Using Prescription Medication in Recovery
The National Survey on Drug Use and Health (NSDUH) estimated that in 2013, as many as 21.6 million Americans ages 12 and older were considered to have a substance abuse or dependency issue.
Substance abuse includes the use of illicit drugs and abuse of prescription drugs and/or alcohol. Chronic abuse can lead to a physical and psychological dependency wherein continued substance abuse may be perpetuated to the point of addiction. Addiction is a chronic, relapsing disease that affects interpersonal relationships as well as makes chemical changes in the brain leading to dysfunctional reward pathways, and these changes take time to reverse. The National Institute on Drug Abuse (NIDA) cites compulsive drug-seeking behavior and drug use regardless of any and all negative consequences as the definition of addiction.
With proper treatment, however, recovery can be successfully managed. A poll published in TIME reported that as many as one in 10 American adults over the age of 18, or 10 percent of the population, considered themselves to be in recovery, having successfully overcome a substance abuse problem. Since addiction is considered a chronic disease, the entire period of time after getting control of a substance abuse issue is considered recovery. Therefore, someone who overcame an addiction 10 years prior is considered to be in recovery, for example.
Chances are if you are in recovery, medication will be deemed necessary at some point in your lifetime. Medications are prescribed for a variety of reasons, such as pain management during and after surgery and as treatment for illness or disease. Someone in recovery can successfully take prescription medications if steps are taken to contain the risks.
Lowering the Risks
When a recovering addict is prescribed medication, there are important things to consider and options to weigh. If you are prescribed a medication during recovery, some of the steps you should take include:
- Consider holistic or non-pharmaceutical options first.
- Ensure your doctor is aware of any previous substance abuse or dependencies.
- Take medication only as directed.
- Discuss any physical or psychological changes that occur while taking the medications.
- Only obtain prescriptions from one doctor at a time to avoid any cross-prescribing or over-prescribing of medications.
- Speak to the pharmacist about any all potential side effects or risks of the medication.
- Educate yourself on the type of medication and any interactions it may have with your body.
- Enlist the help of a friend or family member to regulate your medications or dosages.
- Use your support network; seek counseling or attend meetings in order to keep yourself in check.
- Be honest about the way the medication makes you feel, and when in doubt, obtain a professional opinion.
It is important to know yourself, and if you are in recovery, be honest and open about any and all medications you are taking. If you find yourself seeking more of a prescription than is medically necessary, looking for ways to alter the drug in any way, feeling panicked about your medication running out, or hiding or lying about your usage, it may be time to talk to a professional.
Sometimes medication is actually prescribed as a part of the recovery process. Medically assisted detox is the use of pharmaceuticals to help manage withdrawal symptoms and ease the process of purging substances and toxins from the body. One of these such medications, buprenorphine, is a partial opioid agonist approved by the FDA
in 2002 to treat opioid dependency. Medications containing buprenorphine, such as Suboxone and Subutex, work by binding to opioid receptors in the brain. Partial opioid agonists activate these receptors, although on a much smaller scale, meaning that withdrawal symptoms can be successfully managed. Dosage is lowered and lowered to wean opioids out of the body in a slow and controlled manner, lessening the severity of any side effects.
Buprenorphine also has a “ceiling effect,” meaning that after a certain amount, the effects reach a plateau, making it very difficult to abuse the drug. Sometimes antidepressants or anti-anxiety medications are used to stabilize mood during detox as well. These medications should be carefully monitored by medical professionals, however, as they can be habit-forming.
Medications to Avoid
Some prescriptions medications should be avoided completely, if possible, while in recovery, as many are mind-altering. Opioid medications affect the central nervous system and create changes in the brain’s chemical reward pathways, creating a sense of euphoria that can lead to a relapse. Opioids are often found as narcotic pain relievers, but many other medications contain opioids as well. Many pharmaceuticals, including cough medications containing codeine and hydrocodone as well as some medications for diarrhea relief, contain opiates, which should be avoided in recovery. Other cough suppressants that may not actually contain opioids but still may alter perceptions and act on opioid receptors should also be avoided.
Any medication that works to suppress the central nervous system should be used with caution while in recovery. This includes insomnia medications, sedatives and tranquilizers.
Additionally, stimulant medications containing ephedrine should be avoided during recovery. Stimulants also act on the brain’s neurotransmitters, or chemical messengers, which are partially responsible for feelings of pleasure, meaning that they have the potential for creating an opportunity for dependency and relapse.
Approximately half of all drug abusers and large-4 columns of all alcohol abusers also suffer from mental illness, as published by the National Alliance on Mental Illness (NAMI). When two disorders occur simultaneously, they are considered to be co-occurring, and each disorder needs to be treated specifically in an integrated fashion. Often, mental health disorders will require the use of medication to manage symptoms. All members of the care team need to work together to determine the best course of action and ensure that any medications prescribed will not increase the risks for a relapse. For instance, the American Academy of Family Physicians reports that up to 80 percent of those suffering from alcoholism also present depressive symptoms, and many require the use of antidepressant medications. These should be prescribed with caution, and tricyclic antidepressants, which also have sedative properties, should likely be avoided altogether. Benzodiazepines are commonly prescribed to treat anxiety and panic disorders; however, they have a high potential for abuse and should be avoided during recovery.
Speak to your primary care physician about alternative medications you can take that are not habit-forming and will not increase the risks for relapse. Many prescription medications are perfectly safe when used as directed. Holistic methods, including vitamin supplements, diet, and exercise, may be helpful in managing some conditions in lieu of medication as well.
If you have questions about the appropriate use of prescription medications in recovery, don’t hesitate to contact us today.