Medications and Recovery

Use of medications can frequently by problematic for the recovering person.  How many times have we heard, “My doctor prescribed this medication!” as if this were a fail proof method of avoiding the jump from recovery into relapse?  Or – “If only I had known…” as if it were possible to know which medications are safe and which are dangerous without a degree in addiction pharmacology.  We, the staff at Brighton Center for Recovery, are committed to helping you maintain drug-free recovery.  To that end, we offer the following thoughts:

Cross-Addiction

There are medications that will wake the addiction circuits in your brain.  If you use these medications, you run an enormous risk of either becoming addicted to them or of relapsing into past addiction(s) to drugs or alcohol.

1. Opiates (or pain pills):  We assume that everyone considers Morphine dangerous medications, as are the common pain pills like Dilaudid (hydromorphone); Vicodin or Norco (hydrocodone); Oxycontin or Percocet (oxycodone).  However, the following narcotics are just as dangerous, but may not be as well known: Ultram (tramadol); Tylenol #3 or #4 or 222 pills (codeine); Suboxone or Subutex (buprenorphine); Demerol (meperidine); Opana (ozymorphone).
2. Sedatives:  In addition to the familiar list of characters, tranquilizers like Valium (diazepam) or Xanax (alprazolam) or Klonopin (clonazepam), we would also include Librium (chlordiazepoxide); Ativan (lorazepam); Tranxene (chlorazepate) or Restoril (temazepam).
3. Sleeping Pills:  Don’t even go there by yourself.  If you are having problems sleeping, you should see an addiction expert who understands about cross-addiction (to find out, just ask them what they think about the concept).  Sleep problems are very common, especially early in recovery.  Dangerous sleep medications are also very common, like: Ambien (zolpidem); Sonata (zaleplon) and Lunesta (eszopiclone).  Sleep disorders may also signal the presence of other, serious problems.  A physician with the appropriate skills should evaluate disordered sleep, one who can prescribe appropriate treatments (not always drugs) without danger to recovery.
4. Muscle relaxers:  Drugs like Soma (cariprosodol) or Zanaflex (tizanidine) can be very dangerous for recovering people.

We suggest calling Brighton Center for Recovery (810-227-1211) if you have any questions about any medications.

Hidden Alcohol

Alcohol is one of the oldest potentially addiction molecules known.  It doesn’t seem to matter if you had a drinking problem in the past, which has been dwarfed by your heroin addiction, or if you never had a drinking problem at all.  Alcohol is dangerous to your recovery and must be avoided at all costs.  However, besides all those seductive looking bottles at the grocery store, alcohol is also hidden in many other products.

1.  Many medications are difficult to dissolve, so many drug companies use alcohol in their products.  Beware of any liquid or gel-cap medications.  These can contain enough alcohol to cause a problem – either triggering addictive behavior or causing an alcohol-Antabuse reaction.  These include medications like cough syrups or vitamin supplements.  Sorry, there is no accurate, exhaustive list available; companies are constantly changing ingredients.  You will need to read labels on any liquid products.
2. Some hygiene products also contain alcohol.  Many mouthwashes contain alcohol (it kills germs as well as people).  Many alcohol-based hand sanitizers contain enough alcohol so that some is absorbed.  Come on, substitute botulism toxin for the word alcohol in the sentences above.  Is it really worth taking a chance?
3. Finally, some food products contain alcohol, such as wine vinegar or tiramisu or vanilla/lemon extracts.  You will need to ask your waiter if you not familiar with the food.  If you had a peanut allergy would you hesitate to ask about which foods had peanuts?

Marijuana

Let’s not debate the legal questions here, let’s get to what is important for recovery: Marijuana is addicting.  Let’s not debate how lethal each and every drug is; addiction is lethal.  Let’s not debate whether marijuana makes some things feel better; Sigmund Freud thought that cocaine was fine to use because depressed people did not act depressed any more.  Let’s not talk about how marijuana helps cope with a bad situation, the whole point of recovery is living and enjoying life without having to alter one’s perception of reality.  You cannot smoke or eat or in any other way use marijuana and still be in recovery.

Dangerous Treatments

There are many medications out there which are dangerous to recovery.  Two common areas of concern are medications to treat ADD or ADHD and marginally addictive medications.

We would like to make two points about ADD/ADHD.  Firs, this is not a lethal condition.  However, some of the medications used to treat this condition are potentially addicting, and addiction is lethal.  Amphetamines are one common class used to treat ADD.ADHD.  Amphetamines were brought out years ago to treat obesity.  There were abandoned, not because they did not help people lose weight, but the price of addiction and death was too high to justify using them for this condition.  Why they are now used to treat a non-lethal condition like ADD/ADHD is something for the future generations to judge.  We do not recommend using them in recovery.  These include medications like Vyvanse, Adderall and Dexedrine.  While not amphetamines, any of the methylphenidate preparations are also hazardous to recovery and we do not recommend using them.  It is interesting that ePocrates, a commonly used medical reference service, does not recommend using any of the above medications to treat adult ADD/ADHD.  Which brings up the second point: It is sometimes very difficult to decide when a medication is being used for performance enhancement, which is a continuation of addictive behavior.  World anyone like to suggest that Albert Einstein should have been on Ritalin so that he wouldn’t routinely show up in the classroom with socks each a different color.

With respect to marginally addictive medications, there are some commonly prescribed medications that can be quite dangerous.  These include medications like Flexeril and Benadryl and Pseudoephedrine and Dextromethorphan.  Again, your best resource here is to consult your addiction specialist regarding these types of treatments, or call Brighton Center for Recovery (810-227-1211) with any questions.