Internal and External Addiction Triggers
In the ongoing process that is recovery, there is always the concern of that most-feared occurrence – relapse. Despite complete determination and the best professional treatment, sometimes circumstances or stimuli known as 'addiction triggers' can result in a return to drug or alcohol use and dependency.
This is not a sign of weakness nor does it mean an individual will not eventually achieve abstinence. Recovery is a challenging process, and we are continuously learning as we go through it. There are many different triggers that can create powerful cravings that lead to relapse.
Addiction triggers come from an almost endless number of things, situations or emotions. Generally, they are divided into two types: internal and external.
External triggers – Also known as ‘environmental’ triggers, these are things out in the world that create cravings to resume drug use. In almost all cases, these will be things that remind them of past drug use. This association is what triggers the almost overwhelming desire to use again.
Internal triggers – These are also called mental, emotional and physiological triggers. These are due to thoughts, emotional states, and physical feelings.
Both types of addiction triggers can drive you towards relapse if not identified and avoided. First, there is emotional relapse where your emotional state begins to change. Then there is the mental relapse stage where you consciously begin to consider using again.
To learn how to protect against these triggers, it’s important to truly understand them and why they are so powerful.
External triggers can consist of many outer stimuli, including:
- Seeing drugs or alcohol
- Being in an environment where alcohol and/or drugs are being consumed
- Media (movies, songs, pictures, etc)
In fact, anything that a recovering addict can associate with their drug use can be an external trigger. These are some of the most common due to the powerful memories and feelings they elicit.
Place triggers can be some of the most dangerous. That's because they often include other triggers such as people, objects, sounds, smells. Worst of all, places can easily create associations with drugs and alcohol.
For instance, a recovering alcoholic often needs to stay away from bars for quite a long time. This is obviously due to the availability of alcohol. But it's also dangerous due to the presence of people he would drink with and all the sights and sounds associated.
Bars, locations where drugs would be purchased and places drugs were consumed (friends’ houses, parks, etc) can all be addiction triggers. However, high-stress places such as the workplace or a university exam room can also be triggers. Negative or stressful environments can cause a craving to use in order to relieve the stress.
Naturally, one of the worst addiction triggers someone in recovery can be around is a person either using drugs or providing them. However, a person with whom an individual used to do drugs (even if that person is abstinent) can serve as a trigger as well.
Being around individuals that can cause stress may also result in cravings. Examples of these situations include the following:
- Significant Others
- Family Members
- Anyone with Whom Tere is a Contentious Relationship
Even family members that mean well but inadvertently exhibit behavior that causes the person in recovery pain or stress can act as triggers.
Physical objects strike strong associations with memories in the human brain. As such, they can be powerful addiction triggers. Naturally, drug paraphernalia (pipes, spoons, needles, etc.) can be immediate triggers. So can objects indirectly associated with drug use like a book drugs were hidden in or a picture that once hung in the room drugs were consumed in.
Smells and Sounds
Our senses are inexorably tied to our memories as well – so much so they can cause cravings without us even realizing the source. The bubbling of something boiling may remind a heroin addict of the noise made when cooking her drugs, for example. Even the smell of laxatives or laundry detergent may elicit unexpected cravings to individuals in recovery for something like cocaine.
Proximity to Drugs & Alcohol
This is a particularly powerful trigger – and unfortunately, one that is not always easy to avoid. An individual in recovery will be sure to avoid the places and situations where this is most likely to occur.
However, you cannot always foresee the appearance of drugs and/or alcohol. Since this combines a powerful addiction trigger with immediate accessibility, it is one that must be avoided as much as possible.
Media (Movies, Music, Etc.)
These can trigger cravings in two ways. Drug use and references to drug use are depicted and mentioned in thousands of movies and songs. Seeing the emulation of drug use in movies and on TV (or actual drug use in documentaries) can cause intense cravings. Similarly, so can the glorification of drug use in many types of popular music.
Secondly, there is the matter of association. A TV show you enjoyed watching or music you would listen to while using drugs can certainly be a trigger when seen or heard during recovery.
Guarding Against External Triggers
As with any triggers, the first step is properly identifying them. A professional residential treatment program can help with this. Recovery experts will inform you of common triggers, as well as help you identify ones that are specific to you.
As they are external, an available course of action to guard against many of these triggers is to avoid them altogether. This is especially important in the early stages of recovery.
In some cases, however, it may be impossible to do so (e.g. your workplace, spouse, etc.). That's why it is important to learn how to manage potentially triggering situations. Creating and memorizing an iron-clad plan for how to recognize triggers and leave the situation before succumbing can make all the difference.
In contrast to external triggers, internal triggers are not a result of anything in our environment. They are caused by our internal thoughts, emotions or physical feelings. Some of the most common of these include:
- Withdrawal and post-withdrawal symptoms (nausea, anxiety, pain, and weakness, etc)
- Lack of self-care (lack of sleep, poor eating habits, lack of mindfulness)
- ‘Negative’ or unwanted emotions (anger, loneliness, fear, etc)
- Mental or Physical Illness
We all know that our thoughts and emotions are extremely complex, and their point of origin is not always clear. As a result, lessons in mindfulness and becoming more self-aware are imperative in order to successfully recognize and manage these more subtle types of triggers.
Withdrawal and Post-Withdrawal Symptoms
These can be some of the most difficult internal triggers to deal with. When you become physically dependent on a drug, your body, in essence, needs the drug to operate normally. Withdrawal is your body’s reaction to having that drug removed – and can be truly unpleasant.
There are both physical and emotional symptoms that can range from uncomfortable to seemingly unbearable. Many drug and alcohol-dependent individuals return to using simply to make the withdrawal symptoms stop.
An established recovery center that offers numerous services for different types and levels of addictions is extremely helpful here. Trained professionals minimize the effects of withdrawal (and occasional lingering post-withdrawal symptoms). They can also teach you how to deal with it and other triggers.
Lack of Self Care
When in recovery, the daily struggles and overall challenge of the brave but difficult step you’ve taken can result in a lack of self-care. You may be sleeping an insufficient number of hours, not eating properly, or failing to do things that bring you joy and comfort. All recovery experts agree that individuals in recovery need to willfully and mindfully engage in self-care on a daily basis.
In fact, there is an acronym that refers specifically to the physical and mental states resulting from a lack of self-care that greatly increase the likelihood of relapse: HALT. This stands for Hungry, Angry, Lonely & Tired. When in any of these states, the danger of relapsing is exponentially greater than when not.
This refers back to the ‘Lonely’ in HALT. It is a dangerous trigger both in itself and in its ability to cause the appearance of other triggers. When isolated, you are in a vacuum. This vacuum can be a fertile breeding ground for negative thoughts and emotions.
External sources (treatment professional, friends or family) can help you see that these thoughts are a product of your position and not necessarily based in fact. Also, we are by nature social creatures, and therefore extreme isolation eventually has a negative effect on us all.
No person is happy all the time – anger, sadness and other ‘negative’ emotions are natural responses to different situations. However, left unchecked, these types of emotions are dangerous internal triggers for those in recovery.
Stress may be the most dangerous of them all, causing a number of mental and physical ailments. Also, while the ‘stress hormone’ corticosterone produces dopamine to help us through a difficult time, this can actually promote relapse in addicted persons. In one study, corticosterone's action made stressed rats more sensitive to their relapse triggers.
This and other so-called ‘negative emotions’ will always be part of life. But learning to manage them is a must for anyone in recovery.
Mental or Physical Illness
Often a precursor for addiction in the first place, either type of illness can also be a relapse trigger. Using drugs and alcohol to self-medicate depression or anxiety is common, while other diseases like schizophrenia or bipolar disorder can add an inability to make logical decisions.
Improperly used prescription medications for both mental and physical illnesses can have a psychoactive or otherwise mind-altering effect. This can trigger the desire to abuse drugs for that purpose. The pain and stress of physical illnesses, meanwhile, can be a powerful addiction trigger as well. Drugs or alcohol can be seen as an escape from this stress.
Guarding Against Internal Triggers
Internal triggers are often harder to identify as well as to manage when compared to external triggers. However, it is possible. It often requires incorporating healthier practices and thought processes while learning the art of mindfulness and self-awareness.
The goal is to work to make mindfulness second nature. While certainly no easy task, replacing the behaviors and thought patterns developed through addiction with healthier ones is one of the best guards against relapse. This will not only help them manage triggers but live an overall happier and more fulfilling life.
When hearing the word ‘mindfulness,’ many of us will immediately think of yoga, meditation, and other such ancient practices. Of course these practices are helpful to many people in recovery. But there are also numerous treatments and practices developed by Western science that embrace mindfulness.
Some treatments include Cognitive Behavioral Therapy (CBT), Mindfulness-based Relapse Prevention (MBRP), Acceptance and Commitment Therapy (ACT), Dialectical Behavioural Therapy (DBT) and many more.
Whatever method of mindfulness you may subscribe to, the goal is the same. You want to develop a greater ability to pay attention to, recognize and manage thoughts and emotions as they happen.
An important result of this is the ‘uncoupling’ of addiction triggers from what would have previously been the automatic response of using. With the better understanding of what you’re really feeling and why you are then able to have greater control over your reaction.
Addiction Services To Keep Your Recovery On Track
Clean & Sober Recovery Services provides affordable, dignified and confidential care to help you succeed in your journey of recovery. Our beautiful Sacramento, California property hosts a complete range of services: from the beginning stages of intervention and detox to your choice of inpatient or outpatient treatment.
Those who need it can even take advantage of our transitional housing services – an extremely helpful resource for those continuing to struggle with addiction triggers. Specialty services like Medication Assisted Treatment (MAT) can also help those who find it difficult to overcome the challenges of withdrawal symptoms and other triggers.
If you or a loved one needs help overcoming an addiction, contact us today for a free and confidential assessment.
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