Alcohol cravings: What they are and how to manage them

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Alcohol cravings may occur for a variety of reasons, such as changes in brain chemistry, triggers, and habit formation.

Changes in brain chemistry

Consuming alcohol can produce chemical imbalances within certain neural circuits in the brain.

Alcohol increases activity in brain areas related to reward processing, which produces rewarding or pleasurable effects.

Alcohol can also send dopamine signals to the nucleus accumbens. This area of the brain is often referred to as the pleasure center.

Dopamine plays an important role in the brain learning to associate the rewards of alcohol with certain cues, such as people, places, or things. This process can lead to incentive salience.

Incentive salience is when the motivation for a reward is driven by a person’s physiological state, learned cues, and reward associations.

Triggers

Similarly to how the brain learns cues and reward associations, it can also learn triggers for desiring alcohol.

There are two types of triggers:

• External triggers are the places, people, and things that remind a person of drinking or offer the opportunity to drink. They are more obvious situations and are typically easier to avoid than internal triggers.
• Internal triggers can seem to appear without an obvious cause. However, a person may find that a passing thought, positive or negative emotion, or a physical sensation, such as a headache or anxiety, produced the urge.

Habit formation

If a person repeats drinking patterns, it can cause the brain to shift control over the actions involved with drinking.

It shifts from conscious control using the prefrontal cortex, which relates to thoughts, actions, and emotions, to habit formation using the basal ganglia. The basal ganglia are the part of the brain responsible for motor control, learning, and executive functions.

During this time, the brain transitions from incentive salience to habit formation. This can make it more likely a person will continue to consume alcohol. It can also make it more difficult for them to stop using alcohol.

When they occur, alcohol cravings can feel overwhelming, even if they last only a few minutes.

A person can help manage these cravings in several ways until they pass.

Distraction

Distraction can be a useful tool to help a person manage alcohol cravings in the moment. Finding alternative activities to refocus the brain can allow the craving to pass.

A person can make a list of activities to keep them engaged in the short and long term. Some ideas may include:

• watching videos online
• exercising, such as lifting weights, walking, or biking
• listening to music
• taking a shower
• meditating
• doing a favorite hobby

Reach out

Calling or texting a friend, family member, or another trusted individual can be a form of distraction and support.

Talking about a craving may help a person overcome it. Support from others may help the person manage their cravings as well.

Stay present

Stress and tension can cause cravings and make a craving feel worse. Practicing mindfulness and relaxation techniques can help a person stay in the present and relax, which may reduce the craving.

A person may try any of the following:

• deep breathing exercises
• relaxation exercises
• yoga or stretching
• removing themselves from a situation that is triggering a craving

Having a long-term plan for managing alcohol cravings can help prevent and overcome them when they do occur.

Over time, many people find their cravings easier to control and reduce in strength.

Understand triggers

One of the main ways a person can help control and prevent alcohol cravings is by understanding what triggers the cravings in the first place.

Cues or triggers may differ from person to person. Understanding these cues can help a person predict them, prepare for them, and act against many of them.

Making a list of triggers can help visualize them. A person may want to divide the list into three categories:

• triggers that happen to them, such as advertisements or stressful situations
• activities they participate in, such as sporting events or trivia nights with friends
• strategies to calm themselves, such as physical activity or meditation

Once a person identifies the activities and situations that can cue their cravings, they can work to avoid some of them. For activities and situations a person cannot or does not want to avoid, they can use strategies to overcome the cravings that occur.

Break the habit

The concept of a “habit loop” was originally introduced by journalist Charles Duhigg. He broke down habits into a three-part loop:

• The cue: This is the trigger that leads to the behavior beginning.
• The routine: This is the habit or behavior itself, such as having a glass of wine after getting home from work.
• The reward: This is what the brain gets out of the behavior. For example, it may be feeling more relaxed, a buzz, or a boost in mood.

Breaking this habit loop can be useful in overcoming alcohol cravings. One way to do this is to identify this loop and then build new routines to break the cycle.

Contact a mental health professional

Contacting a mental health professional can help a person better understand their cravings and what the cues are for them.

Mental health professionals can also help treat alcohol use disorder (AUD). AUD is a condition that occurs when a person has a physical need or desire to consume alcohol that is difficult to control.

However, just because someone experiences cravings does not mean they have AUD.

The Food and Drug Administration (FDA) has approved some medications to help treat AUD. Doctors prescribe these medications to people who have an AUD diagnosis. They are not suitable for only managing cravings.

FDA-approved medications to help treat AUD include:

• Acamprosate: This medication seems the most effective in helping people not return to drinking once they have stopped. It is not clear exactly how this medication works.
• Disulfiram: This medication does not stop alcohol cravings. Instead, it causes unpleasant symptoms when a person consumes alcohol. The clinical trials on this medication’s effectiveness are limited.
• Naltrexone: Doctors typically prescribe this medication after a person has completed an alcohol detoxification program, if one is necessary. The medication works by binding to endorphin receptors in the body and blocking the effects and feelings that alcohol can produce. It can help reduce cravings and the amount of alcohol a person consumes.

An alcohol craving is an intense urge or desire to consume alcohol. There are various reasons a person may experience cravings, such as changes in brain chemistry, habit formation, and triggers.

A person who experiences alcohol cravings does not necessarily have alcohol use disorder. Instead, a habit loop of cues, behaviors, and rewards may be causing the cravings.

Breaking this loop can help a person overcome alcohol cravings and manage their alcohol intake. They can break this loop by avoiding triggers when possible, distracting themselves in the moment, and practicing relaxation techniques.

A person can speak with a mental health professional to better understand their alcohol cravings. They can also seek medical support if they believe they may have alcohol use disorder.