What is craving? Craving is a subjective experience of wanting to use a specific drug. Craving is a core symptom of drug addiction. A craving is distinguished from hunger in being an intense, directed toward the use of a specific drug.
Craving is produced by lengthy drug use, and it is one of the most frequent causes of relapse, even after long periods of abstinence. For example, people who have decided to stop drinking may change their minds when offered a drink (Sayette, 2004). Craving produces a powerful, often overwhelming, urge to consume a drug. It often intrudes into addicts’ daily lives, at times controlling their thoughts and causing considerable agony (Tiffany and Wray, 2011). This is why cravings can be irrational and go against what we know is best for us in the long run.
Buddhists consider craving to be one of the primary toxins of the mind. Unlike psychologists, who restrict the idea of craving to conditions produced by substances abuse, Buddhists use the term more broadly to include the desire for attachment to objects and situations for oneself (Goleman, 2004).
One of the major goals of drug addiction treatment is to teach addicts how to deal with the cravings caused by the following triggers:
1. Cues. Cravings may be caused by exposure to a setting in which drugs have been used. Addicts will frequently relapse after reentering an environment where they have previously taken drugs, even if they have just spent time in a rehabilitation program. The addicted brain has an excellent memory for the drugs it has learned to love (Wise, 1988). For every addict, the memory is formed in the first hit. This explains why craving may occur even years after the last drug dose.
2. Expectation. Environmental cues can trigger powerful expectations about, for example, alcohol’s effects and that those expectations will profoundly influence the alcoholic’s behavior. For example, when they see someone drinking, they realize how much they enjoy the effect of alcohol and crave to experience those effects (Tiffany1999). Past experiences with alcohol help to shape people’s current value and the expectations that they place on drinking alcohol.
3. Belief (perceived availability). The perceived opportunity to use drugs is important for a craving to occur (Gu et al., 2016). Cravings may subside when the drug is thought to be unavailable. For example, when the smoker is placed in a context in which the substance is not available (during 9-hours flight), craving is blunted. But the craving will intensify at the airport where there is an opportunity to smoke. When you know a reward is unavailable, you stop craving and shifts your attention elsewhere. Additionally, the cost of a drug can alter craving response. Skog (2003) showed that when the Swedish state-owned monopoly stores for alcoholic beverages switched to self-service, purchases increased substantially. This is equivalent to a reduction in time cost.
4. Attention. According to the elaborated intrusive theory of desire (Kavanagh, et al., 2005), the more attention a person gives to a rewarding stimulus (e.g., a high-caloric food), the more likely he will be to experience craving. As the person mentally elaborates on her or his cravings, the more likely it becomes that they will generate supporting reasons that allow (license) them to indulge (e.g., I have not had a drink for a while). In the extreme cases, craving may overwhelm working memory that crowds out all other opposing self-control goals.
5. Priming effect. This trigger means that a small dose of the drug, administered to an abstinent ex-addict, can immediately initiate craving (As the Lays Potato ad claims: You Can't Eat Just One!). This also explains why eating freshly baked bread or cookies makes you crave and eat more.
6. Stress. Finally, stress can play a destructive role in triggering cravings. Daily stress can cripple the prefrontal cortex, the brain’s executive function, such as concentration, planning, and judgment. As a result, addicts lose the ability to be reflective (regulate behavior), and impulses take a stronger hold over their behaviors (Marlatt and Donovan, 2005). Addicts are often reminded that not to put themselves in certain situations that they will be unable to resist the temptation to consume.
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Gu X, Lohrenz T, Salas R, Baldwin PR, Soltani A, Kirk U, Cinciripini PM, Montague PR. (2016). Belief about Nicotine Modulates Subjective Craving and Insula Activity in Deprived Smokers. Front Psychiatry. 13;7:126.
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