The use of prescription pain medications has sharply increased among soldiers since the beginning of the war, rising from 30,000 monthly prescriptions to more than 50,000 monthly prescriptions.   

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We have investigated the process of a craving from social situations, to emotional triggers.  Set-ups can be avoided.  Triggers can be shut down, but in the end, a craving is inevitable at some point during recovery.  Unfortunately, one slip can put a former cocaine addict back at the beginning.  It is increasingly difficult to stay clean after every relapse.
 

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The recovery process is marked by strong cravings that are taxing on the cocaine addict's body and mind.  As with any  challenge, an addict must overcome the temptation through personal strength.  Strength  comes from understanding and knowledge.   

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Set-ups lead addicts to a point in the craving process that can render them defenseless to the pressures of cocaine; a trigger point.  Terence Gorski says there are four primary types of triggers that activate immediate craving.  These triggers include thoughts, feelings, behaviors, and situations that activate craving.  

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Recovering addicts fight tremendous cravings on a regular basis.  These cravings are often very difficult to overcome, especially in volatile social settings.  Three social set-ups that may spark the craving process are:

1. lack of communication: Cocaine addicts stop talking about their experiences in recovery and, as a result, they get into trouble. They replace rigorous honesty with superficial communication. This isolates them and prevents them from doing a sanity check on their recovery experiences.

2. Social Conflict: Out of isolation and a refusal to communicate comes a tendency to get into arguments and disagreements with other people. This social conflict prompts the recovering cocaine addict to avoid sober social situations and isolate themselves from others, spending more time alone.

3. Socializing With Other Drug-Using Friends: Out of loneliness and desire to be with people who understand them, many recovering cocaine addicts decide to associate with people who they used to drink and drug with. This puts them in the proximity of the drug and sets them up to have a craving.

A recovering cocaine addict must avoid these social set-ups that lead to cravings.  Surrounding oneself with friends and family that want to see recovery success, allows a cocaine addict to receive necessary support.  Finding a social scene far from the scene of their 'using' days will protect the recovering addict from peer pressure and social temptations. 

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This week we have followed Gorksi through the biopsychosocial process of a craving. Understanding the set-ups and triggers may help a recovering addict fight off cravings and stay clean.  Wednesday, we learned about the way an addict's body sets them up for a craving.  Today we are getting into the head of an addict, learning about the tricks the mind uses to get its drug. 

Gorski highlighted fives ways that the mind sets a recovering addict up for a craving.  They are:
  

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Cocaine addiction reaks havoc on the body, mind and soul.  Cocaine use actually produces physiological changes that hinder the body's ability to recover.  The use of cocaine damages the brain causing a predisposition to experience craving.  The best way to combat this dysfunction is by understanding the addict's body and what they will experience. 

With improper care, an addict places himself at risk of relapse.  The body is a powerful tool in the journey.  There are five physical set-ups that should by recognized according to Terence Gorski.  They are:  

1. Brain Dysfunction:  Cocaine damages the brain and leaves recovering addicts physically set up to experience powerful cravings.  The result of this physical predisposition to experience craving is if recovering cocaine addicts don't do special things to avoid craving, they will experience craving.

2. Poor Diet:  Recovering cocaine addicts are often nutritional disaster areas because they live on junk food and don't know what a healthy meal is.  Many have coexisting eating disorders that lead to binging on junk food and/or starving for days at a time to deal with the result of weight gain. 

3. Excessive Use Of Caffeine And Nicotine:  Both caffeine and nicotine of these are low grade stimulant drugs and increase the likelihood of having cocaine craving. 

4. Lack Of Exercise.  Aerobic exercise reduces the intensity of craving, especially cocaine craving.  Regular aerobic exercise is a protective factor against craving, especially in the first six to nine months of recovery.  Not doing aerobic exercise on a regular basis sets the stage for craving.

5.  Poor Stress Management:  When recovering people don't manage stress appropriately in recovery, they increase their risk of having craving by becoming stress sensitive.  Regular stress management activities such as meditation, relaxation exercises, taking regular breaks and rest periods are all protective factors against craving.

On Friday, we will dive deeper into the the process, as we look at the psychological set-ups that a recovering addict experiences.

Recovering from cocaine addiction is a daunting task; however, with the support of loved ones and an understanding of the process, a cocaine addict is more likely to succeed in staying clean. 

During the first 90 to 120 days, the body provokes a physiological craving that far exceeds the craving for alcohol or any other drug.  This time period marks the greatest risk of relapse.

In 1990, Terence T. Gorski developed a three stage model for fighting these cravings.  He believed that by understanding the biopsychosocial model of craving, a recovering cocaine addict could live drug free.  According to Gorski the three stages of craving are:

Stage 1:        Set-up behaviors: Ways of thinking, managing feelings, and behaving that increase the risk of having a relapse

Stage 2:        Trigger Events:  Events that activate the physiological brain responses associated with craving.

Stage 3:        The Craving Cycle:  A series of self reinforcing thoughts and behaviors that continue to activate and intensify the craving response.

Gorski focused on the process rather than the craving.  He taught that a recovering addict must avoid certain triggers and behaviors to be craving free.  Recovering people unconsciously set themselves up to experience cravings he said.  When addict's resistance is down, they are vulnerable to trigger events.  Once they feel the urge to use, they begin habitual behaviors that amplify the cravings. 

Gorski's craving cycle is similar to the process taught by many other counselor and rehabilitative specialists.  It is imperative that a recovering cocaine user recognize the set-ups, triggers and the craving.  Follow me through the life of a craving.  Learn to protect yourself and others through knowledge.  Wednesday we will explore set-up behaviors that put a recovering drug addict at risk for relapse.

Cocaine is presently the most abused major stimulant in America. It recently been linked to an increasing number of emergency department visits. Though cocaine is not a new drug of abuse,  it is now considered an elite recreational drug among users.

A common myth is that cocaine is not addictive because it lacks the physical withdrawal symptoms related to alcohol or heroin addiction. Users who are misinformed on the addictive nature of the drug are often baffled at their inability to quit the drug.  This is due to cocaine's powerful psychological addictive properties. 

Emedicinehealth.com reported that cocaine-driven humans will compel themselves to perform unusual acts compared with their former standards of conduct. For example, a cocaine user may sell her child to obtain more cocaine. Furthermore, there are many stories of professionals, such as lawyers, physicians, bankers, and athletes, with daily habits costing hundreds to thousands of dollars, with binges in the $20,000-$50,000 range. The result of this reckless behavior may be loss of job and profession, loss of family, bankruptcy, and death.

Though the drug has been around for 5000 years, there is a lot of unknown surrounding cocaine use.  Scientists are unable to identify the exact lethal dose.  This is likely due to the variance between users, their genetic make-up and lifestyle.  The ambiguous nature of cocaine addiction increases the threat it poses to society.  If you are addicted to cocaine, seek professional help now. 

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