A trigger is a response in which you are activated to do something based on the recall of a previous experience. The trigger response may be emotional, mental, and/or physiological. For this blog post I will focus on triggers with respect to substance abuse and recovery. However, triggers can happen in a wide variety of contexts including Post-Traumatic Stress Disorder (PTSD).
If someone in recovery from alcohol abuse sees an advertisement on TV for liquor, they could be triggered to drink or at least want to drink. This is an example of an external trigger, which is the advertisement on TV. If that same person were to feel anxious, then they may be triggered to drink because they previously used alcohol to self-medicate worry and stress. This would be an example of an internal trigger, anxiety.
While everyone’s triggers are different, there are some common ones that I see, which can be represented by the acronym HALT. HALT stands for:
Hungry: Clients are more likely to think about substances when they are hungry. Consistently low blood sugar can cause a wide variety of health issues and increase thoughts, cravings, and urges to use. Eating increases dopamine and limits the amount of space in the stomach for alcohol, which can reduce cravings. Many clients who have been abusing substances for extended periods of time are malnourished during early recovery so a balanced diet can even expedite the recovery process.
Angry: Clients are often triggered to drink when they are feeling angry, whether directed at themselves or others. Anger can be associated with physiological responses such as an increased heart rate, blood pressure, or respiratory rate, which makes instant relief, in the form of substances, more appealing.
Lonely: Clients can be triggered to drink when feeling lonely, or even isolated. Keep in mind that you can feel lonely and isolated even when physically surrounded by a group of people. Conversely, you can feel connected even when alone. This trigger has more to do with whether you feel emotionally and mentally connected with people in your life. Many of my clients were isolated drinkers, especially toward the end of their active addiction. Isolation, especially in early recovery, can be a huge trigger for relapse and should be avoided if possible.
Tired: Feeling tired, fatigued, and/or exhausted can adversely impact our physical, emotional, mental, and spiritual health. In early recovery, when the body is repairing itself, sleep is hugely important. It is during sleep when our body clears out toxins that have accumulated during the day. 7-9 hours is recommended for adults. When using substances, we are not getting enough high-quality sleep as these chemicals interfere with the Rapid Eye Movement (REM) stage of sleep.
If you are feeling tempted to drink/use, ask yourself whether you are experiencing any of the above. If so, take appropriate action to reduce or counteract the trigger. Ideally, you can prevent some of these triggers from popping up in the first place by engaging in a consistent, high-quality self-care routine, which includes routines and habits around balanced meals, exercise, and sleep.
Keep in mind that these triggers do not always exist separately from each other, rather, many are interrelated. For example, if we are hungry, we are more likely to feel angry, or Hangry. If we are tired, we may be more likely to feel lonely because we have less energy to stay connected with others. If we are lonely, we may not feel like eating, which can in turn increase the loneliness. The upside to these relationships is that if we successfully address one trigger, we may resolve others as well. It is helpful to work with your therapist to identify your triggers and how you can cope with them. Our triggers do not define us — it is about what we do with them!