Let’s face it. Sometimes - no matter how “strong” we feel, how much work we’ve done or how long we’ve been sober - we feel the urge to use again. Sometimes the urge is triggered by a reminder, by an intense life event, physical pain or overwhelming emotions. Sometimes the urge seems to come out of nowhere as if your disease has been lying in wait like a predator.
Sometimes an urge can feel like a pesky fly that you just need to brush aside to focus on more important things. But, sometimes it can feel like getting crushed by a “ton of bricks,” being drowned under a wave or being chased by a faceless monster. It can feel like an uncontrollable itch that takes all your physical control not to respond to.
The time to learn new behaviors or make a crisis plan is not when you’re faced with an intense urge to use. The time for activities that require thought and planning is before you’re in a crisis situation. The work you’ve done in 12-step programs, your Asana Recovery treatment program and other tools like Cognitive Behavior Therapy or SMART skills will have laid a foundation for coping skills to help you stay sober that you can turn to when an urge hits.
Create a Crisis Plan Checklist
Sometimes, when we’re in intense emotion, we lose the capacity for rational thought. Something triggers our brain to go into “survival mode” and we regress to the more primal parts of our brain. So, your crisis plan does the thinking ahead of time and just presents easy-to-follow steps that you can read and follow. Keep working your way down the list until the urge recedes.
Also, if you’d like to give your checklist a friendlier, less intimidating name, you might find it more palatable. For example, it can be your “Anti-Urge Recipe” or your “To-Do List.”
Ideally, you can create your crisis plan with the help of a drug and alcohol counselor or an AA sponsor. At the very least, turn to a trustworthy friend. This creates accountability - and helps you remember that you are not alone in the fight against addiction.
Some items that might be on your checklist could be:
Call your sponsor.
Call your therapist.
Get coffee with someone in your sober network.
Check to make sure your basic needs are met. Often, after years of using, our brain gets confused about the messages it receives. What we perceive as an urge to use might actually be a hunger signal (or some other message) that got misinterpreted.
It’s usually better to not be alone when we have an intense compulsion to use, but other things that can be helpful include:
Prayer
Reading recovery literature
Exercise
Info from DBT Skills Training Handouts and Worksheets, Second Edition, by Marsha M. Linehan
Tips for Conquering Urges from DBT
Dialectical Behavioral Therapy (DBT) offers a huge assortment of tricks and tips and tools for dealing with urges. If one doesn’t work for you, try a different one!
Burn bridges. In this context, it is a good thing! “Accept at the most radical level that you are not going to engage in addictive behavior again, and then move actively to cut off all addictive behavior options.”
List everything that makes addiction possible for you - and then get rid of those things. This includes throwing out all your drugs/alcohol/paraphernalia, obviously. But it also means deleting the contact info of suppliers, getting rid of possible cues and temptations, and telling the people you’re close to that you have quit.
Build new bridges. “Create visual images and smells that will compete with the information loaded into your visual and olfactory brain systems when cravings occur. Cravings and urges are strongly related to vivid images and smells of what is craved.” If you can drown out or replace the images and smells related to your craving, the craving will decrease.
Build different images or smells to think about when you have an unwanted craving. For example, whenever you crave a cigarette, imagine being on the beach; see and smell it in your mind to reduce the craving.
When you have unwanted cravings, look at moving images or surround yourself with smells unrelated to the addiction. Moving images and new smells will compete with your cravings.
“Urge-surf” by imagining yourself on a surfboard riding the waves of your urges. Notice them coming and going, rising high, going low, and finally going away.
Adaptive Denial. When your mind can’t tolerate craving for addictive behaviors, give logic a break. Don’t argue with yourself when you’re doing this.
When urges hit, deny that you want the problem behavior or substance. Convince yourself you want something other than the problem behavior. For example, reframe an urge to have a cigarette as an urge to have a flavored toothpick; an urge to have alcohol as an urge to have something sweet; or an urge to gamble as an urge to alternate rebellion.
Put off an addictive behavior. Put it off for 5 minutes, then put it off for another 5 minutes and so on, each time saying, “I only have to stand this for 5 minutes.” By telling yourself this, you are saying, “This is not forever. I can stand this right now.”
Most importantly, always remember: an urge, no matter how strong, is a passing thing. Friends in recovery often remind us: “This too shall pass.” We can use the tools of recovery or simply hold on and wait it out. But, sooner or later, the urge will subside, the wave will recede.