Craving and Addiction

Dr Omar Manejwala

I am excited to announce that a new book is out today from my colleague, Dr. Omar Manejwala. He is the former Medical Director of Hazelden (one of the oldest and most respected treatment organizations in the world), and current Chief Medical Officer of Catasys, an innovative health management company focused on treating substance abuse problems.

I was fortunate to receive an advanced copy of his new book, Craving: Why We Can’t Seem to Get Enough so I have had the past month to review it thoroughly. If you struggle with addiction, or care about someone who does, then I strongly encourage you to get this book!

Why I recommend this book

I am excited to announce that a new book is out today from my colleague, Dr. Omar Manejwala.

Reason #1

First, craving is a universal experience we all share and it also happens to be at the heart of addiction.

In healthy doses, it is part of what makes us human. But when cravings become so intense that they lead to out-of-control behaviors, then they are not such a good thing.

In fact, they cause significant pain and suffering. For those who have never experienced addiction, imagine holding your breath and then starting to think about air.

  • How long before your desire to breath becomes an intense craving for air?
  • How long until the craving for air becomes almost unbearable?

You may think this example has little to do with addiction, but the regions of the brain that control your breathing, heartrate and other survival functions happen to be the same areas of the brain that get hijacked by addiction.

By reading Dr. Manejwala’s new book, you will be treated to a very lucid and beneficial explanation of the science of craving. If you are afraid of brain science, have no fear, he makes it very accessible!

Reason #2

Second, once you understand cravings more clearly, you will be in a far better position to do something about them. Perhaps what I like most about this book is that he provides an approach to deal with cravings that links back to the science of what we know about them.

For example, part of the experience of craving is biological. Cravings are not just obsessive thoughts in your head, but are deeply rooted in physical and chemical changes that take place in the brain and body.

Think back to our example about holding your breath. Is your need for air all in your head? Of course not. While we don’t require alcohol or drugs to survive like air, cravings have a similar intensity and feel because of what takes place physically in the body.

So interventions focused on addressing the physical aspects of craving are critical. And at the same time, part of what makes cravings so painful is that once they start, they feel like they will never end until acted upon.

The best news of this book is that cravings can be overcome! Dr. Manejwala outlines a wonderful tool box of interventions that address both the physical aspects of craving, but also the painful obsessions that precede addictive behavior. You will learn about the benefits of self-help meetings, meditation, exercise, and being accountable to others.

There are also some tools that you likely have not heard about, which is a testament to the comprehensive and holistic approach taken throughout the book.

Reason #3

Third, I really appreciate his view that:

Courage is, in fact, the most essential quality of recovery, because without courage, none of the other needed practices are possible.

I couldn’t agree more! Dealing with addiction and all its complicating and co-occurring problems is not for the faint of heart. Those who engage in the process of overcoming addiction and are willing to face their most intense cravings, are among the best examples in our society of courage.

While I have a lot more to say about this book, Dr. Manejwala and I plan to discuss it over a video chat in the next week or so. Stay tuned for the broadcast and in the meantime, checkout the latest on the book on facebook and order your copy today.


  1. Marie C. says

    I always wondered what the term craving meant. Because it’s such a common term used to with people wanting something to eat, but maybe it has to do with more then just food or what you want to do; that it could become an addiction. Like the idea you brought up in your blog – how wanting something at such an extreme level could lead to a serious problem. I agree with this point because for instance, when people have been smoking for a real long time, they have this tendency and urge to smoke more like it was their second nature. I believe this idea can be relevant to how it could make a serious problem. I also like the analogy you used about how we all need air, and without it, we can’t survive; that regions in the brain that control heart-rate, breathing, and other survival functions is the same area as where your brain is hijacked by the addiction – so on this part and correct me if I’m wrong, but is this is the same area of your brain where your body gets addicted to nicotine, in terms of addiction? As far how your session goes with Dr. Manejwala, I’ll stay tuned to watch the video chat that you will have available, hopefully soon?

  2. admin says

    Marie, yes, the area of the brain referred to in the blog is the same area that is also affected by nicotine. Hope to have the session up next week. Thanks for the comment.


  3. Beth says

    Hi John, I found this post really intriguing. As soon as I started reading it and seeing the words “addiction,” “craving,” etc., the first thing that popped into my head was my addiction: food. I know that people can struggle with food and can have a positive or negative relationship with it, but can this really be an addiction? I know what you’re talking about (and what this new book is about) is drug-related addictions, but is it possible to be addicted to food? Your review of Dr. Omar Manejwala’s book seems like such a great tool and guide to overcoming addictions, and it seems like the tools he outlines can be used for any addiction really, not just limited to illegal substances and/or alcohol. I’m going to look into his book because I think there could be a lot of valuable information to take away from it.

    Thanks for posting this!

  4. admin says

    Beth, thanks for the feedback! Yes, I believe food can become an addiction, but it is better compared to sex addiction than drugs or alcohol. The reason is that we need food and sex to survive, but we don’t need drugs. So an abstinence based approach for food and sex will not work. Instead, the goal is to learn to have a healthy relationship with food, which means going to the core of what drives the problem in the first place. The ACE study suggests that overeating is related to unresolved, unconscious traumas. Food becomes the antidote to regulate uncomfortable emotions. There is a bit more to it, but reading over material on this site and checking out Omar’s book on craving will take you a long ways.


  5. Brandy says

    I enjoyed how you explained “craving” to be universal and that in healthy doses it’s what makes us human. Especially when observing humans we crave to have attention from others whether that be our family, friends or loved ones we want the feeling of acceptance. When you explained from the book about cravings being “biological”, I feel this has had an influence in my life because I have witnessed drug abuse from family members even though my parents were very strict and tried to keep us away from that lifestyle. I’ve had a bad curiosity to experiment at a young age. Especially when I tried only a few puffs of marijuana at age 13 from a cousin that made me feel overwhelmed and my anxiety would go up if I would sometimes see people smoking cigarettes I was too young to understand it was a craving but this didn’t last long. Explaining to my parents why I had tried the drugs was challenging especially when they bring up the fact, “you saw what it did to your family members why would you try it? Wouldn’t that have changed your curiosity? A huge problem I had with my “craving” was I have a twin sister and we would try illicit drugs together. But this became bad because when one did want to quit the other still wanted to try. Another problem that I still struggle with is we rely on each other in the fact that, if she is going to smoke or drink I will get the urge to do the same thing so I will drop what I’m doing to join her. Here is an example; I could be in the computer lab busting out homework and my sister will call me tell me “I’m going to stay home because Tiffany and I are going to smoke”. Even if I wasn’t in the mood to smoke before I almost want to do it because she’s doing it this is something that I still don’t fully understand yet just try to notice it more. I feel people as you said need to understand “cravings” to understand addiction because it’s something that is misunderstood. Logic tends to leave your mind when drugs are taking place since the only logically thing to do is to abuse those drugs in your mind. Another piece we must take into account is everyone is different so managing cravings could be hard for some people and for others not. Having the ability to “brake or stop” is different for everyone. My twin sister has an addictive personality so witnessing her attitude and behavior especially since she has hard time at limiting herself and she will do it in excess amounts. Also researchers have found exposure to some drugs may actually weaken the brain’s braking system. A major piece that has helped with my cravings is I am aware of it and I learn more about triggers and how to manage them which I have taken up yoga and running to keep me busy along with school.

  6. admin says

    Thanks for the feedback! Glad to hear you took up yoga and running, two of my favorite activities as well.


  7. Thao says

    This is quite an insight for me, I have not thought of addiction to be in the same region of the brain as instinctive, intuitive survival functionality. That ultimately makes me empathetic to the experiences that the persons are feeling, the uncontrollable urge and constant pangs would be unbearable! I agree with the notion that courage and perseverance would be the central idea to keep one on the right path to recovery. I enjoy this positively hopeful perspective on the humanistic recovery and “holistic approach”; will be looking out for this book.

  8. Apryl (F13) says

    I always thought of craving as only a word that refers to food related desires. I never thought of putting it in another context such as needing air to breathe or water to live. Brain science (when put in lamen terms) facinates me. I am interested in reading this book so i can learn more about the science of cravings and how it effects many aspects of life.

  9. Robin Davis says

    Hi John,

    I really appreciated this blog entry. I myself have never struggled with addiction, however I’ve seen my dad almost die from alcohol addiction. Some of the points you made really hit home for me, I haven’t read Dr. Manejwala’s book yet but I am definitely going to pick it up soon.
    I really liked what you wrote about craving being healthy in small doses and that’s what makes up human. However, when these cravings become addiction they can cause significant pain and suffering for everyone around, not just the user.

  10. Robin Davis says

    I never really knew about cravings and addictions until I saw my dad go through it right in front of me. I had no idea how intense and sudden these cravings could come and go. He was willing to throw away everything he worked his whole life to achieve, and that’s what I had a hard time dealing with. But once he got honest with himself, and got serious about sobriety, it was the best thing to ever happen to him, and our family. I believe that’s where his courage came in. I never looked at overcoming an addiction to be difficult and life altering, but to see what he went through and how he is today. That had to be one of the hardest thing’s ever to do, and I think it not only takes courage, it takes someone who is willing to change the life and how they live it. And I don’t think a lot of people in our society would be able to do some of the kinds of things these people are doing struggling with addiction.

  11. Chris B. says

    I never really understood the term craving; I thought of it as someone wants “this or that.” It’s insightful that cravings have a chemical aspect that result in a physical desire to obtain an object or item. I never would have thought that addiction and craving would operate hand in hand inside the same region on the brain. My mom’s brother had an addiction problem to gambling whatever money he had or got he would go to the casino and wash it all away. My mom says this is what he was like when he was a child growing up. Things got out of hand in the past couple of years and he lost everything, his children couldn’t help him, his wife was the verge of living him and the whole family didn’t know what to do; so we cut him off. Later in life I realized that cutting him off was a bad idea but at the same time it gave my mom’s brother a different perspective on things. He turned his life around and his wife stood by his side through the whole rehab process. It is with pleasure to say that he has been clean for the past 6-7 years and he is on good terms with everyone. It’s nice to know that cravings are a biological instinct with physical and chemical aspects and that preventative techniques are focused around that.

    Thanks for the insightful on the book.

  12. Cortez,B says

    Struggling with addictions and especially cravings is something I have seen a family member struggle with for several years and it’s been hard on himself and those closest to him. For him it’s been hard to establish care because if his language. Several of us have tried to help his cravings of alcohol and sometimes he will take a break from drinking and focus on other parts of his life. Depression then sets in and he begins to drink. This is his cycle and he needs to embrace this fact. To him it’s just something he is drawn to. The alcohol is there to help and soothe. While this may be true he needs to understand that the addiction is winning but we are here to support his struggle. I think to understand cravings and how they are affecting and addictions is a great step to get sober and stay sober.

  13. Saki says

    I have never felt how hard drug addiction is because I have never used illicit drugs and I have never thought about it. If curving drugs are like the way we need air, it is crucial for drug addicted people not to take the drugs. I thought that drug addicted people cannot stop using the drugs because they are not strong or patient enough to manage themselves. But it was not rational and not thoughtful at all. If a chemical change took place in our brains or bodies, the urge to the drugs would be very intense and the curving is extraordinary. The addicted people might feel like they cannot live without the drugs like I feel like I cannot live without air. I have a different perspective about a drug addiction now and it was a very good opportunity to learn about it. After all, I am so glad to know that there is a way to overcome the curving.
    Thank you

  14. Yesenia says

    I think that many of the time we tend to dismiss food as an addictive substance because it doesn’t really lead to becoming aggressive or mood changing. We dont compare food to cocaine or crack because is not as aggressive as food. Many of time we tend to eat more then what we need to, because we like that taste of food that we don’t really realize any of the health consequences this can bring to our life’s. I think that craving is something we all do, and in my opinion a way to deal with things that we go through our life’s. We tend to cope with food, that we end up craving more then what our body needs.

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