What is Urge Coping?

What is Urge Coping?

No matter your stage of recovery, you are likely to experience the urge to use a harmful substance. Urges are a normal psychological and physical response to addiction. Feeling the urge to use is a common occurrence for people in recovery, so it is important to develop strategies to cope with urges to avoid a relapse.

Urge coping is the practice of strategically addressing urges when they arise during addiction treatment and recovery. Urge coping encourages you to use techniques, behaviors, and thoughts to deal with your urge to use in healthy ways to maintain sobriety.

Explore the physiological and mental causes behind urges and learn how you can use urge coping techniques to maintain sobriety at all stages of recovery.

What are Urges?

An urge is an intense desire, craving, or inner tension for something. Feeling an urge often results in the compulsion to act – a common phase in the cycle of addiction.

In a non-addicted person, urges are the body’s way of telling you that you need something, like food, water, or air, to survive. Urges push people to obtain what they need in mostly healthy ways, such as drinking water, eating a meal, or taking a deep breath to pull in more oxygen. These are called primary urges.

People also experience secondary urges, which refer to urges brought on by social pressures and substance abuse problems. These urges do not help you survive like primal urges; rather, secondary urges are created by mental and behavioral patterns. Urges caused by addiction issues fall into the second category.

Why Do Urges Occur?

why recovery is hard sometimesAddiction-related urges (as opposed to primal urges) are due to how drugs affect the structures and neural pathways in your brain. When you repeatedly use opioids, alcohol, and other substances, they affect the center in your brain that regulates decision making and self-control, called the basal ganglia.

Repeated use also affects your extended amygdala and prefrontal cortex, which control how you respond to stress and take action on impulses.

The more you use, the more the neural circuits inside your brain change, leading to tolerance and dependency. This process trains your brain to rely on the substance for feelings of pleasure and happiness and makes you less able to override urges when they occur.

The urges themselves come from many sources, typically the association between stress relief and pleasure and the substance. They can also come from familiar drug-using triggers such as people, places, and emotions associated with your drug of choice.

Essentially, your brain and body think you need the substance to survive or enjoy a situation, so you experience the urge to use it. The urge is your body trying to return to its normal state of being – the one it was trained to be in by consistent substance use.

What Happens When You Give in to Urges?

When you give in to urges, you may find temporary relief. Your body experiences the pleasure of using, and the tension that built up during your urge is now released. However, the relief is short-lived.

The cycle of addiction, a recurring set of phases that people with addiction go through in relation to their substance abuse, shows you will likely experience a full-blown relapse after using. This means you lose control of your behavior for a time. Then, you feel negative emotions, followed by the pledge to stop using.

You may stop until you face a stressful situation, then the cycle starts all over again. You experience a craving, followed by the urge to use, followed by another relapse.

It is helpful to identify this cycle because it demonstrates why learning to resist your urges is so important to sobriety.

Urge Coping Techniques

The following urge coping techniques can help you deal with urges when they arise.

“DEADS” technique

DEADS stands for Delay, Escape, Accept, Dispute, and Substitute. For this method, you go through a series of actions to work through your urges.

  • Delay – allow the urge to pass and remember they are temporary
  • Escape – remove yourself from an urge provoking situation
  • Accept – understand that urges are expected, and they will pass
  • Dispute – use logic to fight against the urge
  • Substitute – engage in a healthy activity like meditation or exercise to replace the urge

Medication

When you enter into a well-rounded addiction treatment program that uses medication-assisted treatment (MAT), you may have access to medication that can help reduce your cravings. When administered under supervision, buprenorphine reduces opioid cravings and minimizes urges so you can focus on other areas of treatment, such as therapy and making lifestyle changes.

Questioning

Use Urge Coping Methods to Maintain SobrietyQuestioning your urge when it arises is a helpful technique. It is a popular technique used in Mindfulness Cognitive Behavioral Therapy (MCBT.) Questioning involves noticing as your urge comes up, then asking yourself questions about why it is happening. You can ask questions such as:

  • “What is happening in my life right now that may be causing this urge?”
  • “What need is this urge connected to?”
  • “What physical sensations occur when I feel this urge?”
  • “What am I experiencing mentally regarding this urge?”

Note down the answers to these types of questions in a journal to better grasp when and why your urges arise. The information can help you deal with your needs in more healthy ways.

Avoiding triggers

Urges are brought on by situational, emotional, and physical triggers. Spend time in counseling or a support group to learn to identify your triggers and make a commitment to avoiding them. Avoiding triggers allows your brain to make neutral connections with new experiences rather than maintaining the old, unhealthy connections.

Use Urge Coping Methods to Maintain Sobriety

Urges occur during every stage of recovery. During the initial stages, urges are frequent and strong, but they usually fade over time. You are better equipped to deal with your cravings and urges if you develop a list of urge coping techniques you can use to minimize their effect on your mind and body.


Written by Sergey Zhitar, MD Medical Director

Native of Moldova, Dr. Zhitar is Board Certified in Addiction Medicine as well as Internal Medicine and completed his training at UPMC Shadyside, Pittsburgh, PA in 2000.

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