James Clear, author of Atomic Habits, defines the Habit Loop as consisting of four components: the cue or trigger, the craving, the response and the reward. He offers strategies for breaking down each component for those who are attempting to create a new habit or extinguish an old habit.
As mentioned in part 1 and part 2 of this series, I am not suggesting that addiction — either a substance use disorder or behavioral addiction — is simply a bad habit. However, for those committed to discovering a life of sobriety, his tools can be an excellent addition to the recovering person’s toolbox.
Make Recovery Attractive
In part 2 of this blog series, I talked about the 1st of the 4 Laws of Creating a New Habit according to Clear, make it obvious. The 2nd law, make it attractive, addresses the idea that our brain must find something rewarding in order to continue that behavior.
With addictive drugs such as opiates and opioids (Opana®, Oxycontin®, heroin, fentanyl, kratom, methadone, etc), benzodiazepines such as Xanax® (alprazolam), Ativan® (lorazepam), Valium® (diazepam), etc, and alcohol, the effects of these drugs — even the very anticipation of the effects of these drugs — produces the neurotransmitter dopamine levels to rise in the brain.
The Role of Dopamine in Forming Habits
Dopamine, a neurotransmitter, spikes when the brain anticipates something good is about to happen. This is why it’s an imperative component in the formation of a habit.
Basically, addictive drugs provide such an overwhelming amount of dopamine to the brain that it overrides any relatively small amount the brain would normally make on its own. This urge — or wanting — created by dopamine is great for keeping us alive as a species if we are seeking water to quench thirst, or shelter to be safe from harm. But it can be the devil to conquer when it comes to stopping an addictive drug.
Use RAIN to Halt Triggers Turning Into Habits
Treatment programs address this issue as a major part of teaching patients how to deal with inevitable urges that arise from triggers. In the words of Dr. Judson Brewer, Medical Director of the Yale Neuroscience Clinic:
“With addicts, we use the RAIN acronym. We get them to:
R – Recognize what craving feels like.
A – Allow it to be present without pushing it away, allow it to come up, do its dance and fade away.
I – Investigate what craving feels like in my body right now with curiosity.
N – Note craving as it comes and goes along with tension, yearning, and tightness in the body.
We have found in our research that the more these addicts practice this approach, the more skillful they become at ‘urge surfing,’ or ride out their urges without acting on them.”
Make Old Habits Unattractive
Jean, mother of three young children, completed a successful accelerated opioid detox off heroin at Coleman Addiction Medicine. Throughout her experience she utilized this tool quite effectively.
She had been drug-free and doing well for several months when she found herself in a funk with negative thoughts and strong emotions taking up residence in her brain. Her old thought habits seemed to reignite with a new ferocity, compelling her to respond in deep-rooted reactive ways: whatever she could do to most efficiently avoid the discomfort she was feeling. In the past, heroin was the solution.
Jean had learned and was still diligently practicing the notion of “this too shall pass,’ using the RAIN acronym.
To her delight — and almost astonishment — the new thought habit she had been striving to create kicked in. She found that, although the stressful situation hadn’t gone away, she was able to ‘ride the wave of discomfort’, and get well beyond a reactive response. She was truly experiencing the “ecstasy of detachment,” described by authors of The Tao of Sobriety, David Gregson and Jay Efran, as “being relieved of the burden of believing that you must always do something special or immediate about upsets, losses, or cravings. Let them be, and they just might let you be.”
If you have any questions about how the Coleman Addiction Medicine can help you or a loved one safely detox off alcohol, or the various opioids, please give us a call at 877-773-3869.
Joan Russell Shepherd, FNP
This is the third post in a five-part series. Check out the other posts in this blog series here.