The Irresistible Urge to Use a Drug, in Other Words the Craving, Is One of the Major Symptoms of Addiction. As part of the April Utile month devoted to chemsex, a focus on the mechanisms of this impulse and the tools to counter it.
Illustration : Laurier The Fox for tetu·
“Craving is this little obsessive voice that resonates in your head and won’t let go, so that, very often, when reason calls you not to consume, you crack.” A sex therapist and addiction specialist (chemsex and sexualized drug use), Fred Bladou describes this irresistible urge to consume a psycho-stimulant, a symptom almost inevitable once one uses regularly, for example, the drugs used in the chemsex practice.
The mechanisms of craving
Far from being the mark of a lack of willpower, craving responds to multiple factors, that is, a combination of biological, psychological and learning mechanisms that sustain themselves over time.
Some psycho-stimulant products – such as cathinones (3-MMC, 4-MMC…), cocaine, methamphetamines (tina, meth…) or the “G” – gradually modify the brain’s reward circuits, particularly the dopamine and serotonin signaling systems, which makes the brain highly sensitive to cues associated with these substances.
Gradually, when used regularly, a portion of dopamine no longer comes from the immediate pleasure of intake but from its anticipation: the brain triggers upstream an irrepressible desire to use as soon as it detects a cue that it associates with the substance – for example places, social circles, or the act of scrolling Grindr on a Friday night to ward off boredom, loneliness, stress or fatigue. Self-control and decision-making, in particular the ability to resist the urge, are then affected.
In other words, this is not simply a craving for chocolate or fries. The manifestations of craving are powerful, producing internal tension (anxiety, irritability, agitation) that pushes toward consumption as a quick solution to this discomfort. Over time, we end up not only consuming for pleasure but to avoid the malaise linked to withdrawal or internal tension, which further reinforces the infernal cycle:
craving → consumption → relief → reinforcement → craving
Powerful, the peak of craving is also ephemeral, and generally lasts only a few minutes. It can also manifest as a wave of 30-45 minutes, notes Dr. Patrick Papazian, a sexologist who works notably with the Chems Pause association. That said, as Fred Bladou emphasizes, “craving is a complicated state but it remains temporary and brief.”
How to face craving
As soon as one knows that they are prone to craving and understands its mechanisms, it is a matter of learning to know oneself better and to build a toolbox to respond.
First, it is necessary to identify the symptoms of craving and its triggering factors, in order to act early and preventively. Patrick Papazian recommends using tools borrowed from cognitive-behavioral therapies: “Try to note the thoughts and emotions associated with the rise of the’envie, what happened in your day, the good as well as the bad things…” Also note the situations, activities, environments that can provoke craving for you: staying alone in the evening or on weekends, going out with certain people, watching porn, etc.
Once these factors are identified, you can learn to avoid situations that trigger a rise of the’envie de consommer. It can also happen that you are taken by surprise by the urge that arrives without warning. As a defense, Fred Bladou invokes the so-called “4 D” method, proven in addictology:
- “Delay” : postpone the decision to consume by 10 or 20 minutes; this simple delay can be enough to pass the peak of the urge.
- “Deep breathing” : do 3 to 5 minutes of deep breathing, to help reduce the brain’s stress and to relax your nervous system. Effective sophrology exercises exist online.
- “Drink water” : drink a large glass of water, or eat a fruit, occupies your body and helps distract you from the consumption you’re trying to avoid.
- “Distract”/”Do something else” : to further distract your brain and divert it from craving, make your own list of alternative activities. This can involve simply going for a walk outside or having a coffee on a terrace, calling a friend, doing sports, starting a series…
Attention, your anti-craving toolbox should only be filled with activities that truly please you, no new constraints. “Do not attempt to resist craving by imposing anxiety-inducing and tedious constraints, insists Fred Bladou. We do not reduce our consumption by forcing ourselves into activities or interactions that do not produce a sense of pleasure or emotional comfort. For example, we do not impose a workout session if you hate sports. That would be counterproductive, a source of stress and could potentially lead to a frustration that we will try to compensate… with products.” Patrick Papazian thus notes that one of his patients, who has a nearby ice-cream shop that he loves, turned every craving into permission to go enjoy a small cone.
If resisting craving seems too difficult, you have undoubtedly need of help. Do not hesitate to seek advice, and do not for a moment self-medicate: addiction medicine is medicine!
