given a drug that can help in extinguishing the conditioned response?

    maybe you could use that drug. i think it inhibits protien synthesis. if no one’s done it maybe you’d get a nature paper 🙂

  2. I would disagree that triggers always bring back drug seeking behavior. The risk is there, but if the person has a RELAPSE PREVENTION PLAN, they are expecting the triggers to come and their plan tells them what to do instead of use.

  3. Ron, as you pointed out, it takes some real training to alter the “automatic” response to triggers. There are some promising ideas in treatment to make the transition easier, but for the most part, without serious work, the thoughts that are turned-on directly by triggers have a tendency to increase the probability of a relapse. Hence the importance of a relapse-prevention-plan!

  4. I used for abt a month and a half and I’m craving heroin very bad.I start freakin crying because I wan’t that feeling that I once had with this drug.I feel as though I can stop it and start when I feel like it.Please someone give me some answers!

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