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Go into any Alcoholics Anonymous (AA) meeting and you will find some “old-timers”—people who have been in recovery from alcohol and drug addiction for 10, 15, 20 years—and even for over 50 years!

First and foremost, it is important to recognize that alcoholism is a chronic medical illness1 —it is not a “moral weakness” or a matter of “pulling yourself up by your bootstraps”. Alcoholism can be defined as “a compulsion to seek and consume alcohol, a loss of control over consumption after beginning a drinking session, and a strong likelihood of relapse during or after withdrawal”2  There are definitive studies 3,4,5  indicating that alcoholism and drug addiction is characterized by distinct differences in the brain’s chemistry 6,7,8,9  that are based on genetics  as well as environment11.  Alcoholism and alcohol abuse are among the most commons diseases, causing increased health care costs, serious illness and death and increased economic costs.

This doesn’t however mean that there is nothing you can do about alcoholism—because there definitely is! I know of a recent celebration in Arizona—for the 3 people celebrating, there was over 100 years of sobriety!

The first few days, weeks and months of sobriety are crucial

Cravings for alcohol diminish over time, but the first few days, weeks and months of sobriety are crucial.  The cravings can be brought on by internal cues (anxiety or the physical effects of withdrawal) or external (social situations, finding bottles of alcohol). Here are some tips that I hope will prove useful if you have decided to get clean and sober.

1.    The single best advice I think I could give for dealing with cravings is to find a support group like AA. Find a sponsor—someone who has been clean and sober for a few years, has done all of the 12 steps involved in AA, and is willing to have you call them any hour if you need to talk to someone.  They have lived through those cravings and have survived them—and they will understand what you are dealing with.

2.    Distract yourself with an enjoyable activity—go for a walk, a drive, talk to a friend or sponsor, clean your house, mow the lawn—anything that will keep you busy and thinking about something else. Find yourself a hobby or renew an old one.

3.    Positive imagery:  Imagine a big stop sign or a red light. Remember good times you had when you were sober. Imagine the rewards for staying sober.

4.    Practice rational answers to some of your “automatic” thinking.  For example, if you are thinking “I felt so much better when I was drinking” the answer might be “Yeah, I felt pretty good, but I really hurt so-and-so when I yelled at them”. Or “Yes, that was a great party, but on the way home I totaled my car and nearly killed myself!” If you are thinking “I won’t be able to get through this” the answer might be “Well, my sponsor, DanD has 32 years of sobriety—if he can do it, so can I!”

5.    Make yourself some flashcards or put up post-it notes for yourself—and put the everywhere.  You might feel silly – but putting up those positive affirmations like “I can get through the next 10 minutes without drinking” or “I deserve to feel better about myself” do work and they do help.  Write down whatever seems right to you, and when you experience cravings, read your notes!

6.    Remember that cravings are a normal part of the recovery process.  You and everyone else with alcoholism and addiction have experienced them.

7.    Remember the “3 D’s”

Stop the Drama by not using terms like horrible, worst, unbearable or phrases like “I won’t survive” or “I can’t DO this!”
Dispute expectations-This has to do with practicing the rational answers.  For example, you might remind yourself that while having a drink may help in the short-term, you won’t (and can’t) stop at just one—you’ll drink the whole bottle and be right back where you started.

Distract- find that activity to distract yourself- make the goal achievable.  Start with 10 minutes…and then another 10 minutes and then another….

One of my favorite sayings from AA—and for years, I never knew that AA used it, is One Day at a Time!  My second favorite is It Works if You Work it! It does work—but it all depends on you.

  • McLellan AT, Lewis DC, O'Brien CP, Kleber HD. Drug dependence, a chronic medical illness, implications for treatment, insurance, and outcomes evaluation. JAMA 2000, 284: 1689-95: Swift,RM, Medications and Alcohol Craving, Alcohol Research & Health, Vol. 23, No. 3, 1999
  • Bowers, MS., Activators of G-protein signaling 3: a drug addiction molecular gateway, Behavioural Pharmacology Volume: 21 Issue: 5-6 Pages: 500-513, 2010
  • Lee, Frankie H. F., Wong, Albert H. C., Dopamine Receptor Genetics in Neuropsychiatric Disorders, Dopamine Receptors, Second Edition Pages: 585-632, Humana Press, Totowa, NJ, 2010
  • DeGrandpre, Z., The Naturopathic Treatment of Alcoholism and Addiction, Lambert Academic Press, 2010
  • Potenza, MN, de Wit, H., Control Yourself: Alcohol and Impulsivity, Alcoholism-Clinical and Experimental Research Volume: 34 Issue: 8 Pages: 1303-1305, 2010
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  • Bearer, CF, Bailey, SM, Hoek, JB., Advancing Alcohol Biomarkers Research, Alcoholism-Clinical and Experimental Research Volume: 34 Issue: 6 Pages: 941-945, 2010
  • Koob GF. The neurobiology of addiction: a neuroadaptational view relevant for diagnosis. Addiction, 101(Suppl 1): 23-30. 2006
  • Reich, T, Edenberg, HJ, Goate, A, et al., ome-wide search for genes affecting the risk for alcohol dependence, American Journal of Medical Genetics Volume: 81 Issue: 3 Pages: 207-215, 1998
  • Foroud, T, Edenberg, HJ, Crabbe, JC.,Genetic Research Who Is At Risk for Alcoholism? Alcohol Research and Health Volume: 33 Issue: 1-2 Pages: 64-75, 2010
  • Room R, Babor T, Rehm J. Alcohol and public health. Lancet,365 (9458): 519-30, 2005.