What Are Substance Use Triggers?

Triggers are events, objects, places, people, and other things that could be experienced that cause an individual to experience an emotional response, which is in this case, to crave or use a specific substance.¹

People with substance use disorder (SUD) or related mental health issues often find it very difficult to control these emotional responses, which can lead to more substance use, relapses, and a worsening of their condition. For this reason, trigger management and other related concepts are central in most SUD treatment and rehabilitation programs.^1,2,3

How Can They Affect SUD Recovery?

Cravings for substances are now generally understood to be caused by maladaptive brain connections that resulted from continued substance misuse. Additionally, they could be caused or further exacerbated by co-occurring mental health issues such as anxiety, depression, and trauma.^1,3,4,5,6

Because the brain can take a relatively long time to readjust, these cravings can remain even after the affected individual has “detoxed” and no longer has appreciable traces of habit-forming substances in their body.^2,4,5,6

This means that the recovering individual will remain vulnerable to substance use triggers and the resulting relapses up until their brain has made the new connections necessary for healing. Cognitive-behavioral therapy and supplemental therapies like mediation and exercise are often used to speed up and strengthen this process.^2,4,5,7

How Co-occurring Mental Health Issues Worsen Substance Use Triggers

Anxiety, trauma, and depression are among the many mental health conditions that may be caused by or contribute to SUD. When these conditions are present, they could make affected individuals even more vulnerable to triggers, and therefore, relapses.^1,3,5,6,7

The presence of co-occurring mental health issues can increase your vulnerability to substance use triggers in a number of ways.

• They can reduce mental resilience. Mental resilience is a catch-all term that refers to the ability of a person to regulate their thoughts and emotions, both of which are already also influenced by substance misuse. Mental health problems like anxiety or depression can cause people to use substances as a way to ease their symptoms. This, in turn, can make cravings and triggers even more difficult to handle than they would be otherwise.^1,3,5,6,7
• May make individuals more vulnerable to risk-seeking behavior. Some mental illnesses may people more prone to more dangerous behavior. Risk-taking is often associated with depressive and social anxiety disorders. Taking dangerous substances that one would not normally consider can be part of this risk-seeking behavior.^1,3,5,6,7
• Can complicate SUD treatment. Not all SUD treatment and rehabilitation programs are necessarily equipped to handle individuals with a mental health condition other than SUD. When SUD patients with a co-occurring mental health issue go through a program meant for the general population, the program may not be able to provide the kind of care they need. When the co-occurring illness is not addressed adequately, it may continue to cause substance use problems for affected individuals.^2,3,5,6

Ways to Improve Trigger Avoidance

Regardless of whether you have an SUD, another mental health issue, or are completely healthy at the moment, being able to manage your emotional triggers well can be the key to a better quality of life. Here are some things you can try to further improve your ability to handle your triggers.^2,3,5,7

• Create a healthy routine. Building routines can help conserve mental energy, allowing you to maintain and improve your mental and physical health without being quickly overburdened.²
• Learn to accept some loss of control. Anxiety over things you have no power over can lead to you being on edge for no good reason. Learning to let go and accept what you can’t control — and recognizing what you can —is often key to reducing stress.^3,7
• Exercise regularly. Regular exercise can help improve sleep quality, has anti-anxiety and anti-depressive effects, and works synergistically with other interventions used for SUD and other mental health issues.^2,5
• Try regular meditation. Regular meditation can help improve your ability to handle emotions, which in turn, may prevent negative emotions from being acted on. Additionally, evidence points to mindfulness meditation techniques being specifically effective for SUD.^2,5,7
• Limit anxiety-inducing substances. Limiting the amount of caffeine, tobacco, and other stimulants that you consume can keep the effects of stress and anxiety from becoming even worse. Reducing your intake very slowly over a few months tends to work better than quitting cold turkey.³
• Keep attending therapy sessions. If you aren’t already regularly attending therapy sessions, you should consider giving them a try, especially if substance use is becoming a concern.²
• Consider a change of scenery. If your emotional triggers are tied to a person, your job, or your home, you may want to seriously consider giving these up. Understandably, this can be easier said than done but is worth considering where serious mental health issues are involved.²

Find Help Managing Your Triggers Today

Managing triggers related to substance use and other emotional impulses is key to a long-lasting recovery. If you’re in the North Texas area and feel that you’re having problems with drug or alcohol use, you can call Dallas Drug Treatment Centers at +1(214) 453-5663 to discuss your long-term recovery options.

Resources:

1. Asensio, Samuel et al. “What Is the “Trigger” of Addiction?.” Frontiers in behavioral neuroscience 14 54. 21 Apr. 2020, doi:10.3389/fnbeh.2020.00054

2. National Institute on Drug Abuse. (2020, July 10). Treatment and Recovery.

3. Sinha, Rajita. “Chronic stress, drug use, and vulnerability to addiction.” Annals of the New York Academy of Sciences 1141 (2008): 105-30. doi:10.1196/annals.1441.030

4. National Institute on Drug Abuse. (2021, July 27). Drugs and the Brain.

5. Mavrikaki, M. (2020). Brain Plasticity in Drug Addiction: Burden and Benefit. Harvard Health Publishing.

6. Pailing, A. N., & Reniers, R. L. (2018). Depressive and socially anxious symptoms, psychosocial maturity, and risk perception: Associations with risk-taking behaviour. PloS one, 13(8), e0202423.

7. Witkiewitz, K., Bowen, S., Douglas, H., & Hsu, S. H. (2013). Mindfulness-based relapse prevention for substance craving. Addictive behaviors, 38(2), 1563–1571. https://doi.org/10.1016/j.addbeh.2012.04.001