Cravings


Doc’s Thoughts

Broaden your perspective. Live a happy, healthy, meaningful life.

Subscribe to Doc's Thoughts

Chemical coping is another name for addiction. It describes a cycle: feel distress, take a chemical, feel better. The specific chemical might be fentanyl, alcohol, nicotine, or cocaine, but the process is the same—it’s a learned response to distress that, when repeated many times, becomes automatic. Feel distress → take a chemical → feel better.

From the outside, addiction looks irrational. Why would anyone keep doing something that is so obviously self-harming? But from the inside, it’s actually a familiar and very human pattern: it’s just a form of distress response. Many of us engage in this kind of pattern, even if not to excess—a drink at the end of a hard day, an edible to take the edge off social anxiety.

Addiction is an extreme form of this behavior, and it's not as distant from our own lives as we’d like to think. At its core, addiction is about continuing to engage in a pattern of behavior that we recognize is harmful—but feeling unable to stop. That stuckness, that conflict between intention and action, is something almost all of us know intimately. We stay up too late, scroll our phones too long, eat what we said we wouldn’t, work past the point of exhaustion, or say yes when we meant no. We keep getting pulled into patterns we know don’t serve us, yet they repeat again and again.

While these everyday habits may not carry the same obvious risks as injecting heroin, the emotional mechanics—seeking relief from distress, feeling stuck, struggling to change—are strikingly similar. There’s the behavior itself, and there’s what lies beneath it. Why do I keep prioritizing my job over time with my family? Why do I keep eating when I feel sad? Why do I keep prioritizing money over my health?

When we hold onto something too tightly, our knuckles turn white—that’s the recovery term “white-knuckling”: forcing ourselves not to use through willpower alone. As a strategy, it almost always fails. To avoid that, we often talk about alternatives—exercising, distraction, building community, reaching out to people. These are important, practical tools that can create space between the urge and the action.

Fundamentally though, cravings are distress signals. The urge to use, to engage in a behavior we know does not serve us, is a direct call from the pain we’re trying to numb. If we can learn to be curious about the craving—what’s underneath it—we often find the demon inside us that is crying out for attention. Loneliness? A sense of being unworthy? The behavior is the distress response, and if we follow the thread backward from the urge, we often find the parts of ourselves that are most disquieted.

Following that thread is hard because it leads, almost by definition, to the parts of ourselves that are most frightening. If our deepest fear is not being enough, not being adequate, then that’s where that road leads.

When we are afraid, when we screw up our courage to do hard things, we often think about going into battle—about facing problems with strength. Facing these parts of ourselves does require courage and strength, but it requires the courage and strength to be soft, to be kind, to seek peace and stillness. These places cannot be subdued, beaten, or slain. The only way to be with this part of ourselves is with kindness and compassion—and summoning the strength to forgive and make peace is much less intuitive than summoning the strength to fight.


Cheers,

Doc

Forwarded this email? Sign-up here

Follow me on Bluesky | LinkedIn

Doc’s Thoughts

Every week, Dr. Justin Altschuler writes a post that provides new insight and perspective into the familiar parts of life, helping readers live a healthy, happy, meaningful life.

Read more from Doc’s Thoughts

Doc’s Thoughts Broaden your perspective. Live a happy, healthy, meaningful life. Subscribe to Doc's Thoughts When patients have been in recovery for a while, there often comes a moment when they want to put it all behind them. “Doc,” patients will say, “I want to get off this medication. I just want to move on with my life.” It’s an understandable desire. Addiction isn’t something most of us feel proud of, and it often comes with shame, regret, and a deep wish that it had never been part of...

Doc’s Thoughts Broaden your perspective. Live a happy, healthy, meaningful life. Subscribe to Doc's Thoughts We like to believe that we choose our norms—that we live our lives based on principles, values, and reasoned decisions. While this is true to some degree, one of the most powerful forces shaping our behaviors and the structure of our society is far more mundane: repetition. Repetition is a neutral force—not good or evil. It doesn’t care what it reinforces. But what we repeat, we...

Doc’s Thoughts Broaden your perspective. Live a happy, healthy, meaningful life. Subscribe to Doc's Thoughts “How did you go bankrupt?”“Two ways. Gradually, then suddenly.” Hemingway was talking about money, but he could’ve been describing almost anything that falls apart—our health, our relationships, our sobriety, even our identity. Collapse is rarely abrupt. Usually, it's a slow unraveling we tolerate, excuse, and ignore—until we can’t. We all do this, in one form or another. We normalize...