Difference Between Internal and External Triggers of Addiction

Addiction is a complex and often misunderstood disorder that affects individuals from any background, culture, or demographic and can be caused by a wide range of triggers.

Addictions vary from person to person in terms of what they are addicted to, the effects of this, and how best the individual should go about seeking help.

In the UK, addiction (also known as a substance use disorder or substance misuse disorder) causes a strain on public healthcare, with over 290,000 adults reported as seeking some form of drug and alcohol support services (1).

At the time of the study in 2023, this sample represented around 0.4% of the population, and although this may seem like a small percentage, it is still a significant number and one that should aim to increase research around the different elements and factors that cause an addiction to originate.

This blog aims to explore the topic of triggers within addiction, but first, it is vital to understand the process of addiction.

Your First Appointment

When first seeking rehabilitation for an addiction, individuals will be faced with many options, and the first decision is generally to determine whether the individual would be more suited to inpatient care or outpatient care.

This refers to whether the individual will reside within a dedicated rehab centre (inpatient care) or remain at home or in the local area during treatment (outpatient care).

This choice will generally depend on the individual’s history with addiction. For example, an individual who has a long history of a serious addiction (i.e., to substances such as alcohol and heroin), as well as past and failed attempts to undergo rehabilitation, will be more suited to inpatient care within a dedicated centre.

An individual who has a shorter history with addiction may be more suited to outpatient care. However, this varies from case to case and not every individual falling into either of these categories may be suggested these options.

Individuals should always enter a rehabilitation programme that they feel will benefit them, and this should be thoroughly discussed with a medical professional or rehabilitation officer.

What Drug Treatment Involves

Before covering the key topic of this blog – triggers – it is first important to understand the process of rehabilitation, as this is something that all individuals struggling with addiction should consider.

Entering rehabilitation is vital to reduce the negative impacts of addiction, both to the mind and body, and to begin to help the individual overcome the addiction in general, working on the journey to recovery and sobriety.

In general, rehabilitation can be split into three stages: detoxification, rehabilitation (therapy), and aftercare.

The following subheadings outline some of these concepts, as well as some other important factors of rehabilitation that are beneficial to most individuals who begin this process.

1. Detoxification (detox)

This is the essential first stage of drug rehabilitation where individuals will withdraw from the substance that they are addicted to.

Depending on the substance that the individual was addicted to, the withdrawal process and withdrawal symptoms will be different. These vary in frequency, severity, and prevalence amongst individuals, and every case should be treated as unique.

Some addictions – those to opioids, for example – can require additional medical interventions, with specialist drugs prescribed to help lessen the effects of withdrawal and allow the process to be safer for the individual, as well as being more comfortable where possible (2).

2. Talking therapies

This is the most common form of therapy that can be implemented when an individual is undergoing rehabilitation, and it has many different forms that can be applied in different cases and situations.

The most well-known, perhaps, is cognitive behavioural therapy (CBT). This form of therapy is individual and assists the individual struggling with addiction to recognise negative thought patterns that may contribute to the adverse impacts that they are experiencing and work toward altering them.

Another popular form of talking therapy is group therapy. Popularised through groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), this is a great way for individuals to connect with others who may have experienced similar situations to share and learn from one another in a safe space and a respectful environment.

3. Self-help

One of the main lessons that rehabilitation aims to teach is the concept of self-help. This is something that many individuals who struggle with addiction also struggle with, as addiction can often cause individuals to feel negatively about themselves and their actions.

However, all individuals deserve to care for themselves and give themselves rest where needed – one of the key concepts of rehabilitation.

Individuals are encouraged to engage in self-help activities throughout their rehabilitation journey. This can include activities such as meditation and yoga but can also be more focussed on rehabilitation with journaling, independent CBT activities, and more specialised forms of care.

What is a Trigger?

When an individual is struggling with addiction, there is no ‘cure’, meaning that an individual will have to live with some of the long-term effects for the rest of their lives.

Rehabilitation aims to give individuals the tools and techniques that they need to maintain their sobriety and continue their recovery in the long term.

One of the effects of addiction that is hardest to overcome is the occurrence of triggers. Triggers are caused by a huge range of factors and can cause the individual to fall back into old patterns, including seeking out the substance that they are addicted to and, in some cases, the risk of relapse.

This means that triggers are something that individuals going through rehabilitation want to avoid, but this is not always possible. This is why individuals are taught to manage these triggers as they may arise, and to deal with unavoidable factors in their daily routine in a way that is progressive and beneficial toward their long-term recovery.

Two Types of Triggers: External & Internal

In general, there are two different types of potential triggers: internal triggers and external triggers.

All triggers will be considered during the recovery process, and individuals will be actively encouraged to think about new and overlooked relapse triggers and personal triggers that they may not have considered before.

They will then be supported and coached through the process of creating effective strategies to deal with these and to act suitably at signs of relapse.

The following subheadings outline these different trigger types, as well as providing some examples for each type.

1. Internal Triggers

As expected, internal triggers refer to triggers that occur as a result of something internally within the individual struggling with addiction. This makes them hard to detect from an external point of view and can be impossible to predict for both the individual and those around them.

Emotions: Emotions are something that humans often have little control over and can take a long time to ‘gain control’ of – even if this is not completely. Emotions are especially linked to addiction, as substance use and abuse can have serious impacts on individuals’ emotions. When acting as a trigger, emotions could affect individuals suddenly and without warning and can be especially strong. For example, individuals could associate an emotion such as feeling lonely with the desire to consume substances, meaning that anytime they feel as they are alone, they may begin to feel strongly toward consuming substances again.
Thoughts: Like emotions, thoughts are also unpredictable and sudden. If an individual has been struggling with addiction for a long period of time, then they may develop recurring thoughts of consuming substances in order to keep up with the body’s physical dependence on these substances. In some cases, just thinking about the substance that the individual can be a strong trigger, often snowballing into thoughts about consuming it and sometimes relating into actions. This is something that individuals have little control over but can learn to deal with and manage as they occur.
Memories: Another abstract and unpredictable concept, memories can often act as powerful triggers for individuals who are struggling with addiction. For example, remembering a time when an individual was consuming a substance may cause cravings and urges to consume the substance again, purely based on the memory and, tying them all together, the emotions and thoughts that the individual had at the same time.

2. External Triggers

An external trigger, therefore, is a trigger that occurs as a result of the individual’s external environment around them. This includes people, places, and situations, and can sometimes be more detectable by others and the individual themselves, but this is not always the case.

People: Addiction can be caused by a number of different factors, and, in some cases, consuming substances could have originally occurred as a result of social situations, pressure, and/or events. This may mean that an individual has particular associations about seeing/interacting with specific people and their addiction. When the individual is confronted with this person, for example, their brain may reactivate this association and therefore lead to a greater chance of consuming the substance and relapsing. In addition, the person themselves may be a bad influence on the individual who is going through rehabilitation and may try to pressure them into further consumption of substances directly – something which should be avoided at all costs where possible.
Places: Addiction can often cause individuals to become increasingly secretive and protective of their behaviours, and this can lead to the creation of a ‘safe place’ in which they can engage in addictive behaviours. This place would therefore become associated with the individual’s addiction, and they may not be able to visit the place, think about it, or see it anywhere, without feeling the need to consume substances. This can be especially risky in the cases where individuals may have been engaging in addictive behaviours in their bedroom, for example, enter a dedicated rehab centre to overcome this, and then return home after An individual’s environment can be a huge influence on their triggers, so this should always be considered when entering rehab, leaving rehab, and everything in between and afterwards.
Situations: A common theme of triggers is the associations that individuals form when they are actively struggling with addiction, compared to those that they are faced with when undergoing rehabilitation. This is true also with the general situations that individuals may be in when they become ‘triggered’. For example, if an individual experiences a ‘high-risk situation’ that is similar to one that they may have experienced before engaging in substance abuse or misuse, then they may be more likely to feel the same desire to consume substances or to engage with them in general. This is something that could greatly increase relapse rates and negatively impact the future of the individual’s rehabilitation.

Rehab 4 Addiction is here to help

Rehab 4 Addiction is a dedicated referral service, aiming to help every individual who seeks our help to find the most effective, suitable, and appropriate form of rehabilitation for them.

We offer advice on triggers, cravings, rehabilitation in general, and any other addiction-related questions that you may have in the case of your own situation or the situation of someone you know.

To find out how we can help you or someone you know, take a look at some of our other blog posts, articles, and webpages that cover a variety of addiction topics, or give us a call on our addiction support hotline on 0800 140 4690 today.

References

[1] Office for Health Improvement and Disparities; Adult substance misuse treatment statistics 2022 to 2023: report; Updated 21 December 2023; https://www.gov.uk/government/statistics/substance-misuse-treatment-for-adults-statistics-2022-to-2023/adult-substance-misuse-treatment-statistics-2022-to-2023-report

[2] Diaper, A.M., Law, F.D. and Melichar, J.K., 2014. Pharmacological strategies for detoxification. British Journal of Clinical Pharmacology, 77(2), pp.302-314.

Boris MacKey

Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field. His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline. You can connect with Boris online at LinkedIn or X.com.