The craving for alcohol is a significant factor in relapse. It is a subjective experience – much like pain – and must be measured by an individual’s self-report. There is no objective means of measuring whether cravings exist at any given time or how intense they are. However, craving is reported by almost everyone who has relapsed back to the use of alcohol after an attempt to remain sober. There are thought to be two types of alcohol cravings: physiological and psychological. In the first – physiological – it is believed that the body itself is sending signals that alcohol should be consumed. In the second – psychological cravings – an individual has typically become used to drinking in certain situations and is triggered to do so when those situations recur.
It is thought that stabilized blood sugars help to reduce the physiological craving for alcohol. Exercise, overall good nutrition and restriction of sugar and caffeine intake help to maintain stable blood sugar levels. In addition, physiological and psychological cravings can be successfully controlled by the use of social support, behavioral techniques and cognitive techniques such as 12-step programs, counselling, talking about cravings when they occur, avoiding situations that trigger craving, using substitute or distracting behaviours, using self-talk that coaches oneself through cravings, meditating and deep-breathing. Additionally, some medications have been used to reduce the craving for alcohol, including topiramate, nefazodone, ondansetron, cameral and naltrexone.