Understanding Addiction
What is addiction?
A chronic, treatable condition involving difficulty controlling substance use or behavior despite harmful consequences. It can affect reward, motivation, learning, judgment, relationships, health, and daily functioning.
What is a trigger?
: A trigger is an internal or external cue associated with substance use or a strong emotional response that can increase thoughts about using or craving.
What is a recovery plan?
A personalized plan that identifies recovery goals, risks, supports, coping strategies, routines, treatment needs, and specific actions for maintaining recovery.
Name one healthy coping skill you can use during stress or cravings.
Paced breathing, walking, exercise, grounding, journaling, calling a support person, attending a meeting, mindfulness, music, prayer/spiritual practice, healthy distraction, or speaking with staff.
What does recovery mean beyond simply not using alcohol or drugs?
Recovery can include improving health, relationships, decision-making, emotional regulation, responsibility, purpose, stability, connection, and quality of life as you work toward personally meaningful goals.
What is the difference between substance use and a substance use disorder?
Substance use means a person uses alcohol or another drug. A substance use disorder involves a problematic pattern of use that causes clinically significant impairment or distress, such as impaired control, social problems, risky use, or physiological effects.
Give one example of an internal trigger and one example of an external trigger.
Internal examples include anger, loneliness, anxiety, excitement, memories, pain, or negative self-talk. External examples include people, places, money, parties, paraphernalia, neighborhoods, music, conflict, or seeing substances.
Why should a recovery plan identify supportive people?
Recovery is harder during stress or cravings. Identifying safe people in advance makes it easier to ask for help before risk escalates.
What is the purpose of the 5-4-3-2-1 grounding technique?
To redirect attention to the present moment through the senses. A common version identifies 5 things you can see, 4 you can feel, 3 you can hear, 2 you can smell, and 1 you can taste or appreciate.
A friend offers you alcohol or drugs after learning you are in recovery. Give an assertive response.
'No, I'm not using. I'm working on my recovery.' The person can repeat the boundary, leave the situation, and contact support if the pressure continues.
Why might a person continue using even when they know substances are causing problems?
Repeated use can strengthen learned associations between substances, relief, reward, people, places, and emotions. Cravings, withdrawal, habit patterns, stress, distorted thinking, and impaired decision-making can make stopping difficult, even when the person understands the consequences.
Complete this sequence: Trigger → Thought → Feeling → ______ → Decision.
Craving. A useful recovery sequence is Trigger → Thought → Feeling → Craving/Urge → Decision/Behavior. Recognizing the sequence early creates opportunities to intervene.
Name three important parts of a relapse-prevention or recovery plan.
Personal triggers, warning signs, coping skills, backup coping skills, support contacts, meetings/treatment, medication plan when applicable, healthy routines, high-risk situations, exit plans, emergency actions, and continuing-care appointments.
What is the difference between coping with a problem and avoiding a problem?
Healthy coping acknowledges the problem and responds constructively. Avoidance may temporarily reduce discomfort but can leave the problem unresolved and sometimes increase stress or relapse risk.
After an argument with a family member, your first thought is to use. What should you do next?
Recognize the argument as a trigger, pause before acting, identify the thought and feeling, create distance from substances, use a coping skill, and contact support. Address the family conflict after the immediate relapse risk has decreased.
How can repeated substance use affect decision-making and the brain's reward system?
Repeated use can make substance-related rewards and cues unusually powerful while weakening attention to delayed consequences. This can contribute to craving, impulsive decisions, reduced control, and prioritizing substance use over healthier rewards.
A patient receives upsetting news, becomes angry, isolates from peers, and begins thinking about using. Identify the trigger and two warning signs.
The upsetting news is the immediate trigger. Warning signs include escalating anger, isolation, substance-related thinking, stopping communication, romanticizing past use, or withdrawing from recovery supports.
Your first coping strategy is not working, and the craving is increasing. What should your recovery plan tell you to do?
Move to the backup plan rather than continuing to struggle alone: leave the high-risk setting, contact a support person, notify staff or a counselor, attend a meeting, use another coping strategy, remove access to substances, and increase the level of support.
How can the STOP skill interrupt an impulsive recovery decision?
STOP can be used as: Stop; take a step back or breathe; observe thoughts, emotions, urges, and the situation; proceed mindfully with a recovery-supportive action. The pause creates space between an urge and a behavior.
You are invited to an event where substances will probably be present. Describe a recovery-centered decision.
Declining the invitation, attending only with strong safeguards when clinically appropriate, bringing sober support, having transportation and an exit plan, avoiding substance-use areas, checking in with support, and leaving immediately if risk increases.
Why is addiction more complex than simply making 'bad choices'?
Substance use behavior can be influenced by biological vulnerability, learning, trauma or stress, mental and physical health, relationships, environment, availability, coping patterns, and social conditions. Personal choices still matter in recovery, but addiction cannot be explained by willpower alone.
A person says, 'I wasn't planning to use. It just happened.' Name at least three things that may have occurred before the use.
Precursors include exposure to a trigger, an automatic thought, emotional distress, craving, isolation, contact with high-risk people, failure to use coping skills, access to substances, minimizing consequences, or making a risky decision. The purpose is to identify the chain, not assign blame.
Create a brief emergency recovery plan for a strong craving.
Identify what triggered the craving; pause and avoid acting impulsively; leave or secure the environment; use an immediate coping skill; contact a specific support person; use a backup strategy; avoid access to substances; seek staff/professional support when needed; and review what happened afterward.
You feel angry, anxious, and strongly crave something. Name three different coping strategies and explain why you would use them.
Use paced breathing to lower physical arousal; use grounding or walking to redirect attention and tolerate the urge; and contact a counselor, sponsor, peer, or trusted support person to reduce isolation and get help. Other healthy combinations can receive full credit.
After 60 days in treatment, someone says, 'I'm doing well now. I don't need meetings, counseling, support, or a recovery plan anymore.' What risks should the person consider?
Improvement can lead to overconfidence or reduced attention to warning signs. The person should consider whether triggers, cravings, stressors, relationships, housing, legal obligations, mental/physical health needs, and recovery supports have actually stabilized. Continuing care can help protect gains made in treatment.