“The urge to drink or drug is not an enemy to be summarily vanquished but a signal to ferret out the root cause.” Lance Dodes, M.D.

Triggers and addiction are inexorably linked. Even so, the chain reaction of craving, urges and relapse can be broken. First, one has to develop the ability to identify the unique triggers that precede a fall. The stressors can be simple or complex. The experience is often a shock. It may seem to come out of the clear blue or reveal itself as a growing sense of unease that intensifies.

Psychiatrist Dr. Chad Coren defines a trigger as “Any high-risk situation or stressor that sparks off a thought, feeling, or action to use drugs or alcohol. This spark, which is experienced as a temptation to use, is called a ‘craving’ or ‘urge.’ Triggers lead to cravings, and urges to use.”

Things that trigger us come from within and without. For the sake of clarity, I’ll break them down with the help of The Addiction Recovery Guide section on relapse prevention.

Some examples of external triggers:

People:

• An old friend who you drank and used with makes contact and wants to “party”
• A connection who sells his medication contacts you
• Running into a former drug dealer unexpectedly

Places:

• Business requires attending a club you once drank or used at
• Your living room couch that had been a favorite spot to nod out
• Driving by the neighborhood you once scored drugs in

Things:

• A half-full bottle of alcohol on a table
• Painkillers unattended in a medicine cabinet
• Smoking paraphernalia at a clothing boutique

Situations:

• Celebrations, holidays or sporting events
• Emotionally charged interactions—arguments, criticism, upsetting news
• Times of day that one associates with a regular drink, drug or smoke

Internal triggers

Internal triggers can be sense memories, feelings or thoughts.

Physical sensations:

• Pain, fatigue, panic

Thoughts:

• I can’t have physical intimacy without using
• I haven’t used in a year, I’m not an alcoholic anymore
• Concerts aren’t fun without getting stoned

When people experience triggers their thinking gets hijacked. They may experience a combination of fear, anger and despair. They may also start to think they’re not doing recovery right. Constant cravings can lead to frustration with and abandonment of the path to recovery altogether.

Managing triggers requires the willingness to look at our actions, peering below the surface. Certain scenarios or people set us off, and the results aren’t pretty. The stress, conflict and resulting pain become unsustainable. While examining unchecked emotions is a messy business, is there really an alternative?

The things that irritate us the most, that take us from zero to 60 in a flash are exactly the ones to slow down and have a look at. There are some sure signs that you’ve been punked by a trigger. Aggression and rage are the type of explosive emotional responses that exemplify the domino effect a trigger can set off.

Evan Haines, who founded Acadia Malibu and is in recovery, shared some of his thoughts on triggers. He spoke with me about how the rehab process can help clients to have a better understanding of what lies beneath this complex phenomenon. Read more “the Fix”..