Craving (24 page)

The Alcohol Use Disorders Identification Test (AUDIT)

The AUDIT screening tool is a short questionnaire created by the World Health Organization that you can take yourself, or for a loved one, to determine whether there’s a potential for hazardous drinking, or a need for counseling and/or treatment. You can find the test online at
www.integration.samhsa.gov/AUDIT_screener_for_alcohol.pdf
.

• A score of 8 or more suggests hazardous or problematic drinking.
  
• A score of 15 to 19 suggests benefit from brief counseling and support.
  
• In general, scores of 20 or greater suggest that treatment should be sought.
  

About My Drinking

Another great resource is
www.AboutMyDrinking.org
, which is a free, online screening tool offered by Hazelden. The screening tool allows you to see how your alcohol or drug use compares to what’s considered healthy use. The site can also connect you with resources, products, and services to help you reduce or stop your drinking or drug use altogether, as well as treatment and recovery services.

…

Tips for Specific Cravings

The following section contains tips and information for dealing with specific cravings, including smoking, alcohol, narcotic pain pills (for people with chronic pain), sugar, chocolate, gambling, and the Internet. Try a few of the suggestions to get started and keep trying until you land on one or two that work for you. Some of these techniques will take time to become a part of your routine, so stick with them. You may also find these suggestions lead you to create your own healthy ways of coping with cravings.

Smoking

Trying to quit smoking? The following list contains proactive measures you can take to prevent or lessen your cravings for cigarettes when you are trying to quit.

• Set a quit date.
  Note: there is no time like the present.
  
• Tell your friends, colleagues, and loved ones what your quit date is.
  Although you may be embarrassed about what they’ll say if you relapse, remember that your true friends will support rather than judge you.
  
• Remove all smoking paraphernalia from your home, office, car, and anywhere else you go.
  This means ashtrays, cigarettes, lighters, matchbooks, even clothing with cigarette logos. Wash your clothes so they don’t smell like smoke, and wash your car too. Remember: you are a nonsmoker, and nonsmokers don’t smell like smoke.
  
• Take medications for smoking cessation.
  There are many available, including over-the-counter options like nicotine gums and patches, and prescription options like Zyban and Chantix. These medications are not without risk, so be sure to talk to your physician about them. Remember, however, that quitting success rates are dramatically higher in people who use these types of aids. And it’s
  not
  cheating!
  
• Change your routines.
  If you smoke with your coworkers, let them know that you won’t be joining them and ask them not to invite you. Don’t frequent establishments where smoking is permitted. In the early days and weeks of quitting, try not to be alone too much. If the person you are with can support your abstinence, that’s great too.
  
• Identify an accountability partner.
  Preferably this is a trusting, nonjudgmental friend who is willing to provide emotional support during the tough times. It may be someone who has successfully quit. Ask this person if he or she would be willing to check in with you regularly, and if you can call him or her too.
  

When the craving for a cigarette hits, try one or more of the following to avoid lighting up:

• Change your environment.
  For example, if you’re in a bar, go home. If you’re in a place or situation that is high-stress, leave.
  
• Ask for help.
  Call your accountability partner or friend and tell him or her you are craving. Remember: your friend doesn’t need to know how to solve the problem for you—the mere act of sharing your craving has been shown to diminish it.
  
• Distract yourself and do something else.
  Preferably, it would be something productive, like going for a walk, exercising, cleaning the house, or reading. But even a mindless activity like chewing gum or watching TV is better than smoking.
  
• Write it down.
  If you write down how you are feeling, what you are doing, and what is going on every time you crave a cigarette, you will start to see patterns. Maybe you crave more after sex, after a movie, before dinner, or when you are stressed at work. By identifying high-risk scenarios, you can develop a plan to deal with them the next time they occur.
  
• Remind yourself that all cravings end, and that most only last a few minutes.
  If it’s helpful, carry an index card with these suggestions in your wallet.
  
• Grab this book and re-read
  chapter 10
  to give you hope and inspiration.
  Or find a different inspirational book. Focusing on the positive will reduce your cravings.
  
• Practice mindfulness meditation or other forms of relaxation.
  Time and again, stress-reduction techniques have been shown to reduce craving duration and intensity. Find a method that works for you and
  practice!
  

Alcohol

For those who are in recovery from alcohol addiction, trying to quit for personal or health reasons, or simply attempting to reduce their drinking, the following techniques can help you deal with alcohol cravings and avoid relapse.

• Leave the situation.
  Whether it’s a bar, a friend’s house, an office party, or even your own home, changing the scene is usually a good idea. When a craving hits, it can be hard to know what exactly triggered it. It’s usually best to leave the situation, then try to figure out what sparked the craving later. Sometimes no reason can be found; cravings are common in early sobriety.
  
• Call or talk to someone.
  Talking about cravings reduces the frequency and intensity of cravings. Discuss them, don’t keep them to yourself. Remember, the person you talk to doesn’t need to have a solution for the cravings—they just need to lend an understanding ear. Keep many numbers in your cell phone contacts of people who would be willing to talk you through the cravings.
  
• Get to a meeting.
  If you prefer Twelve Step meetings, get yourself to an AA meeting. If you are receiving support from some other group, go there. Get with like-minded people as soon as possible.
  
• Eat. Drink. Rest. Connect.
  You’ve heard me mention anxious-scared-preoccupied-hungry-angry-lonely-tired (ASPHALT) as a recipe for disaster. Counteract these known craving triggers by staying hydrated, staying well-fed, resting, and connecting as much as possible with healthy, supportive people. You can’t rely on your body’s own signals during a craving, so eat a healthy snack and drink (nonalcoholic) fluids even if you aren’t hungry or thirsty.
  
• Keep a list of reasons you are quitting in your wallet.
  Refer to them often, not just during the cravings.
  
• Change your environment.
  For example, if you’re in a bar, go home. If you’re in a place or situation that is high-stress, leave.
  
• Distract yourself and do something else.
  Preferably, it would be something productive like going for a walk, exercising, cleaning the house, or reading. But even a mindless activity like chewing gum or watching TV is better than taking a drink.
  
• Write it down.
  If you write down how you are feeling, what you are doing, and what is going on every time you crave a drink, you will start to see patterns. Maybe you crave more after sex, after a movie, before dinner, or when you are stressed at work. By identifying high-risk scenarios, you can develop a plan to deal with them the next time they occur.
  
• Remind yourself that all cravings end, and that most only last a few minutes.
  If it’s helpful, carry an index card with these suggestions in your wallet.
  
• Grab this book and re-read
  chapter 10
  to give you hope and inspiration.
  Or find a different inspirational book. Focusing on the positive will reduce your cravings.
  
• Practice mindfulness meditation or other forms of relaxation.
  Time and again, stress-reduction techniques have been shown to reduce craving duration and intensity. Find a method that works for you and
  practice!
  
• Remember that these tips might not work immediately.
  The nature of alcoholism is that it can trick you into not taking action. As soon as the craving ends (and before then, if you can) start to do the real work of recovery, which is all the things you need to do to prevent cravings in the first place, and it’s what this book is all about.
  

Narcotic Pain Pills (for People with Chronic Pain)

The following tips are for people with chronic pain who want to cut down or eliminate their use of narcotic pain pills by managing their pain in other ways.

• Move.
  The biggest risk factor for worsening chronic pain is sitting still. Don’t get frozen. Sometimes fear may get in your way, but it’s absolutely critical that you get active (within the safe limits prescribed by your doctor, of course). It may seem counterintuitive, but people who move have reductions in chronic pain more than those who stay still. Not sure what activities are safe for you? Ask your doctor.
  
• Sleep.
  The research on sleep and chronic pain is clear: sleep deprivation worsens chronic pain. If you aren’t sure how to get a good night’s sleep, try these tips from the Mayo Clinic:
  www.mayoclinic.com/health/sleep/HQ01387
  . Research shows that simple actions can be more effective for insomnia than sleeping pills. Sound too good to be true? The research is in: cognitive-behavioral methods for improving sleep are as effective as pills and may be even more so in the long run.
  
• Remember that narcotic pain pills can make it easier for you to feel pain in the long run.
  There is a fancy medical term for this: opiate-induced hyperalgesia. What you need to know is that
  your individual threshold for pain
  (how bad it needs to be before you really feel it, before it bothers you) can go down with long-term exposure to narcotic pain pills. Making an effort, with your doctor’s approval/assistance, to reduce or eliminate your dependence on narcotic pain pills can actually improve your pain threshold in the long haul.
  
• Address the stress.
  Stress has been shown time and again to worsen chronic pain. People with higher stress levels also tend to take more narcotic pain medications. Reducing your stress can make it much easier to taper off your pain medications (under a doctor’s supervision, of course).
  
• Connect with others.
  Chronic pain support groups can really make a difference.
  Chapter 7
  of this book explores the power of groups, and they can work for chronic pain too. There are many groups to choose from. One place to start is the American Chronic Pain Association. See
  www.theACPA.org
  for more information.
  
• Do things you enjoy.
  As long as they are safe for you (and your doctor can tell you whether they are), staying involved in hobbies and interests that you enjoy can reduce pain.
  
• Reduce or eliminate alcohol.
  Alcohol can worsen chronic pain and can interact with pain medications in a way that makes pain worse over the long haul. Also, alcohol can worsen sleep—and good sleep is critical to managing chronic pain. Finally, alcohol use can make it harder to wean yourself off narcotics.
  
• Ask your doctor if you can come off narcotic pain medications.
  If you can, detoxing from these medications and following the suggestions in this book can dramatically reduce or eliminate cravings for addictive pain medications.
  

Sugar

Too much sugar can cause many health problems, including weight gain, heart disease, diabetes, tooth decay, and depression. If you have a health condition or illness, connect with your doctor or nutritionist to make sure these tips for cutting back on sugar and dealing with sugar cravings are right for you.

• Stop eating sugar and refined carbohydrates.
  This is the hardest suggestion of all. You may go through sugar withdrawal, and it can take a couple of weeks for the cravings to calm down, although each individual craving will generally only last a few minutes. One thing is clear: sugar cravers should detox from sugar if at all possible. And white flour should be avoided at all costs. To be clear: the sugar in natural foods like fruits are fine, but the white powdery/granular stuff that looks like cocaine should be avoided—for sugar cravers it’s just as addictive!
  
• Get your healthy sugars from whole foods, not processed foods.
  That means it’s better to eat oranges than drink orange juice. The fiber will fill you up as well.
  
• Eat lots of vegetables.
  Six to twelve servings a day. That might sound like a lot of vegetables. Guess what? It is. Throughout this book you’ve learned that dealing with cravings is much more about what you
  start
  doing than what you
  stop
  doing. If you get six to twelve servings of vegetables a day (try to include as many colors as possible: orange, green, yellow, red), your sugar cravings will diminish.
  
• Eat complex carbohydrates instead of refined carbohydrates.
  Whole grains like quinoa, oatmeal, whole wheat, or kamut are much better than white flour for maintaining steady insulin levels. Whole wheat is better than wheat. You may need nutritional consultation if you have conditions like gluten allergy.
  
• Eat five or six small meals a day.
  Sugar cravers do better with grazing than with three square meals a day.
  
• Eat healthy fats, avoid unhealthy fats.
  Don’t be afraid of fats in your diet. Olive oil, nuts (like almonds), and avocados are great examples of healthy fats. Reminder: peanuts are not nuts, they’re legumes. If you are trying to lose weight, remember that nuts need to be limited to a small handful a day.
  
• Eat protein at every meal.
  Proteins, especially lean proteins, can really help reduce sugar cravings.
  
• Plan your meals and plan your grocery shopping.
  If you can write down your goals and plans, you will be much more successful in achieving them. Never grocery shop on an empty stomach. When at the grocery store, stick to the perimeter and avoid the aisles. The outer ring is where the good stuff is.
  
• Connect with others.
  There are many groups (Twelve Step types and others as well) that can be helpful to sugar cravers. One example is Overeaters Anonymous. See
  www.overeatersanonymous.org
  for more information.
  
• Learn from others.
  For tips on healthy eating, I love
  www.fitnessandfuel-la.com/blog
  . They’re especially good at figuring out how to address cravings for unhealthy foods with similar but healthier foods. The blog is fantastic, and the duo that runs it really knows what they are doing when it comes to making healthy choices. Their recipes are particularly great when it comes to sugar cravings.