Two main causes of relapse are personal triggers and stress. And while it may be somewhat easy for a recovering addict to avoid going to bars or hanging out with people they used with before getting sober, it’s not nearly as easy to avoid stress.

emotions that cause stress

Stressors, which are events or emotions that cause stress, are everywhere around us.  Every single person on the face of this planet has to deal with daily uncertainties, illness, aging, death, job security and many other stressors including traffic jams and missing the bus on a regular basis. We live in a world where we are constantly connected to news that focuses on trauma and upset, and feel the need to be constantly moving and constantly available via cell, text, email, etc.

When a person experiences one of these stressful situations, the body releases hormones as a response to danger. When these stressors are not dealt with properly, the body continuously releases these hormones, harming the body in various ways over time. Prolonged stress can cause nausea, increased heart rate, problems with the digestive system, and of course – addiction or relapse.

Stress and drug addiction: the psychology

It is far easier to understand the psychology behind stress-related drug abuse than it is to understand the neurology, so that’s where we’ll start. Because most drugs cause some type of escape from reality – some feeling of euphoria – people with chronic stress often turn to drugs or alcohol when they can no longer deal with their daily stressors. Whether it’s a beer after a long day of work, or rewarding yourself for a long week with a bottle of wine – the more that the brain feels a clear connection between “reward” and “alcohol” or “drugs”, the more likely the brain is to create a psychological dependence on the substance. And the further along the psychological dependence is, the further the neurological dependence becomes. Even when an addict has completed a successful rehabilitation programme, a bout of severe stress in recovery will cause major craving patterns in the brain, and the addict will have a very hard time saying no to using again.

Stress anrug aiction: the neurology

In response to a stressor, the human brain releases hormones, chemicals and neurotransmitters nicknamed chemical “messengers”. First corticotrophin-releasing factor (CRF) is released, which triggers adrenocorticotropin (ACTH), which stimulates the adrenal glands, and cortisol is produced. When cortisol is present in the blood stream, it tells the brain that CRF and ACTH do not need to be produced any longer (unless it is a particularly serious stressor.)

A study of addicts performed at Rockefeller University involved stopping the production of cortisol in both drug users and non-drug users. Each person was given a pill that stopped the production of cortisol. In those who were not using drugs, the lack of cortisol production caused high levels of ACTH. In those who had recently used heroin, ACTH increased only slightly. When researchers tested a group of people who were in withdrawal from opiates, the ACTH levels doubled that of the non-using group, showing that the brain of a drug addict in recovery is much more sensitive to stress, increasing the addict’s susceptibility to relapse during stressful situations – especially within the first couple of years of recovery.

Learning to cope with stress to avoid relapse

Because there is no way to avoid stress forever, a recovering addict needs to learn how to lower their sensitivity to stress. Mindfulness meditation has been used to relieve stress for hundreds of years – and now more and more studies are scientifically proving that practicing mindfulness meditation in addiction recovery actually helps prevent relapse.

According to the United Nations Office on Drugs, approximately 200 million people around the world are drug users. Of those, millions of them are addicted to different drugs and alcohol, and the lucky ones find their way into treatment programmes.

Cognitive behavioural therapy (CBT) has proven very successful in addiction treatment, and is a modern, evidence based psychology. The main focus of CBT is to teach addicts strategies and techniques that will help them think rationally and positively. And practicing mindfulness in conjunction with CBT almost seems like a very natural progression.

In short, mindfulness is the practice of cultivating nonjudgmental awareness in day-to-day life. It means being fully aware of what is happening in the present moment, without filters or judgement. By practicing mindfulness meditation, you can teach your brain to consciously accept the stressors that you experience in day-to-day life and deal with them in a calm and positive way instead of letting them ‘ruffle your feathers’.

Being in the “present moment” with mindfulness

If you pay attention to what your mind is doing when you are sitting still, washing the dishes or even going for a walk – you will notice that the mind is incredibly noisy. Whether thinking about what might happen in the future, or rehashing things that have already happened in the past, the mind rarely sits still. However, it is only the present moment in which anybody truly lives. Tomorrow is not here yet, and yesterday already happened – the only moment you truly have is now.

Mindfulness is a practice in which we can learn to quiet the mind by focusing on the activity/moment in which we are living – be it doing those dishes or sitting still. One sample exercise to practise is mindful eating. For this, take a grape, a piece of fruit or even a piece of chocolate bar and hold it in your hand. Explore it with all 5 senses. Look it over, smell it, and use your fingers to really feel the textures of the fruit. Then, place it in your mouth. Notice how it feels on your tongue, the saliva building in your mouth and the way that it tastes. Notice the moment that you bite into it – how does it feel? What new flavours can you taste?

This is a simple exercise, but it is the basis of mindfulness – being completely focused on the present moment. Focusing on the tastes and flavours – and quieting all other thoughts in your head.

Using mindfulness to relieve stress

In the same way that you can quiet your thoughts while eating, you can quiet your reactive thoughts when you encounter a stressor.

When someone yells at you, cancels plans last minute, or disappoints you in some manner, most people will automatically react. Perhaps you are getting annoyed while waiting in line at the bank or at the post office. Maybe someone cut you off on the road, and you had to swerve to avoid hitting them. These are all stressors that are easy to encounter in day-to-day life situations. And while the stressor may seem small, they have significant physical effects on your body. Muscle tension, headaches, insomnia, gastrointestinal upset and skin conditions are short-term effects of stress. Long-term effects include heart disease and dementia among others.

Instead of allowing these small life situations to cause so much stress, mindfulness helps you to recognise that there are choices in how you respond to any stressful situation. Between a stimulus and your response, there is a space in which you can choose your reaction – and the key to finding that space is awareness. Awareness of the situation – but more importantly – awareness of your own self.

Mindfulness teaches you to observe your thoughts and emotions without reaction. When something stresses you out, it is important to take a moment to register what you are feeling. Maybe you feel anger. Maybe you are sad. Whatever you are feeling – simply acknowledge the emotion without judgement until it passes through you or subsides. Allow yourself to feel whatever emotion just flooded through you, but do not react to it unconsciously. Take a few deep breaths and allow yourself to feel that emotion. Then, act in a non-reactive way. Allowing yourself this moment between stimulus and auto-pilot reaction will allow you to choose your own responses that will keep your psychological and physical reactions more calm.

Learning to live in awareness and practicing mindfulness on a regular basis can help you prevent a relapse

Yoga helps to harmonise the mind and body.
Yoga helps to harmonise the mind and body

How mindfulness is directly related to long-term recovery

The 12 Steps reminds addicts to take recovery ‘one day at a time’, and mindfulness takes that one step further – take life one moment at a time. As we have pointed out – addicts’ brains are more sensitive to stressors, and therefore they are more likely to react to them in a heated, negative manner.

Not to say that these stressors aren’t real, and there is no doubt that they can be upsetting, but mindfulness teaches awareness of the present moment. If you are upset by  the long line at the bank, or because a friend or family member went back on their word, living in the present moment can show you that your initial negative feelings will pass and that life will go on again normally.

One thing you can ask yourself in the moment in which you want to react, is this: “Is everything okay right now?” Close your eyes and take a few deep breaths. Concentrate on your lungs moving in and out. Feel the inner workings of your body, and just remind yourself that whatever that stressor is, it is not as bad as you feel in the heat of the moment. You are alive, you are healthy, and you are sober.

One moment at a time…

When stress in life leads you to cravings for drugs or alcohol, use mindfulness to regain your thoughts. When your mind is screaming for your drug of choice, take two minutes to yourself and get into the moment. Be aware of your emotions, of your cravings. With mindfulness practice you can become aware of your cravings, become aware of why you are experiencing these cravings, and then you can watch those feelings pass.

In reality, cravings only last for a few minutes  if you help move them on their way. An addict in recovery can learn to allow those cravings to come, acknowledge those cravings, and then move them out of their train of thought. The more you practice this, the easier it becomes and dealing with cravings or stress will become an easy part of your routine – fleeting through your mind without as much as a second thought.

Mindfulness meditation at The Cabin Chiang Mai

At The Cabin Chiang Mai, we believe that mindfulness meditation is an important part of recovery. During a 28-day stay at our residential rehab, mindfulness is introduced to each and every client.

In order to get our clients used to the idea of mindfulness and meditation we begin quite slowly, with introduction courses two to three times per week. During these sessions, our clients are encouraged to sit in peaceful silence for only 5 to 10 minutes at a time, and simply be aware of their breathing, the way their body feels, and to acknowledge the thoughts that are passing through their mind.

Learning to watch your thoughts pass through your mind without judgement, working through thoughts and behaviours instead of avoiding them or acting out negatively, can go a long way to control your cravings and prevent relapse.

Participation in mindfulness meditation is not mandatory, but it is strongly recommended, as the results have been quite impressive.

Mindfulness proven to help addiction recovery

More and more studies on mindfulness are being done and the positive results keep pouring in. At The Cabin Chiang Mai we have been using mindfulness in our treatment programme with excellent results, and it is great to see that the research findings are finally catching up.

For more information on our modern, three-part addiction treatment programme including mindfulness practices, check out our website.

About the Author

Dr. Saji Joseph

Dr. Saji Joseph

Gradueted MSW, PhD. Certified addiction therapist who has worked in multiple international rehabs since 2009 with a strong focus on treating addiction and related psychiatric comorbidities. His PhD work focuses on addiction relapse, and his practice is based on scientific evidence, ethics and compassion. He is a Certified Substance Abuse Therapist (CSAT) Level 3 by the Asia Pacific Certification Board and an International Certified Addiction Professional (ICAP) Level 3 by the Global Centre for Credentialing and Certification.

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