Alcohol cravings are very common for people navigating sobriety or moderation and are nothing to be ashamed of. While cravings can feel especially overwhelming at the beginning of the alcohol recovery timeline, you can manage them with the proper tools, online alcohol treatment, and understanding.
In addition to seeking insight into how to address cravings when they do arise, many of my patients often wonder, ‘why do I crave alcohol in the first place?’.
The simplest answer is that an alcohol craving is a result of the chemical changes that take place in the brain due to excessive alcohol use over an extended period. However, biological, psychological, and social factors influence our relationship with alcohol, and there are often other factors at play.
Understanding how cravings work and the evidence-based tools to address them can help us retrain our brain, reframe our perspective, and enable healthier habits.
How Drinking Alcohol Affects Dopamine In The Brain
What Is Dopamine?
First, let’s talk about dopamine. Dopamine is one of the primary neurotransmitters released when you receive pleasure from certain things and activities. It’s also known as the ‘feel-good hormone.’
Sometimes even the thought of receiving pleasure from something will lead to the release of dopamine in the brain. Dopamine affects our reward system, memory, motivation, decision-making, and beyond. It can become deregulated with extended alcohol use.
How Alcohol & Dopamine Interact
When you use alcohol to destress, decompress, relax, or reward ourselves, your brain forms associations. Your brain connects drinking alcohol with a feeling of relief and reward. As you continue to use alcohol in these moments, the association is strengthened in your brain’s pleasure center.
If these associations become strong enough, even just the thought of having a drink can increase dopamine levels. Then, when you consume alcohol, even more dopamine is released. This ramping up of dopamine can lead to an acceleration of consumption, and what you might have thought would be one drink to ‘take the edge off’ becomes several.
My patients frequently ask why they can’t stop after one drink like they had planned to, and the ramping of dopamine is often part of the explanation. Over time, the anticipation of alcohol becomes part of the drinking experience, and the brain adapts to “crave” alcohol in its pleasure center. This ultimately results in the urge to drink alcohol. This is also sometimes referred to as a “chemical romance” with alcohol.
Why Alcohol Changes Brain Chemistry Over Time
When alcohol is consumed in increased amounts over an extended period brain chemistry continues to adapt in response. The brain moves beyond associating alcohol with pleasure or relaxation and begins to recognize alcohol consumption as required for basic functioning.
The body craves alcohol not only to destress but to maintain a state of normalcy. This is a sign of alcohol dependency and a common indicator of an alcohol use disorder. A specific example of this is when people have to continue to drink more to avoid alcohol withdrawal symptoms.
The body “depends” on alcohol to rid itself of withdrawal symptoms such as anxiety (or ‘hangxiety‘), heart palpitations, alcohol shakes, and increased heart rate. In extreme cases, people can have seizures when they try to abstain or decrease their alcohol intake. This is why it’s so important to work with a medical professional before quitting cold turkey or cutting back significantly.
If you believe you might be experiencing acute alcohol withdrawal, please contact your healthcare provider immediately and visit https://findtreatment.gov/ to find a location to get supervised detox near you. If this is a medical emergency, call 911. If you’re looking to cut back on drinking, join Monument to connect with a physician about the safest path for you.
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How Habits & Routines Play A Role In Cravings
While the changes to neurotransmitters explain cravings on a chemical level, habits and routines also influence cravings. These patterns include rituals like having a glass of alcohol in hand at 5:00 pm after work, or subconsciously buying alcohol every trip to the supermarket.
These behaviors become automatic with time, and can often function as triggers when people try to cut back or abstain from alcohol. Noticing the routines that have become an alcohol cue is a helpful first step in creating a new habit, avoiding potential triggers, and preventing alcohol relapse.
To learn more about how to build healthier habits and avoid triggers, you can read more about how to curb alcohol cravings when they do occur.
How Treatment Works To Combat Cravings
Even if you know the why and how of cravings, they can still be challenging to navigate. However, you have great behavioral and therapeutic tools at your disposal, and you are not alone in this journey. At Monument, you have a dedicated Care Team providing support, and evidence-based tools to empower your progress.
One tool I discuss with many of my patients in the context of managing alcohol cravings is medication to stop drinking. Medications such as naltrexone affect dopamine receptors in the brain and block the effects of dopamine when drinking or anticipating alcohol.
When drinking on naltrexone, it decreases the likelihood that dopamine levels will ramp up. Therefore, the brain’s association with alcohol and pleasure begins to weaken. This can be a very effective tool for many in managing cravings.
However, long-standing habits and routines still play a large role in our brain’s associations, so there is no singular ‘fix’ for cravings. To build new habits and healthy responses to triggers, it’s often beneficial to engage in online alcohol therapy and participate in alcohol support groups to process emotions, develop coping mechanisms, and create long-lasting lifestyle changes.
A specialized therapist can work with you to identify what habits trigger your desire to drink, manage thoughts about drinking, build drink refusal skills, and so much more. Why we drink is complex.
The combination of medication, therapy, and community support is the gold standard in alcohol use disorder treatment because it takes a holistic approach, and empowers you to create sustainable behavioral change.
What causes an “urge” to drink can be as simple as what alcohol means to a person at a single moment in time. The good news is, you can change what alcohol means to you, and there’s evidence-based support to help you do it. While combating intense alcohol cravings can be an uncomfortable and challenging experience, it is also a sign of growth towards a more balanced self.
Naltrexone has the capacity to cause hepatocellular injury (liver injury) when given in excessive doses. Naltrexone is contraindicated in acute hepatitis or liver failure, and its use for a patient with active liver disease must be carefully considered in light of its hepatotoxic effects.
In treating alcohol dependence, adverse reactions include difficulty sleeping, anxiety, nervousness, abdominal pain/cramps, nausea and/or vomiting, low energy, joint and muscle pain, headache, dizziness, and somnolence. This is not a complete list of potential adverse events associated with naltrexone hydrochloride. Please see Full Prescribing Information for a complete list
Disclaimer: Our articles and resources do not constitute clinical or licensed therapy or other health care services. If you need counseling or therapy services please contact a licensed provider. If this is a medical emergency, call 911.