Cravings are typically most acute during the first few weeks of recovery. While they may never entirely go away, their severity may lessen in time. And you’ll learn to control them too.
Medication for Addiction Treatment (MAT) can ease your opioid cravings and help you develop good habits that reduce your relapse risk.
Why Do I Have Drug Cravings?
Drug cravings are subjective, and everyone describes them differently. But typically, people with opioid use disorders (OUD) describe them as an overwhelming urge to misuse the drug.
Cravings are an essential part of an addiction diagnosis. If you have an OUD, cravings are part of your condition.
Opioids alter brain chemistry, and patients develop dependence on the drug such that, when the drug is discontinued, the patient experiences strong cravings and withdrawal symptoms.
A number of factors including emotional states, stress, illness, and pain, can all acutely worsen cravings  But some people say their urge to take drugs is always with them, just lurking in the background. The goal is to keep cravings at a manageable level to prevent relapse to opioid misuse.
Physical vs. Psychological Cravings
In studies, people often say their cravings come in the form of “interfering thoughts.”  They’d like to focus on something useful, like work. But they end up thinking about drugs instead, and their cravings are either physical or psychological.
Even people taking opioids as prescribed can become physically dependent. Physical cravings for opioids are most common during withdrawal. Flu-like symptoms, insomnia, and shaking could all be considered physical drug cravings. These feelings make you want to use drugs to get relief.
As you maintain abstinence for a period of time, the physical cravings tend to subside, and the cravings become more psychological. People with addictions describe a psychological need to use their substance of choice. Psychological cravings, while often subtler and less intense than physical cravings, can last longer, even months or years after abstinence is achieved.
You Can Manage Your Opioid Cravings
Everyone with an OUD deals with cravings. Treatments are available, namely:
Suboxone and Methadone are the two most commonly prescribed treatments for OUD and associated cravings. They are both opioid (or partial opioid) medications that provide your body with enough opioid to control cravings but little enough that you are able to function normally without getting high or being at risk for overdose.
Various forms of therapy including support groups or individual one on one counseling have been proven to help patients cope with cravings in a healthy way and to prevent relapse to drug use.
Feeling tired, hungry, angry, or dehydrated could all cause your cravings to intensify. Taking care of your physical and mental health can help you stay strong enough to avoid acting on your cravings.
Often, simply avoiding the people, places, and things that worsen your triggers is the best relapse prevention strategy.
The more of these resources you employ all at once, the more likely you are to be successful in controlling opioid cravings and preventing a relapse to drug use.
- Systematic Review of Pain Severity and Opioid Craving in Chronic Pain and Opioid Use Disorder. Pain Medicine. https://academic.oup.com/painmedicine/article/21/2/e146/5570912. February 2020. Accessed July 2022.
- Sex Differences in Daily Life Stress and Opioid-Dependent Patients. The American Journal of Drug and Alcohol Abuse. https://www.tandfonline.com/doi/full/10.1080/00952990.2018.1454934. April 2018. Accessed July 2022.
- A Preliminary Examination of the Multiple Dimensions of Opioid Craving. Drug and Alcohol Dependence. https://www.sciencedirect.com/science/article/abs/pii/S0376871620306384. February 2021. Accessed July 2022.
- Is There a Difference Between Physical Dependence and Addiction? National Institute on Drug Abuse. https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence-addiction. January 2018. Accessed July 2022.
- Psychological Management of Craving. Journal of Addiction Research and Therapy. https://www.omicsonline.org/open-access/psychological-management-of-craving-2155-6105-1000230.php?aid=54616. June 2015. Accessed July 2022.
Medically Reviewed By Elena Hill, MD, MPH
Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More