Studies show that cravings can be set off by external cues such as sights, sounds, and smells previously associated with drug-use. Even internal cues can act as a trigger. For a drinker, looking at a clock can remind him it is time for a drink. Food, sex, holidays, and sporting events may have nothing directly to do with using, but for some individuals, they remind them of using. Anger, sadness or even extreme happiness can be a reminder of using and when you feel these emotions, they may be a cue to use if that was your chosen response when you were actively using drugs or drinking (Goodwin, 2000).
To take action on cues, you need to identify them. There are four kinds of cues (Marlatt, & Donovan, 2005):
1. Things: The things you surround yourself with, such as a favorite tee shirt you wore to get high with friends, a spoon and a piece of mirror, a mug or a chair.
2. Gatherings, occasions or events: Work, hobbies, holidays, family gatherings or the sports you associate with using.
3. Places and locations: It’s the places you associate with buying and using such as a particular street, bar, liquor store, cafe, club, alley, house or corner.
4. Emotional states: Emotions you associate with using such as sadness, anger, desire, and depression. For example, when you felt anger, you headed out the door and used or got drunk. When you felt sad, you took a drug or drank. These negative emotional states became your cues to use.
To begin identifying cues, it’s often easiest to start by making a list of your cues that are things. These cues are the particular objects that for you have become closely associated with specific activities related to drinking and using drugs.
Check any items on the following list that are cues for you.
These are examples of things that may cause you to think about using. Using the “Personal Cue Inventory and Strategies to Manage Cues” form at the end of this chapter, make a list of your unique cues that are things, and then keep adding to this list. In your mind, walk through your home, your neighborhood, and the homes of your friends. As you mentally walk through each place, add cues to your list. Do it now.
Think about it. When you were using and drinking, you surrounded yourself with items that supported your beliefs about your life as a user. These symbols gave meaning to using. It made drinking or using drugs feel special. These items may have signaled to others that you were one of them or to your family that you were not one of them. Now you need to take action and remove these reminders (Marlatt, & Donovan, 2005).
Most likely, you are reading this book because you want to make a life change. To do that, you must give up the symbols and things from your old life that cued you to your old using habits and beliefs. You can’t make this life change without giving up some things. Change requires new symbols and new things. You can’t succeed at relapse prevention and meet your life goals if you don’t remove and replace your using cues.
The good news is you get to replace old things with new things and create new meanings for yourself. You can create positive, safe spaces in your life by creating positive cues. This will reduce your craving and your choice not to use will automatically be reinforced by the cues around you. Stress and being around things that are drug related cues are critical factors to relapse and drug use.