Medications in Recovery

Those in recovery from alcohol or other drug addiction frequently want to know,
"What medications are safe to use in recovery?" 
 
The answer is this:  All medications have the potential to be abused, some much more than others.  
 
When discussing the use of medications with your physician/nurse practitioner or pharmacist, be upfront about your addiction.  Although some "addictive" medications (stimulants in cold medications, short term opiates, etc.) may be appropriate for you, medical professionals may have other suggestions that would work just as well and put your recovery at much less risk.  
 
There may be times when sharing your history of addiction may not be enough. If your physician prescribes a medication you feel may put you at risk for relapse, get a second opinion. Better yet, try to work with an addiction specialist, if possible. Have a conversation with your doctor about what to expect after the procedure so the two of you can plan accordingly.  As a person in recovery, you need to advocate for yourself.  Ask for help from your sponsor as well.  
 
As a general rule, there are certain medications that should be avoided by people in recovery. Be sure to read labels carefully on medications as some of the secondary ingredients may have addictive properties such as:

• any medication containing pseudoephedrine, diphenhydramine or dextromethorphan contained in such brands as Sudafed, Dayquil, Theraflu, Benadryl, Robitussin DM or any other "DM" cough syrup
• prescription opiates of all kinds such as in Tylenol #3, Percocet, Vicodin, Darvocet
• all benzodiazepines including Ativan, Xanax, Klonopin, Valium
• stimulants such as diet pills or ADHD medications such as in Adderall, Ritalin, Concerta, phentermine
• sleep agents with addictive properties including  Tylenol PM, Advil PM, Ambien, Lunesta
• all preparations that have an alcohol base such as mouthwash and cough syrup

If this list seems large, it is only to bring attention to some agents that could put you at risk. If you and your doctor do feel that the above medications are to be used, they should be used with caution under close supervision by your provider and for only a brief period of time. None should be used long term. A well-trained addiction medicine physician should be able to provide you with alternatives. 
 
Luckily, there are also medications that can be used to manage cravings. Several pharmacologic interventions for addiction medications are available for use as well:

• Naltrexone is given as a part of an alcohol or opiate treatment program. It is a once-daily oral medication. It blocks intoxication associated with opiates.  It also helps patients with alcohol dependence by reducing cravings. Vivitrol is the once monthly injectable form of Naltrexone.  Although Naltrexone has been approved for both opiate and alcohol dependence, Vivitrol has only been approved for alcohol dependence at this time.
• Campral is given as a part of a treatment program for alcohol dependence. It is an oral medication given three times a day. It helps by reducing the desire to drink again. Studies are also showing that relapse rates are shorter in duration as well. 
• Antabuse is used as a part of a treatment plan for problem drinking. An oral medication given once a day, it creates an unpleasant series of reactions if alcohol is consumed, which reduces the desire to drink. 

Ask your doctor if any of the above pharmacologic intervention medications may be right for you. There may be some lab work that should be drawn prior to beginning these medications. These medications are not to be used alone, but as a part of of your ongoing recovery program that includes medical supervision and counseling.  
 
Pharmacologic intervention medications seem to be the wave of the present and the future as research findings show that these medications help patients sustain lifelong recovery.
 
--by Anna Bjork, Clinical Nursing Supervisor at Hazelden in Center City

March 2010