How to stop alcohol cravings: recognise, avoid, cope

Why cravings happen when you cut back

NIAAA, the US government institute for alcohol research, says that as you change your drinking it is normal and common to have urges or a craving for alcohol. It uses both words for a broad range of thoughts, physical sensations or emotions that tempt you to drink even though part of you does not want to. You may feel pulled in two directions, or feel you are losing control.

The reassuring part, in NIAAA's words, is that urges to drink are short-lived, predictable and controllable. Its advice comes from a recognise-avoid-cope approach used in cognitive behavioural therapy, and it says that with time and practice your urges will lose strength and you will gain confidence in handling the ones that still come.

Step 1: recognise your two kinds of triggers

NIAAA describes two types of trigger. External triggers are people, places, things or times of day that offer a chance to drink or remind you of drinking. They are the more obvious kind, and the easiest to predict and avoid.

Internal triggers are harder to spot, because the urge seems to pop up from nowhere. NIAAA says that if you pause when it happens, you will often find it was set off by a passing thought, a positive emotion such as excitement, a negative one such as frustration, or a physical feeling such as a headache, tension or nervousness.

To learn your own pattern, NIAAA suggests tracking your urges for a couple of weeks: when they come, what set them off and what you did. Our free tracker counts your alcohol-free days; a note on your phone works for the urges themselves.

Step 2: avoid the triggers you can

NIAAA says that in many cases your best strategy is not to take the chance of an urge at all. Its suggestions:

• Keep little or no alcohol at home.
• Avoid social activities that centre on drinking for now.
• Suggest other plans to friends, so you stay in touch without the drinks.
• If you feel guilty turning down an invitation, remember it is not necessarily forever: once urges ease, you can return to some situations gradually.

Step 3: cope with the urges you cannot avoid

You cannot avoid every trigger, and internal ones cannot be blocked, so NIAAA recommends having several ways to handle an urge ready in advance:

• Remind yourself of your reasons. Keep your top reasons for changing on a card in your wallet or in a note on your phone.
• Talk it through. Have a friend you trust ready for a call, or bring one along to situations where you might be tempted.
• Distract yourself. Plan short, medium and longer options: texting or calling someone, watching short videos, lifting weights to music, a shower, meditating, a walk or a hobby.
• Challenge the thought. When you catch "one little drink couldn't hurt", stop it, notice what is wrong with it, and replace it with your decision.
• Ride it out. Instead of fighting the urge, accept it as normal and temporary; NIAAA compares it to an ocean wave that builds, crests and passes.
• Leave tempting situations quickly and politely, ideally with an exit planned in advance.

Evenings, weekends and other predictable cravings

Because urges are predictable, the times they usually arrive are the times to plan for. If the urge comes when you get home from work, decide beforehand what you will do and drink at that moment. Our guide on how to stop drinking every night covers the evening habit in detail, and how to say no to a drink covers the moment someone offers you one.

Alcohol-free versions of your usual drink can help some people, but NIAAA's advice to avoid triggers applies to them too: a review cited by the UK government, covered in our guide to alcohol-free drinks, linked these drinks with more craving in people with alcohol use disorder or heavy drinking patterns, and their look, flavour and smell can act as cues.

If you give in to a craving

If your goal is to stop and you have a drink, NIAAA's advice is to get right back on track: stop drinking, the sooner the better, and remember that each day is a new start. It says setbacks are common when people make a major change, that your progress in the long run is what counts, and that running yourself down does not help.

It also suggests talking to your healthcare provider or a supportive friend about what happened, working out why it happened at that time and place, writing down what you will do differently, and removing any alcohol from your home.

When to get help with cravings

NIAAA says to see a healthcare professional if urges are very difficult or you make no progress with these strategies after a few weeks. It notes that some newer, non-addictive medicines can reduce the desire to drink or make drinking less rewarding, so it is easier to stop.

In the UK, the NHS says medicines such as acamprosate or naltrexone help reduce alcohol cravings, and are usually offered once you have stopped drinking and need help to stay stopped. In the US, NIAAA says naltrexone helps reduce the urge to drink, and acamprosate eases the unpleasant feelings some people have while not drinking. A doctor decides whether either is right for you.

One safety point comes before all of this. If you get shaky, sweaty, sick or anxious when you go without a drink, those can be withdrawal symptoms rather than cravings, and the NHS says stopping suddenly can be very dangerous if you are dependent on alcohol. Get medical help before you stop. Our guide on how to quit drinking safely explains the options.

Common questions

When to get help

This site offers self-help tools and information, not medical advice. Talk to a doctor, or call one of the lines below, if:

• you feel shaky, sweaty, sick or anxious when you haven't had a drink;
• you find it hard to stop once you start, or you want to cut down and can't;
• drinking is causing problems with your health, work or the people close to you.

Before you stop: It can be very dangerous to stop drinking suddenly if you are dependent on alcohol. If you get withdrawal symptoms, get medical help before you try to stop drinking.

Sources

1. How to Stop Alcohol Cravings. NIAAA Rethinking Drinking. rethinkingdrinking.niaaa.nih.gov
2. Recovering from a Drinking Episode When Your Goal is to Quit. NIAAA Rethinking Drinking. rethinkingdrinking.niaaa.nih.gov
3. Alcohol-use disorder. NHS. nhs.uk
4. Treatment for Alcohol Problems: Finding and Getting Help. National Institute on Alcohol Abuse and Alcoholism (NIAAA). niaaa.nih.gov
5. Updating labelling guidance for no and low-alcohol alternatives: equality impact assessment. Department of Health and Social Care (UK). gov.uk